best practice for the management of lymphoedema ... - EWMA

MLLB
FIGURE 28 Application of
underpadding to lower leg
Apply soft synthetic wool padding
to protect and reshape the limb.
Soft foam underpadding can also
be used.
(a) (b)
FIGURE 29 Spiral bandaging of foot and lower leg with inelastic bandage
(a) Anchor an 8cm inelastic bandage with a turn around the base of the toes.
(b) Bandage the foot using spiral technique. Use figure of eight technique around the ankle. Continue up the
leg using spiral technique with any remaining bandage.
(c) Bandage the lower part of the leg using a 10cm inelastic bandage and spiral technique, and continue up
the limb.
(d) The end of the tubular bandage can be folded back and concealed under the next layer of bandage.
FIGURE 30 Spiral bandaging of the thigh with inelastic bandage
(a) If swelling occurs above the knee, the thigh should be bandaged. Ensure the cotton tubular bandage is long enough to cover the thigh.
(b) After bandaging the lower leg, allow the patient to stand with the knee slightly bent. Apply soft synthetic wool padding to the knee and thigh.
(c) At the popliteal fossa, double or triple the padding or apply a foam insert.
(d) Ask the patient to shift their weight to the leg to be bandaged, providing support if necessary, so that the thigh can be bandaged with the muscle
contracted. Use a 10cm or 12cm inelastic bandage and apply a loose turn to anchor the bandage below the knee.
(e) After anchoring the bandage obliquely across the popliteal fossa, make a circular turn once around the distal aspect of the thigh. Then continue
down to the starting point of the bandage, wrapping the flexed knee with figure of eight turns. Then wrap through the popliteal fossa over the
patella using spiral technique.
(f) Continue the bandage up the thigh to the groin using spiral bandaging technique. The next layer is applied in the same way, but in the opposite
direction.
36 BEST PRACTICE FOR THE MANAGEMENT OF LYMPHOEDEMA
(c)
(d)
(a) (b) (c)
(d) (e) (f)