Skin pressure profiles and variations with body postural changes beneath medical elastic compression stockings

Exploration of Effects of Graduated Compression Stocking Structures on Performance Properties Using Principal Component Analysis: A Promising Method for Simultaneous Optimization of Properties

This paper focuses on the comfort properties of graduated and preventive compression stockings for people who work long hours in standing postures and for athletes for proper blood circulation. The present study was conducted in order to investigate the effects of the yarn insertion density and inlaid stitches on the performance of the compression stockings. The effects of these parameters on the thermo-physiological comfort properties were tested with standard and developed methods of testing. All compression stockings were maintained with class 1 pressure as per German standards. The structural parameters of the knitted fabric structures were investigated. The stretching and recovery properties were also investigated to determine the performance properties. The theoretical pressure was predicated using the Laplace’s law by testing the stockings’ tensile properties. The compression interface pressures of all stockings were also investigated using a medical stocking tester (MST) from Salzmann AG, St. Gallen, Switzerland. Correlation between the theoretical pressures and pressures measured using the MST system were also assessed. The current research used a multi-response optimization technique, i.e., principal component analysis (PCA), to identify the best structure based on the optimalization of the above-mentioned properties. The results also revealed that samples with higher insertion density levels exhibit better comfort properties. The results showed that sample R1 was the best sample, followed by R2 and P. In addition, all developed stocking samples exhibited better comfort properties than the control sample from the market.

Study of Three Interface Pressure Measurement Systems Used in the Treatment of Venous Disease

The aim of the publication is to report the accuracy, repeatability and the linearity of three commercially available interface pressure measurement systems employed in the treatment of venous disease. The advances in the treatment and management of chronic venous disease by compression therapy have led to considerable research interest in interface pressure measurement systems capable of measuring low-pressure ranges (10-60 mmHg). The application of a graduated pressure profile is key for the treatment of chronic venous disease which is achieved by using compression bandages or stockings; the required pressure profiles are defined in standards (BSI, RAL-GZ, or AFNOR) for different conditions. However, achieving the recommended pressure levels and its accuracy is still deemed to be a challenge. Thus, it is vital to choose a suitable pressure measurement system with high accuracy of interface pressure. The authors investigated the sensing performance of three commercially available different pressure sensors: two pneumatic based (AMI and PicoPress®) and one piezoresistive (FlexiForce®) pressure sensors, with extensive experimental work on their performance in terms of linearity, repeatability, and accuracy. Both pneumatic based pressure measurement systems have shown higher accuracy in comparison to the flexible piezoresistive pressure sensors.

Prevention of edema after coronary artery bypass graft surgery by compression stockings

Background:

Lower limb edema may occur after removal of the saphenous veins in coronary artery bypass graft (CABG) surgery. Compression therapy is often used to prevent postoperative edema.

Objectives:

The objective of this study was to evaluate the efficacy of medical compression stockings (TED) on the prevention of donor limbs edema and wound complications after CABG surgery.

Patients and Methods:

In this prospective cohort study, we enrolled 100 patients who underwent elective CABG surgery at Rajaie Cardiovascular Medical and Research Center. The patients were divided into two groups; group A who applied TED stockings regularly (exposure group) and group B who did not apply TED stockings at all or apply it irregularly (no exposure group). The degree of donor limb edema and the differences of the peripheries of calf and thigh before and after the surgery (in 1, 2 and 4 weeks) were recorded and analyzed statistically.

Results:

The patients' weight (P = 0.02) and the degree of their daily activity (P = 0.002) were the significant factors for the incidence of the donor limbs edema. The incidence and degree of lower limb edema were significantly lower in exposure group 4 weeks after the surgery (P < 0.001). The differences of the periphery of the calf before (at admission time) and after the surgery (in 1, 2 and 4 weeks) between two groups were also statistically significant (P = 0.41, P = 0.39, P = 0.40, respectively). Lower limb wound complications was higher in patients who have peripheral edema in the 4th week of post-CABG (P = 0.09).

Conclusions:

Regular use of TED stockings may have positive effects on the prevention of donor limb edema (especially higher degrees of edema) and wound complications after CABG surgery.

Evaluation of lower limb vein biomechanical properties and the effects of compression stockings, with an instrumented ultrasound probe

We present a new approach for the evaluation of the biomechanical properties of lower limb veins based on the simultaneous measurements of the vein cross-sectional area with B-mode ultrasound imaging and of the force exerted on the skin by the ultrasound probe. Ongoing clinical trials allowed us to identify a behavioral model of lower limb veins without and with compression stockings.

Effect of walking on pressure variations that occur at the interface between elastic stockings and the skin

The aim of this work was to dynamically study pressure variations exerted by elastic compression stockings during walking. While study participants walked, the pressure variations at the interface between elastic stockings and the skin were measured dynamically. Three healthy individuals wearing 10/20 and 20/30 elastic compression stockings manufactured by Sigvaris((R)) (Jundiai, São Paulo-Brazil) were requested to walk along a course for ten times at a constant speed. For every event, an apparatus specifically developed for the study and programmed to take readings at half-second intervals was used to measure the pressure exerted by the elastic stockings. The pressure exerted by the 10/20 stockings varied between 5 and 32 mmHg and for the 20/30 stockings it varied from 10 to 52 mmHg. Elastic stockings with larger pressures generate larger pressure variations during muscle activity (P-value < 0.001). In conclusion, muscle movements during walking cause the pressure exerted by elastic stockings on the leg to vary; thus, the pressure is not constant but has peaks and troughs according to the type of muscle movement and the gradient of the stockings.

Comparison of compression stocking with elastic bandage in reducing postoperative edema in coronary artery bypass graft patient

The removal of the saphenous veins in coronary artery bypass graft (CABG) surgery may cause leg edema. Compression therapy is often used to prevent postoperative edema. The objective of this study was to compare the efficacy of medical compression stocking (TED) and elastic bandage-type on donor limbs after CABG. The peripheries of lower limbs were measured at four regions (A: end of tarsal bones, H: heel , B: immediately above the ankle, C: largest circumference of the calf) at admission in 295 patients how CABG candidates and differences in these measurement points at discharge compared to measurements at admission time were calculated. The difference was considered as a measure of the effectiveness of two types of compression to prevent postoperative edema in donor limbs after CABG. The alterations of 396 donor limbs of 295 patients were examined after CABG at admission and discharge time. In 101 patients veins for graft were taken from both lower limbs. After analysis, if subjects had worn TED stockings, the peripheries of donor limbs at discharge were less than at admission time in the A and H regions compared to elastic bandage group (P(A) = 0/009), (P(H) = 0/012). The conclusion reached was that using the kind of knee length compression stocking (TED stocking , Kendall Co.) is more effective edema at foot and heel regions in donor limbs after CABG than elastic bandages.