Abstract
Introduction and aim: Compression therapy is a key component in lymphedema management. However, due to the hot and humid climate in summer, it is difficult to maintain motivation for wearing compression stockings. To resolve this problem, we developed a prototype of cool feeling compression stocking for patients with lower limb
lymphedema using Cupro fabrics with xylitol coating. This study aimed to clarify the effect of this prototype on contact subject thermal sensation and safety in patients with lower limb lymphedema.
Methods: We conducted a preliminary pre-post study to compare the prototype stocking（post-intervention） with a conventional stocking（pre-intervention）for patients with lower limb lymphedema, and the patients spent a day at home with these stockings. The outcome of contact subject thermal sensation was measured using the self-administered questionnaire of the American Society of Heating, Refrigerating, and Air-Conditioning Engineers （ASHRAE）score, which employed seven-stage scoring（-3, cool;＋3, hot）, just after putting them on and when removing them. Safety issues, such as skin problems and lymphedema status, were confirmed by telephone interview.
Results: A total of 13 female patients with lower limb lymphedema completed the study without any adverse event; 11 of them felt that post-intervention was cooler than pre-intervention, responding immediately after putting the stockings on. The median ASHRAE score decreased from ＋ 1 to -1（P = 0.002）. However, when removing the stockings, the ASHRAE score showed no significant change（P = 0.133）. Skin problems and exacerbation of lymphedema did not occur in any patient in this study.
Conclusion: This preliminary study indicated that compression stockings made from Cupro coated with xylitol made patients with lower limb lymphedema feel cooler immediately after putting the stockings on without any skin problems.
