A New Medical Adaptive Compression System Is Effective in Reducing Oedema and Promotes Patient Self-management – Final Results of the ACROE Study

Introduction, Objectives, and/or Purpose: Compression therapy is the treatment of choice for chronic leg oedema. Despite the well-established indications for compression therapy in venous or lymphatic diseases, recent studies show a glaring underuse. Medical adaptive compression systems (MACs) are designed to minimise the problems patients have encountered when applying previously available compression devices. The MACs are particularly appropriate for and primarily used in the decongestion phase. Similar to short-stretch bandages, MACs generate high working pressure and low resting pressure. In contrast to conventional bandaging, MACs are able to prevent pressure loss through a readjustment of touch fasteners, which effectively promotes oedema regression.
The current study aimed to verify whether a newly developed MAC enables self-care in patients with chronic leg oedema. The secondary objectives were to assess the effectiveness of the MAC in reducing oedema, patients’ handling of the wrap, and its wearing.

Methods: The investigators conducted a multicentre prospective observational study on 99 adult patients with chronic leg oedema at three centres in Germany and one centre in Poland. At baseline, all patients received an MAC. Their overall satisfaction with the therapy was assessed at visits 3 and 4. Leg volume was determined in a contactless manner during visits 2 – 4. All patients completed the Cross-Cultural Adaptation of the Lymphoedema Functioning, Disability and Health Questionnaire for Patients with Lymphoedema of the Lower Extremity in Germany (Lymph-ICF-UG).

Results: A total of 86 patients completed the study and underwent follow-ups over a period of six weeks. At the final follow-up, 82 out of the 86 subjects (96.3%) indicated that they were able to put on the wrap independently or with a little help from family (Figure 1). The overall satisfaction rate was 88.5% (95% CI, 80.4% to 94.1%). The mean leg volume reduction from the baseline to six weeks was -4.7% (95% CI, -6.3% to -3.0%; p < 0.001) (Figure 2). Their Lymph-ICF-UG scores and scores in all domains improved significantly from the baseline to the final follow-up.

Conclusion(s): The new MAC promoted self-care in a high proportion of patients with chronic leg oedema, with nearly 95% of those who completed the study stating that they were satisfied or quite satisfied. Unlike other devices, the MAC can be put on using only one hand; hence, its use is more feasible for people who are obese or otherwise disabled. A significant reduction in oedema was observed in patients who both did and did not undergo prior compression therapy.
Based on the findings of the study, more widespread use of MACs during the decongestion phase, as well as long-term use in the preservation phase, on a permanent or intermittent basis, can be recommended as an effective tool for patient self-care in cases where compression stockings are either not sufficient or when patients are unable to put them on by themselves.