What is MLLB?

MLLB is the application of many layers of different types of bandages used to manage lymphoedema of both the arms and legs, and on occasion the genital region. It can be used as a stand alone treatment, but has best results when used in conjuction wit other therapies such as MLD and Kinesio Taping. Different types of bandages are used and applied in a very specific way whch will encourage the re-shaping and reduction of a limb size. Short-stretch bandages are mainly used to create a resistance, or rigid support for the muscles to work against, improving lymphatic drainage as well as preventing further build up of swelling in the limb. In most instances bandages will be applied to the fingers and toes, depending on which limb is being bandaged.

Will I benefit from MLLB?

The benefits can help to reduce the severity of symptoms and also address the following:

• Improve lymph drainage by encouraging re-absorption of tissue fluid and preventing fluid leaking into the tissues.
• Improve movement and function of the limb (by reducing the overall size/weight of the limb).
• Improve distorted limb shape so that compression garments can be fitted correctly.
• Reduce thickened fibrotic tissue.
• Minimise chronic inflammation of the skin.
• Reverse lymphorrhoea (leaking of lymph through the skin).
• Decrease excessive limb size.
• Alleviate chronic skin problems.

How will treatments be arranged?

A thorough assessment of your limb swelling during your initial consultation will be undertaken. MLLB is generally carried out between 3-5 times a week for between one and three weeks (more maybe indicated and this will be discussed). Your limb will be measured to gain an approximate volume (size) at the start and end of treatment. In some cases MLLB will be carried out together with MLD to enhance the overall effects of treatment. An individual exercise programme may also be implemented to further improve the results gained during your course of bandaging.

MLLB is usually performed between 3 and 5 times a week and will involve the following pattern of events:

• Your bandage sessions will be planned and booked at a mutually agreeable time for both you and the clinic. You will be given a letter to take to your GP to request the bandages you will need to carry out your treatment. If this is not an option, a bandage package will be given specific to your individual needs and priced accordingly.
• Hygiene is taken very seriously at Northern Lymphology, so with this in mind you will be invited to use the walk-in travertine wet room to shower prior to each bandage application.
• If you are having MLD as well as MLLB, this will be carried out before the bandages are re-applied.
• Skin care with appropriate moisturising creams/lotions will be performed prior to the bandages being re-applied.
• Following the initial application of the MLLB, your limb movement may feel limited due to the semi-rigid nature of the bandage. However, it is essentioa that you are able to move the limb as much as you can.
• An individual exercise programme (using your joints) will be encouraged to enhance muscle pump activity. Exercise is essential during MLLB – the effects of the bandages are enhanced by the muscle movement.

What happens after MLLB?

Following MLLB, as before your treatment started, your limb will be re-measured and re-assessed. This will show an objective comparison of your limbs before and after MLLB and will determine the results of fluid volume reduction. Other things will also be taken into account during this evaluation, such as shape, extent of the swelling, skin condition and texture of the tissues.

Once MLLB is complete, you will enter the next phase of treatment which will include Compression Garments, Exercise, Simple Lymphatic Drainage (SLD) and skin care. You may also be recommended to have monthly top-up treatments of MLLB and/or MLD. The aim of this next phase of treatment is to maintain and further improve the work that has been achieved during the 'decongestive phase'.