Exploration of two compression bandaging techniques to reduce oedema in the hands of people with tetraplegia: a mixed-methods study

Background/Aims Hand and arm function is one of the most important factors in improving quality of life of people with tetraplegia. Oedema in the hands can cause pain, stiffness and impact hand function. The aim of this study was to explore two treatment methods to reduce oedema in the hands of people with tetraplegia. Methods A mixed-methods study with an A–B–A approach, followed by semi-structured interviews, was conducted in a spinal injury unit. Participants included people with newly acquired tetraplegia with hand oedema, who received either high-stretch compression bandaging or the boxing glove compression bandaging technique. Circumferential measurements determined treatment effect. Semi-structured interviews recorded participants' experience of oedema and treatments received and were analysed through thematic summary using interpretative description. Results Five participants were recruited (n=4 bilateral, n=1 unilateral oedema). The boxing glove compression bandaging technique (n=5) did not demonstrate evidence to suggest treatment effect. High-stretch bandaging (n=4) showed promise at reducing oedema and was the preferred treatment. Conclusions This small study showed that high-stretch bandaging is a promising treatment method and further exploration of the type of bandaging, application method and regimen are needed. The continuing use of the boxing glove compression bandaging technique to reduce oedema is questioned because of unclear effect and reported experiences. Implications for practice The promising findings related to high-stretch compression bandaging support the incorporation of this technique into clinical practice with additional investigations required to establish appropriate protocols. However, it is important that compression bandaging to reduce oedema is followed by other interventions to maintain the reductions.