Textile-based compression therapy in managing chronic oedema: Complex interactions

A 24-hour interval compression plan for managing chronic oedema: part 1-the science and theory behind the concept

Compression, skin care, manual lymph drainage and exercise form the mainstays of treatment of chronic limb oedema. The compression aspect of the regimen is often prescribed and used without conscious concern for the patient's ability for self-adjustment and skin hygiene. This article will focus on the action of compression therapy using a new concept of encouraging patients to apply and reapply an adjustable compression garment or multiple garment types during a 24-hour interval. The benefits of this focus on interval compression therapy on all aspects of care will be explained and case studies presented.

Prediction of applied pressure on model lower limb exerted by an air pneumatic device

Air pneumatic compression is a concept used for management of venous disease, including oedema. A typical air pneumatic compression device (PCD) consists of an inflatable sleeve composed of either single or multiple pressure chambers that encircle a limb. The aim of this research was to develop a mathematical model to predict the pressure applied by an air pneumatic device to an irregular cross-sectional lower limb manikin. The radius of curvature at any cross-section of the lower limb (i.e. calf (gastrocnemius), tibial crest (anterior edge of the tibia bone)) is irregular, and differs amongst individuals and populations. The effectiveness of air pneumatic devices is difficult to predict with these irregular cross sections. A theoretical model was developed to calculate pressure applied by compression sleeves on a lower leg manikin and results compared against experimental pressure exerted on the manikin by a silicone-based PCD. This prediction was made at each of three positions. The theoretical model developed based on elliptical shaped forms predicted the pressure more accurately for the ankle to above ankle position, whereas the model based on circular shaped forms predicted the pressure more accurately for below the calf to below the knee position. Refinements to the theoretical model to predict the pressure applied by PCD are recommended.