The Effect of Hosiery on Interstitial Fluid Pressure and Arm Volume Fluctuations in Breast Cancer Related Arm Oedema

Abstract

Objectives:

(1) To measure interstitial fluid pressure under one brand of hosiery in arm lymphoedema. (2) To assess the stability of the swelling over various time scales.

Setting:

Human microvascular studies laboratory of a teaching hospital.

Subjects:

Patients with arm oedema following successful breast cancer treatment.

Main outcome measures:

(1) Arm volume calculations using multiple circumferential measurements by tape measure. (2) Interstitial fluid pressure measurements by wick-in-needle technique in subcutis.

Results:

The mean swollen arm was 33% greater in volume than the contralateral arm (n = 50). There was no significant correlation between the size of the arm and the duration of the swelling. There was no significant change in arm volume over 2 weeks (n = 8) but there was a small (50 ml), significant increase overnight (p < 0.05). The mean (SD) interstitial fluid pressure while wearing one brand of hosiery (Sigvaris) was 18.7 (5.8) cmH₂O compared with 1.2 (2.8) cmH₂O after its removal. There was a significant correlation between the pressure under the sleeve and the pressure without the sleeve (r = 0.68, p < 0.05).

Conclusions:

The Sigvaris sleeve exerts sufficient compression to underlying tissue to raise interstitial fluid pressure. This may control arm swelling by reducing fluid filtration rate and/or raising fluid drainage rate from the arm.