Compression Wrap Research Articles

Adjustable compression wraps: back to the future

Adjustable Compression Wraps (ACWs) are used to treat a variety of conditions, in particular venous leg ulcers, edema and lymphedema. Publications on the use of these devices are ultimately few and far between, with limitations or biases (small sample sizes, methodological weaknesses, non-comparative studies, lack of interface pressures). A development model like that used in the study of a drug could be more rational. We propose five phases: phase 1) discovery and development, phase 2) in vitro testing, phase 3) clinical trials, phase 4) real-life data analysis, medico-economic investigation using Artificial Intelligence (AI), and phase 5) preparation of regulatory dossiers. This lack of coherence in development could be an obstacle to widespread clinical use. Using AI to analyse large quantities of data could reduce the cost and number of clinical trials needed to generate more robust evidence. This would make it possible to better define the clinical effects of ACWs in specific situations (e.g., leg wounds in the elderly, diabetic wounds, mixed leg ulcers, secondary lymphedema of the upper limb, efficacy, and comfort...) and to compare treatment costs between bandages and ACWs. If we don't explore the future with AI, we'll never know what will be useful for the present - hence the title “Back to the Future”.

Assessing the Physical and Clinical Characteristics of a New Adjustable Compression Wrap: Insights from a Single-center Pilot Study in India

Introduction: Adjustable wraps are a revolutionary avenue in compression therapy because of their ease of application and removal, as well as their ability to be manipulated and readjusted, particularly in older adult patients with leg ulcers. Methods: We analyzed the physical and clinical features of a new adjustable wrap marketed by Vein Care, India. Hirai leg was used to demonstrate the stiffness of the wrap, followed by validation on five healthy male participants. Next, we conducted a pilot clinical study to assess the effect of wearing the wrap for 4 h on volume reduction in seven patients with open leg venous ulcers. Results: The Vein Care Calf Compression Wrap® functioned similarly to a short stretch bandage, which we demonstrated through the tests performed on Hirai’s leg and on healthy participants. In the pilot clinical study, following 4 h of application, a statistically significant decrease in total leg volume (median 34.5 cc; P = 0.018) was observed. Moreover, a significant decrease in volume at the calf level compared to the lower leg (P = 0.038) was noticed. However, no significant correlations were found in volumetric reduction with age or body mass index. The wrap posed challenges in applying pressure exceeding 40 mmHg due to its unique composition, stretch, and stiffness properties. This characteristic is especially significant for patients with diabetic or mixed arteriovenous ulcers (ankle–brachial index >0.5 and <0.8). Conclusions: The wrap’s clinical utility and effectiveness necessitate additional clinical trials and studies with a greater number of patients from diverse demographics.

(083) CHRONIC VULVAR PAIN AND URINARY DISTURBANCES REVEALING A LARGE TARLOV CYST IN A 41-YEAR-OLD WOMAN: A CASE REPORT

Abstract Introduction Perineural cysts, also known as Tarlov cysts, are cerebrospinal fluid-filled nerve root cysts predominantly located at the sacral spine. While typically asymptomatic, large Tarlov cysts may elicit discomforting symptoms. Diagnostic challenges stem from limited understanding and symptom overlap with various disorders. Objective This case report explores the presentation of a 41-year-old female patient exhibiting symptoms of vulvar pain and urinary disturbances, which were ultimately attributed to a large Tarlov cyst, highlighting the complexities of diagnosis and management associated with this condition. Methods A 41-year-old female patient with a past medical history of linear scleroderma, chronic left hip pain with leg length discrepancy, and family history of endometriosis presented to her primary care physician with vulvar pain and urinary symptoms. She had burning vulvar pain, predominantly on the left side, radiating from the vulvar vestibule to the perineum, which gradually worsened over 6 months. She also had lower back pain radiating into her legs and calves, along with increased urinary frequency, urgency, retention and burning upon micturition. Patient underwent a 11-month treatment regimen following a referral to pelvic pain specialist, including being initiated on gabapentin and vaginal suppositories, which provided significant pain relief. However, over time, her vulvar pain gradually worsened, and gabapentin was replaced with pregabalin. She underwent six weeks of pelvic floor physical therapy and received a series of peripheral nerve blocks, including multiple pudendal nerve blocks, trigger point injections and hydrodissection of connective tissue around the nerves, yielding little pain relief. Due to persistent vulvar pain, the patient was referred to our clinic. Her examination revealed tenderness upon palpation over the lumbar-sacral spine and sacroiliac joint and para-spinal muscle spasm on the left side. She had provoked vestibulodynia that was predominately on the posterior aspect of the vestibule with a Q-tip test 8/10, and about 4/10 at anterior vestibule. She also continued to have tenderness in her pelvic floor muscles. Given her history and physical exam, a spinal pathology was suspected, and lumbosacral MRI was ordered. Results The lumbosacral MRI revealed a Tarlov cyst measuring 7.7 cm x 3.9 cm x 4.2 cm, extending from the L5-S1 disc level to the S3-S4 vertebral body junction. The patient was subsequently referred to a neurosurgeon who performed a twelve-hour surgery, including a dissection of the intrasacral meningeal cyst that was causing sacral nerve root compression and subsequent wrapping of the weakened right S2-S3 nerve roots. Postoperatively, the pain, although decreased, persisted due to nerve root thinning and long-term compression of the sacral nerve roots. She is currently being managed by our clinic, pain specialists and rehabilitation. A two-year recovery period is anticipated. Conclusions This case underscores the diagnostic challenge of vulvar pain in the context of a Tarlov cyst and emphasizes the necessity for heightened clinical suspicion and comprehensive evaluation. Additionally, the case highlights the importance of considering MRI of the lumbosacral spine as an early investigation in patients presenting with otherwise unexplained chronic vulvar pain, offering a valuable diagnostic tool for identifying conditions like Tarlov cysts that might otherwise remain elusive. Disclosure No.

Pressure and stiffness of a new air-inflated compression wrap.

To report pressure and stiffness, in healthy volunteers, of a new compression device with an air bladder inflated by a pump to regulate pressure. The device was applied to 60 legs of 30 volunteers and set to exert different pressures of 20-50mmHg. The exerted pressure was measured in supine and standing positions and during simple physical exercises; static stiffness index, dynamic stiffness index, and walking pressure amplitudes were calculated. The exerted pressure showed a good correlation with the expected pressure at each pressure range. The stiffness indices were >10mmHg in the range of inelastic materials. The device was considered very easy to apply and use by the testing researchers. The device stiffness is in the same range as the inelastic bandages. Consequently, similar hemodynamic effectiveness could be expected but must be proved. Unlike inelastic bandages, this device was easy to apply and use.

Harvest of large fascia lata autograft: Outcomes in 108 patients.

Due to the reclassification of transvaginal mesh as a high-risk device, there has been renewed interest in the use of fascia lata in pelvic floor reconstruction. Here we report our experience in 108 patients who underwent large fascia lata harvest for pelvic organ prolapse (POP) repair. Our primary objective was to highlight the postoperative morbidity of the large fascia lata harvest in patients who underwent POP repair using fascia lata autograft. Surgery involved harvesting a fascia lata graft through a small lateral upper thigh incision and was used for either autologous transvaginal POP repair or autologous sacrocolpopexy. To prevent seroma, a temporary Jackson-Pratt drain was intraoperatively placed and a mild compression wrap was applied to the area for 4-6 weeks postoperatively. Patient demographics were obtained preoperatively, while physical exam findings and postoperative outcomes related to the fascia lata harvest were collected at sequential follow up visits. One-hundred eight patients underwent 111 large fascia lata harvests for either transvaginal or abdominal/robotic POP repair from July 2016 to January 2022. Mean follow-up was 19.6 months (range: 1-65) with 38 patients having 24 months or more of follow-up. Mean Visual Analog Pain (VAP) score was 1 (range: 0-10). Sixteen patients developed asymptomatic thigh bulges, 16 patients developed harvest site seromas (of which 14 resolved), and 59 patients experienced mild, non-bothersome paresthesia near the incision. Large fascia lata harvest offers a robust autograft for transvaginal or transabdominal POP repair with minimal morbidity. Harvest site complications are minor and typically resolve with expectant management. This technique can be safely utilized in patients who desire graft-augmented repair of POP without the use of synthetic mesh, allograft, or xenograft.

Integrating new approaches to care in a vascular wound clinic

IntroductionAn evidence-based approach is essential in the treatment of wounds to optimise healing, reduce costs and improve patient outcomes. AimThis case study aimed to demonstrate our model of care, which assesses and manages patients with venous disease and complex wounds. In this case, venous leg ulcer (VLU) was treated with TLC-NOSF dressing and therapeutic compression. The wound was serially assessed using a smart App that gave the patient a graphic representation of their progress. DesignDescriptive Observational Case Study. Clinical careAn evidence-based approach for managing a chronic, severe VLU. The patient was initially seen at the Outpatient Vascular Wound Clinic twice weekly, then every two weeks for conservative sharp wound debridement, skin care, dressing change, and compression therapy using a compression (Ready) wrap. Wound progress was monitored by the digital application ‘Tissue Analytics’, a “purposedesigned digital wound management platform that records, tracks, and analyses wounds”. ResultsWeek 1: On initial review, ulcer length was 3.15cm, width was 3.1 cm, and total surface area was 6.31 cm2. The wound base was mildly sloughy (<25%), with areas of good granulation tissue on view.Week 12: Length was 1.32 cm, width 1.50 cm, and total surface area of 1.45 cm2, a 77% reduction in wound size.Week 24: The length was 0.48 cm, the width was 0.64 cm, and the total surface area was 0.18 cm2. This represented a 97% reduction in wound size.Week 36: Length was 0.01 cm, the width 0.06 cm, with a total surface area of 0.00 cm2. This represented a 99.99% reduction in wound size. ConclusionThe patient’s treatment for a complex venous leg ulcer included the application of TLC-NOSF dressing in combination with individualised therapeutic compression therapy. We found TLC-NOSF was very effective in combination with the best standard of VLU care (i.e. therapeutic graduated compression therapy). The clinician and patient were impressed with the healing rate at 12 weeks, as the wound dimensions were the lowest since the wound started six years ago. This dramatically improved patient concordance and engagement in care. Despite incomplete healing at 36 weeks, the wound-healing journey over the 36 weeks indicated wound closure was close. In addition, using a wound assessment App, the patient could immediately see the benefits of the new treatment, facilitating patient compliance with the treatment.

Performance of an adjustable compression wrap in occupational leg swelling.

Edema in some subjects worsens over time and wraps help to reduce the leg volume. An adjustable compression wrap was tried on volunteers for 5 h and volumes measured in each limb before and after wrapping using a 3D surface scanner (HandySCAN 3D®) to estimate the volume of the leg. The contralateral leg was used as control. We observed a significant decrease in volume in the wrap legs and an increase in the control legs (p < .001), both in the lower part of leg (p = .001) and in the upper part (p = .001). Using the Readywrap® for 5hours significantly reduces the leg volume. This study enables Readywrap to be studied in a population that is easy to observe in the context of a research program. The Handyscan3D® was shown accurate and reproducible to assess leg volume in future studies.

Adjustable Compression Wraps (ACW) vs. Compression Bandaging (CB) in the Acute Phase of Breast Cancer-Related Arm Lymphedema Management-A Prospective Randomized Study.

The objective of this study is to compare the effectiveness, comfort and possibilities of the self-application of adjustable compression wraps (ACW) with compression bandaging (CB) in the acute phase of treatment in advanced upper-limb lymphedema. In total, 36 patients who fulfilled the admission criteria were randomly assigned into ACW-Group (18 patients), or CB-Group (18 patients). Treatment in both groups lasted for two weeks. In the first, all patients were educated in applying adjustable compression wraps (ACW-Group) or self-bandaging (CB-Group) and treated by experienced physiotherapists. In the second week, the use of ACW and CB was continued by the patients themselves at home. In both groups, a clinically significant reduction in the affected limb volume was found after the first week (p < 0.001). A further decrease in the affected limb volume within the second week was noted only in the CB-Group (p = 0.02). A parallel trend was found in the percentage reduction in the excess volume after one and two weeks of compression therapy. Within two weeks, both groups achieved a significant improvement in decreasing lymphedema-related symptoms, but women from the ACW-Group reported complications related to carrying out compression more frequently (p = 0.002). ACW can reduce lymphedema and disease-related symptoms, but based on the results it is difficult to recommend this method as an alternative option in the acute phase of CPT among women with advanced arm lymphedema.

Use of Advanced Elastomeric Skin Protectant on Venous Leg Ulcer Periwound Skin

Introduction. VLUs are associated with prolonged wound healing, high recurrence rates, and fragile periwound skin. Objective. Skin protectant use with wound dressings and multilayer compression wraps was examined. Methods. Deidentified retrospective patient data were assessed. Patients received endovenous ablation, followed by application of zinc barrier cream to periwound skin before wound dressing and multilayer compression wrap use. Dressings were changed every 7 days, and zinc barrier cream reapplied. After 3 weeks, advanced elastomeric skin protectant use was initiated due to periwound skin injury during zinc barrier cream removal. Topical wound dressing and compression wrap use was continued. Wound healing and periwound skin condition were monitored. Results. Five patients presented for care with medial ankle VLUs. Within 3 weeks of zinc barrier cream use, unwanted product buildup was noted and removal often led to epidermal stripping. Skin protectant use was changed to advanced elastomeric skin protectant. All patients showed periwound skin improvement. Epidermal stripping was not observed with advanced elastomeric skin protectant, and the product did not require removal. Conclusions. In these 5 patients, advanced elastomeric skin protectant use under wound dressings and multilayer compression wraps resulted in improved periwound skin and reduced erythema compared with zinc barrier cream use.

The use of ReadyWrap® reduces the volume of the upper limb with lymphedema related to breast cancer: a case report

Lymphedema secondary to breast cancer is a chronic condition that requires continuous care to control the volume of the affected limb, with compression therapy as the main treatment. The self-adjusting compressive wrap is a new option, whose main advantage is the fact that it is put on by the patient himself. The aim of this study was to describe the use of self-adjusting clothing as an alternative to reduce the volume of the upper limb of a patient with breast cancer-related lymphedema. This study was part of the study adjustable garment compression therapy (ReadyWrap®) in lymphedema secondary to breast cancer: a randomized clinical trial, approved by the CEP/INCA under opinion 4.611.711 and registered in the Clinical Trials under no. NCT04934098. The patient was evaluated before and after the 30-day intervention using physical examination (e.g., inspection, palpation, and perimetry). Skin tissue characteristics were collected using a thermographic camera, while the health-related quality of life (HRQoL) was assessed by answering the EORTC-QLQ C30 questionnaire. As an intervention, an adjustable garment (ReadyWrap®) was used for 30 days. An absolute reduction of 612.47 mL (61.1%) was observed, and at the end of this period, the difference of 21.5% in excess volume compared with the volume of the contralateral limb was maintained. Regarding the tissue characteristics of the skin, there was an increase in the minimum temperature in the affected upper limb, which reached 31.8°C, against 31.2°C in the contralateral limb, with ∆T=0.6°C. Compressive therapy by adjustable garment (ReadyWrap®) demonstrated a 61.1% reduction in the volume of the upper limb with breast cancer-related lymphedema in 30 days of use.

Lower Extremity Edema and Lesions Not Responsive to Conservative Therapy

A 66-year-old man with at least 2 years of progressively worsening unilateral left lower extremity edema and recurrent episodes of cellulitis of the anterior left lower leg, treated repeatedly with diuresis and antibiotic therapy, was referred by his rural family physician to the community paramedic (CP) service for diuresis, compression wrapping, wound care, and self-management education. His medical history included prior stroke with residual left-sided hemiplegia; insulin-treated type 2 diabetes complicated by peripheral neuropathy, retinopathy, and stage 3b chronic kidney disease; and obesity with body mass index 39 kg/m.

Effect of Compression Therapy in the Treatment of Tibial Stress Syndrome in Military Service Members.

Tibial stress syndrome (TSS) is an overuse injury of the lower extremities. There is a high incidence rate of TSS among military recruits. Compression therapy is used to treat a wide array of musculoskeletal injuries. The purpose of this study was to investigate the use of compression therapy as a treatment for TSS in military service members. A parallel randomized study design was utilized. Military members diagnosed with TSS were assigned to either a relative rest group or compression garment group. Both groups started the study with 2 weeks of lower extremity rest followed by a graduated running program during the next 6 weeks. The compression garment group additionally wore a shin splints compression wrap during the waking hours of the first 2 weeks and during activity only for the next 6 weeks. Feelings of pain, TSS symptoms, and the ability to run 2 miles pain free were assessed at baseline, 4 weeks, and 8 weeks into the study. Feelings of pain and TSS symptoms decreased during the 8-week study in both groups (P < .05), but these changes were not significantly different between groups (P > .05). The proportion of participants who were able to run 2 miles pain free was significantly different (P < .05) between the 2 groups at the 8-week time point with the compression garment group having a significantly increased ability to complete the run without pain. Although perceptions of pain at rest were not different between groups, the functional ability of running 2 miles pain free was significantly improved in the compression garment group. These findings suggest that there is a moderate benefit to using compression therapy as an adjunct treatment for TSS, promoting a return to training for military service members.

Decongestive progressive resistance exercise with an adjustable compression wrap for breast cancer-related lymphoedema (DREAM): protocol for a randomised controlled trial

IntroductionBreast cancer-related lymphoedema (BCRL) is a chronic swelling in the arm on the side of the breast cancer surgery, affecting one in five women. Recent studies in BCRL have demonstrated...

81 Post-operative Self-adherent Compression Wrapping of the Hand and Its Impact on Skin-graft Viability

IntroductionPotential complications of autografting for burn wound coverage of the hand include edema, hematoma formation, and bleeding; all of which can lead to graft failure. Self-adherent elastic wraps are commonly used by burn rehabilitation clinicians to minimize complications by providing graft protection and decreasing edema post-operatively; however, there is a lack of evidence on its impact on graft healing. The purpose of this study was to determine if the application of self-adherent elastic wraps to the hand in the operating room after autografting improves the percentage of graft viability.MethodsA retrospective chart review was performed for 37 patients with burned hands who underwent autografting from January 2017 to July 2021. Grafted hands were categorized into 2 groups: post-operative dressings with and without self-adherent elastic wraps. Post-operative day 4 pictures for both groups were collected from the medical record and a blinded digital photograph analysis of graft viability was performed by 5 expert raters including 3 Burn Surgery Fellows,1 Burn Attending Surgeon and 1 Hand Attending Surgeon. A rating system was developed based on percentage of graft take as seen in Table 1 and presence of hematomas were assessed.ResultsPatients who received self-adherent elastic wraps suffered burns with significantly larger TBSA (p=0.007) and were admitted for a longer duration (p=0.009) than patients who did not. Patients with elastic wrap had a higher percentage of grafts with >95% take (64.0% vs 41.7%, p=0.227) and a lower rate of hematoma formation (24.0% vs. 41.7%, p=0.443). Intra-class correlation coefficient across raters was 0.90 for graft take and 0.87 for determining presence of hematomas, indicating excellent interrater reliability.ConclusionsDespite suffering larger burns requiring longer hospitalizations, patients who received elastic wrap had a higher rate of >95% graft take than those without. This study is limited by a relatively small sample size, however these findings warrant continued research in the use of self-adherent elastic wrap to maximize graft take in hand burns.

The effects of gravity and compression on interstitial fluid transport in the lower limb

Edema in the limbs can arise from pathologies such as elevated capillary pressures due to failure of venous valves, elevated capillary permeability from local inflammation, and insufficient fluid clearance by the lymphatic system. The most common treatments include elevation of the limb, compression wraps and manual lymphatic drainage therapy. To better understand these clinical situations, we have developed a comprehensive model of the solid and fluid mechanics of a lower limb that includes the effects of gravity. The local fluid balance in the interstitial space includes a source from the capillaries, a sink due to lymphatic clearance, and movement through the interstitial space due to both gravity and gradients in interstitial fluid pressure (IFP). From dimensional analysis and numerical solutions of the governing equations we have identified several parameter groups that determine the essential length and time scales involved. We find that gravity can have dramatic effects on the fluid balance in the limb with the possibility that a positive feedback loop can develop that facilitates chronic edema. This process involves localized tissue swelling which increases the hydraulic conductivity, thus allowing the movement of interstitial fluid vertically throughout the limb due to gravity and causing further swelling. The presence of a compression wrap can interrupt this feedback loop. We find that only by modeling the complex interplay between the solid and fluid mechanics can we adequately investigate edema development and treatment in a gravity dependent limb.

The utility of routine cultures, cell count, and crystal evaluation of aspirate from aseptic olecranon bursitis.

BackgroundAspiration of the olecranon bursa is a treatment option for acute olecranon bursitis (OB). Typically, the aspirate is sent for microbiologic analysis, cell count, and crystal analysis. This study investigates the utility of fluid aspirate analysis from patients with clinically diagnosed aseptic OB.MethodsIn this prospective study (IRB #i20-00986), patients presenting with acute aseptic OB were treated with aspiration as standard of care. Patients consented to participate in this study via phone. Patients with suspected infectious bursitis, open draining wound, and chronic OB were excluded. The aspirate was sent out for routine microbiologic analysis (aerobic and anaerobic cultures and Gram staining) and fluid analyses, including cell count with differential and crystal analysis. Nucleated and differential cell count was reported as absolute numbers per cubic millimeter and percentage, respectively. Compression wrap was applied after OB aspiration, and patients were asked to ice and take anti-inflammatory medications. Clinical follow-up was done after 6 weeks and at 3 months for resolution vs. recurrence of symptoms, and the mean time to resolution was reported.ResultsA total of 26 patients (28 cases) with aseptic OB were enrolled in this study. Two patients had bilateral OB. The mean time to aspiration after the onset of symptoms was 26.4 days. One patient had recurrence of swelling after the first aspiration and underwent repeat bursa aspiration. No organisms were isolated or reported on Gram staining on any of the aspirate samples. Two aspirates were reported positive for calcium pyrophosphate dihydrate crystals. No patient had monosodium urate crystals. All patients had resolution of swelling and symptoms without the development of postaspiration infection.ConclusionsThis study demonstrates limited clinical utility of routine microbiologic analysis (cell count, microbiologic, and crystal evaluation) of fluid aspirate from clinically diagnosed aseptic OB. Although 7% of fluid aspirates were positive for calcium pyrophosphate dihydrate crystals, it did not change the overall treatment.

Advances in surgical treatment of lymphedema.

An estimated 250 million people worldwide suffer from lymphedema. In the past, the firstline option for treatment was nonsurgical management, either in the form of compression garments or wrapping, or comprehensive decongestive therapy, with debulking surgery reserved for the more advanced cases. However, with improvements in microsurgical techniques and imaging modalities, surgical intervention is increasingly being utilized. This review highlights recent advancements in the surgical treatment of lymphedema, specifically focusing on improvements in imaging, surgical techniques, and prevention of lymphedema.

First aid

The European Resuscitation Council has produced these first aid guidelines, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics include the first aid management of emergency medicine and trauma. For medical emergencies the following content is covered: recovery position, optimal positioning for shock, bronchodilator administration for asthma, recognition of stroke, early aspirin for chest pain, second dose of adrenaline for anaphylaxis, management of hypoglycaemia, oral rehydration solutions for treating exertion-related dehydration, management of heat stroke by cooling, supplemental oxygen in acute stroke, and presyncope. For trauma-related emergencies the following topics are covered: control of life-threatening bleeding, management of open chest wounds, cervical spine motion restriction and stabilisation, recognition of concussion, cooling of thermal burns, dental avulsion, compression wrap for closed extremity joint injuries, straightening an angulated fracture, and eye injury from chemical exposure.

European Resuscitation Council Guidelines 2021: First aid

The European Resuscitation Council has produced these first aid guidelines, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics include the first aid management of emergency medicine and trauma. For medical emergencies the following content is covered: recovery position, optimal positioning for shock, bronchodilator administration for asthma, recognition of stroke, early aspirin for chest pain, second dose of adrenaline for anaphylaxis, management of hypoglycaemia, oral rehydration solutions for treating exertion-related dehydration, management of heat stroke by cooling, supplemental oxygen in acute stroke, and presyncope. For trauma related emergencies the following topics are covered: control of life-threatening bleeding, management of open chest wounds, cervical spine motion restriction and stabilisation, recognition of concussion, cooling of thermal burns, dental avulsion, compression wrap for closed extremity joint injuries, straightening an angulated fracture, and eye injury from chemical exposure.

The Comparative Efficacy of Conventional Short-Stretch Multilayer Bandages and Velcro Adjustable Compression Wraps in Active Treatment Phase of Patients with Lower Limb Lymphedema.

Background: Compression is the most important component of complete decongestive therapy (CDT), but there is no standard best method for applying compression. The aim of this study was to evaluate the comparative efficacy of conventional multilayer short-stretch bandaging, and a velcro adjustable compression wrap with regard to volume reduction, ultrasonographic measurements, functional-status, and quality of life (QoL) in the active CDT period of patients with lower limb lymphedema. Methods and Results: The demographic and clinical variables of lower limb lymphedema patients were recorded. All patients received skin care education, manual lymphatic drainage, and supervised lyphedema exercises, and were randomly allocated to Group1 (multilayer short-stretch bandaging-Rosidal-K®) or to Group 2 (adjustable-compression-velcro-wrap-Circaid Reduction-kit®) for a duration of 3 weeks with 15 sessions. Limb volumes were assessed by perometer. Ultrasonographic measurements included subcutaneous soft tissue thickness. The functional disability and QoL were evaluated by the Lower Extremity Functional Scale and LYMQOL-Leg (Lymphedema Quality of Life Questionnaire-Leg), respectively, at baseline, after CDT, and at first-month follow-up. Thirty-six patients (10 male and 26 female) with mean age of 51.6 ± 11.7 years were included. Fourteen patients had primary and 22 patients had secondary lymphedema. The median duration of lymphedema was 68 months. Significant improvements in volumes and ultrasonographic measurments were observed in both groups at the end of therapies, and improvements sustained up to a month. Appearance, symptoms, and overall QoL-subscores were improved only in Group 2. Conclusion: In conclusion, adjustable compression velcro-wrap performed as a part of CDT can greatly reduce the volume similiar to conventional multilayer bandages, as well as improve the QoL. It can be a comfortable alternative to the conventional multilayer bandages in the active treatment phase of the CDT.