A recent randomised trial from Belgium followed 160 participants over 5 years of follow-up. The experimental group received guidelines about prevention of lymphoedema, exercise therapy and manual lymph drainage. The control group received the same guidelines and exercise therapy, but no manual lymph drainage.
Incidence rates of lymphoedema were comparable between experimental and control groups at all follow-up measurements, regardless of how the lymphoedema was measured and defined. The manual lymph drainage in this study was applied from 1 month after surgery and with a frequency of 1 to 3 times a week.
It is difficult to compare the results of this study to those of other studies, because of differences in the definition of lymphoedema and in the duration of follow-up. Perhaps the manual lymph drainage should be started immediately after surgery, with the aim of stimulating the postoperative rerouting of the lymphatic system as soon as possible.
To optimise its effect, the frequency of manual lymph drainage application could be increased to 7 days a week. To make this more feasible, patients would have to be instructed to perform the technique on themselves.