MLD Compression Therapy & Bandaging 1 — Questions and Answers
Question 1: Which layer of a short-stretch multilayer bandage system is applied directly against the patient's skin to protect it from pressure and friction?
- Short-stretch bandage
- Stockinette or tubular sleeve (Correct answer)
- Foam padding layer
- Cohesive bandage
Correct answer: Stockinette or tubular sleeve
The stockinette or tubular sleeve is the innermost layer and serves as a skin protector before any padding or bandages are applied.
Question 2: What is the primary mechanical effect of short-stretch bandages on the lymphatic system during muscle activity?
- They create high resting pressure to push fluid continuously
- They create a rigid casing that increases tissue pressure during muscle contraction to enhance lymph propulsion (Correct answer)
- They warm the tissue to dilate lymph capillaries
- They reduce arterial inflow to decrease overall fluid load
Correct answer: They create a rigid casing that increases tissue pressure during muscle contraction to enhance lymph propulsion
Short-stretch bandages have a high working pressure and low resting pressure; the rigid casing increases interstitial pressure during muscle contraction, which drives lymph propulsion.
Question 3: In the context of complete decongestive therapy (CDT), bandaging is typically applied during which phase?
- Phase II (maintenance) only
- Phase I (intensive/reductive) only
- Both Phase I and Phase II (Correct answer)
- Neither phase; bandaging is a separate modality
Correct answer: Both Phase I and Phase II
Multilayer compression bandaging is used in Phase I to reduce limb volume and is continued or transitioned to compression garments in Phase II to maintain results.
Question 4: When applying a compression bandage to a lower extremity, the therapist should begin at which anatomical location?
- The popliteal fossa
- The mid-calf
- The digits or foot (most distal point) (Correct answer)
- The inguinal region
Correct answer: The digits or foot (most distal point)
Bandaging always starts at the most distal point (toes/foot) and proceeds proximally to create a distal-to-proximal pressure gradient that promotes fluid movement toward drainage areas.
Question 5: Which of the following best describes the pressure gradient that should be achieved with a well-applied compression bandage?
- Uniform pressure throughout the limb
- Higher pressure proximally than distally
- Higher pressure distally than proximally (Correct answer)
- Alternating high and low pressure segments
Correct answer: Higher pressure distally than proximally
A correct compression bandage creates a graduated pressure gradient with the highest pressure distally and decreasing pressure moving proximally, facilitating lymph flow toward the trunk.
Question 6: A patient with upper extremity lymphedema is being fitted for a compression garment. Which compression class is most commonly prescribed for mild to moderate lymphedema (20–30 mmHg)?
- Class I (15–20 mmHg)
- Class II (20–30 mmHg) (Correct answer)
- Class III (30–40 mmHg)
- Class IV (40–50 mmHg)
Correct answer: Class II (20–30 mmHg)
Class II garments (20–30 mmHg) are most frequently used for mild to moderate lymphedema in the maintenance phase to sustain volume reduction achieved during CDT.
Question 7: Which of the following is a contraindication to the application of compression bandaging in a patient with lymphedema?
- Pitting edema without skin breakdown
- Untreated acute deep vein thrombosis (DVT) (Correct answer)
- Mild fibrotic tissue changes
- Skin that is slightly dry or flaky
Correct answer: Untreated acute deep vein thrombosis (DVT)
Acute untreated DVT is a contraindication to compression because increased pressure could dislodge a thrombus and cause a pulmonary embolism.
MLD Compression Therapy & Bandaging 1
Which layer of a short-stretch multilayer bandage system is applied directly against the patient's skin to protect it from pressure and friction?