ST. LOUISIn a study of 31 breast cancer patients with chronic lymphedema who had failed other treatment methods, 27 showed significant improvement with use of the Reid Sleeve, a custom-designed pattern of soft polymer ridges that apply varying degrees of pressure, Diane Radford, MD, of Washington University, said in a poster presentation.
"Most of our patients had had multiple episodes of cellulitis while using either an elastic stocking or a compression pump device," Dr. Radford said. The study patients were advised to wear the custom-fitted Reid Sleeve for eight hours a night while sleeping. Of the four patients who did not improve, Dr. Radford said, two were noncompliant.
The 27 patients who showed improvement had a 3 cm average decrease in circumference at 10 cm above and below the elbow. In addition, the majority of patients reported improvements in quality of life with use of the Reid Sleeve.
Although the study was not controlled and follow-up is relatively short (mean, six weeks), Dr. Radford found the results very encouraging and suggested that a controlled trial, possibly with a crossover design, should be done.
Tony Reid, MD, a medical oncologist at Stanford University and the inventor of the Reid Sleeve, was also on hand to discuss the new device.
He made the first Sleeve about three years ago for a patient who was spending much of her time on a mechanical pump. The device worked so well for her that she talked about it in her support group, and demand for the Sleeve began to grow. "About a year ago, we started a lymphedema clinic at Stanford because of the number of patients seeking treatment, "Dr. Reid said.
He described a trial at Stanford, similar to Dr. Radford's study, that involved 30 patients who had been on multiple therapies for severe lymphedema for an average of eight to 10 years. Of those, 26 showed significant improvement with the Reid Sleeve.
Dr. Reid said that the Sleeve is custom made for each patient, with Velcro straps to adjust the pressure, based on readings from a small compression gauge. "We think it is critical to be able to adjust the pressure, since it is a fairly narrow range that provides the right pressure for a patient," he said.
He pointed out that lymphedema is "not a disease that will ever really go away," but with the Sleeve, he said, "patients have improved to the point where they don't rely on it on a daily basis anymore. The patient who has been on it the longest now uses it maybe once or twice a week."
He also noted that lymphedema can be more than just "unsightly and cumbersome." In patients who develop cellulitis, it can also be a serious medical problem.
One patient, prior to using the Sleeve, had recurrent hospitalizations for infections, including several stays in the ICU because of sepsis from these infections. "Since starting on the Sleeve a year ago," he said, "she has gone from a very enlarged, edematous red limb to one that now looks almost normal, and she hasn't had a single infection."
For more about the Reid Sleeve, contact www.noblemed.com on the Internet or call 1-800-29-EDEMA.