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Mosti G, Gasparis A, Oropallo A, Labropoulos N. Pressure and stiffness of a new air-inflated compression wrap. Phlebology 2024; 39:456-464. [PMID: 38613486 DOI: 10.1177/02683555241246606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2024]
Abstract
OBJECTIVE To report pressure and stiffness, in healthy volunteers, of a new compression device with an air bladder inflated by a pump to regulate pressure. METHODS The device was applied to 60 legs of 30 volunteers and set to exert different pressures of 20-50 mmHg. The exerted pressure was measured in supine and standing positions and during simple physical exercises; static stiffness index, dynamic stiffness index, and walking pressure amplitudes were calculated. RESULTS The exerted pressure showed a good correlation with the expected pressure at each pressure range. The stiffness indices were >10 mmHg in the range of inelastic materials. The device was considered very easy to apply and use by the testing researchers. CONCLUSIONS The device stiffness is in the same range as the inelastic bandages. Consequently, similar hemodynamic effectiveness could be expected but must be proved. Unlike inelastic bandages, this device was easy to apply and use.
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Affiliation(s)
- Giovanni Mosti
- Angiology Department, Clinica MD Barbantini, Lucca, Italy
| | | | - Alisha Oropallo
- Department of Surgery, Northwell Health, New Hyde Park, NY, USA
| | - Nicos Labropoulos
- Division of Vascular Surgery, Stony Brook Medicine, Stony Brook, NY, USA
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2
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Conde-Montero E, Dissemond J, Protz K. Compression Therapy in Dermatology. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:693-701. [PMID: 38382747 DOI: 10.1016/j.ad.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/23/2024] Open
Abstract
The benefit of lower limb compression therapy is not limited to chronic venous insufficiency or/and lymphoedema. Thanks to its anti-edema and anti-inflammatory effects, compression therapy is considered a beneficial adjuvant therapy to treat atypical wounds, inflammatory dermatoses, cellulitis, and traumatic wounds in the absence of contraindications. Strict contraindications are limited to severe peripheral arterial disease and decompensated heart failure. The variability of commercially available compression materials and systems, such as short-stretch bandages, multi-component systems, zinc oxide bandages, medical adaptive compression systems, ulcer compression stockings or medical compression stockings, facilitates the adaptation of compression therapy to the individual needs of each patient. Compared to venous leg ulcers, low pressures of 20mmHg are often sufficient to treat dermatological disorders, with higher patient tolerance and compliance.
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Affiliation(s)
- E Conde-Montero
- Servicio de Dermatología. Hospital Universitario Infanta Leonor y Virgen de la Torre, Madrid.
| | - J Dissemond
- Department of Dermatology, Venerology and Allergology, University Hospital Essen, Essen, Germany
| | - K Protz
- Competence Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Conde-Montero E, Dissemond J, Protz K. [Translated article] Compression Therapy in Dermatology. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T693-T701. [PMID: 38821356 DOI: 10.1016/j.ad.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 06/02/2024] Open
Abstract
The benefit of lower limb compression therapy is not limited to chronic venous insufficiency or/and lymphoedema. Thanks to its anti-edema and anti-inflammatory effects, compression therapy is considered a beneficial adjuvant therapy to treat atypical wounds, inflammatory dermatoses, cellulitis, and traumatic wounds in the absence of contraindications. Strict contraindications are limited to severe peripheral arterial disease and decompensated heart failure. The variability of commercially available compression materials and systems, such as short-stretch bandages, multi-component systems, zinc oxide bandages, medical adaptive compression systems, ulcer compression stockings or medical compression stockings, facilitates the adaptation of compression therapy to the individual needs of each patient. Compared to venous leg ulcers, low pressures of 20mmHg are often sufficient to treat dermatological disorders, with higher patient tolerance and compliance.
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Affiliation(s)
- E Conde-Montero
- Servicio de Dermatología. Hospital Universitario Infanta Leonor y Virgen de la Torre, Madrid.
| | - J Dissemond
- Department of Dermatology, Venerology and Allergology, University Hospital Essen, Essen, Germany
| | - K Protz
- Competence Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Meaume S, Senet P, Thomé B, Aragno VA, Bohbot S, Fortin S, Boucley I, Michon-Pasturel U, Colboc H. Aetiological treatment of venous leg ulcers with compression therapy: real-life outcomes with two different procedures. J Wound Care 2023; 32:615-623. [PMID: 37830834 DOI: 10.12968/jowc.2023.32.10.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
OBJECTIVE To evaluate the healing outcomes and costs associated with the aetiological management of venous leg ulcers (VLUs) treated with recommended multicomponent bandages (MCBs) and short-stretch bandages (SSBs). METHOD This observational study is a retrospective comparative study (Level 2b), based on the French administrative healthcare database (Système National des Données de Santé, SNDS). It includes patients treated from onset with reimbursed MCBs and SSBs for a VLU episode, between July 2018 and September 2020. Although other compression systems, such as long-stretch bandages, are commonly used for the treatment of VLUs, they are not recommended by health authorities in France and thus, were not considered for this study. A binomial regression model was performed to estimate the adjusted relative risk of wound closure rates at three months for each group, based on potential confounding factors including, notably, age, sex, key comorbidities, and wound dressing size. The mean healthcare cost was calculated for patients whose VLUs healed within the study period. RESULTS The reimbursement data (including prescribed compression systems and nursing care) of the 25,255 selected patients were analysed in the study. There were no significant differences between the MCBs and SSBs groups when considering patient characteristics. The healing rates after three months' treatment, were 42% and 35% (p<0.001) in the MCBs and SSBs groups, respectively. When adjusting the statistical model, the chance of healing at three months was still 12% higher with MCBs compared with SSBs (p<0.0001). The median healing time was estimated at 115 (interquartile range (IQR): 60-253) days in the MCB group versus 137 (IQR: 68-300) days in the SSBs group. The average treatment cost per patient with a healed ulcer was €2875±3647 in the MCB group and €3580±5575) in the SSBs group (p=0.0179), due to lower hospital stay and nursing costs in the MCB group. Differences in wound characteristics between the two groups cannot be totally excluded, due to the limited content of the database in terms of clinical data, but should have been addressed, to some extent, through the study selection criteria and the chosen regression model. CONCLUSION In this study, this SNDS analysis seemed to confirm that the healing outcomes achieved in real-life with MCBs were in line with those reported in clinical trials, and superior to SSBs, which reinforces the current position from the guidelines.
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Affiliation(s)
- Sylvie Meaume
- Geriatry, Dermatology and Wound Healing Department, Rothschild University Hospital, Paris, France
| | - Patricia Senet
- Dermatology and Vascular Medicine Department, Tenon University Hospital, Paris, France
| | | | | | - Serge Bohbot
- Global Medical Affairs, Laboratoires URGO, Chenôve, France
| | - Sophie Fortin
- Global Regulatory Affairs and Market Access Department, Laboratoires URGO, Chenôve, France
| | - Isabelle Boucley
- Global Regulatory Affairs and Market Access Department, Laboratoires URGO, Chenôve, France
| | | | - Hester Colboc
- Geriatry, Dermatology and Wound Healing Department, Rothschild University Hospital, Paris, France
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5
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Santandrea S, Benassi M, Tedeschi R. Comparison of short-stretch bandage and long-stretch bandage for post-traumatic hand edema. Int J Surg Case Rep 2023; 111:108854. [PMID: 37738827 PMCID: PMC10523425 DOI: 10.1016/j.ijscr.2023.108854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Hand edema is a common post-surgical or traumatic complication in orthopedic patients, necessitating effective treatment interventions. This study aimed to investigate the effects of two different types of bandages, along with finger flexion exercises, on managing hand edema. CASE PRESENTATION Our orthopedic patients with post-surgical or traumatic hand edema and three non-edematous hands were enrolled in the study. A mixed model effect with fixed factors of time (pre-post) and bandage type (M, C, N), and random factors of hand, edema, fingers, and phalanges was applied. The bandage types were circular with short elastic bandage (M) and circular with elastic bandage (C). Finger flexion exercises involved alternating contractions of extrinsic and intrinsic flexors. Randomization ensured unbiased allocation to bandage types. CLINICAL DISCUSSION The M bandage demonstrated a significant reduction in hand edema by effectively moving free fluids, reinforcing tissue hydrostatic pressure, and facilitating venous and lymphatic flow. On the other hand, the C bandage did not produce significant pre-post differences in hand circumference. CONCLUSIONS The combination of a circular bandage with finger flexion exercises shows promise in reducing hand edema in orthopedic patients. Particularly, the stiff bandage M exhibited superior efficacy compared to the elastic one C in reducing hand circumference. These findings provide valuable insights for clinical practice, offering an effective strategy for managing hand edema and promoting better patient outcomes.
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Affiliation(s)
- Sheila Santandrea
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Mariagrazia Benassi
- Department of Psychology Renzo Canestrani, University of Bologna, Viale Berti Pichat, 5, 40127 Bologna, Italy
| | - Roberto Tedeschi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
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Hettrick H, Ehmann S, McKeown B, Bender D, Blebea J. Selecting appropriate compression for lymphedema patients: American Vein and Lymphatic Society position statement. Phlebology 2023; 38:115-118. [PMID: 36609200 DOI: 10.1177/02683555221149619] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Lymphedema is a significant and disabling disorder affecting millions of people worldwide. Compression therapy is an important component of lifelong treatment but the specifics of appropriate compression garment selection and prescribing is not always well understood by practitioners and payers. METHOD An expert panel of the American Vein and Lymphatic Society was convened to write a Position Statement with explanations and recommendations for the appropriate compression therapy to be used in the treatment of lymphedema patients. RESULT A Position Statement was produced by the expert panel with recommendations for documentation and compression therapy treatment. Their recommendations were reviewed, edited, and approved by the Guidelines Committee of the society. CONCLUSION This societal Position Statement provides a useful document for reference for medical care providers for the appropriate compression therapy selection and treatment of patients with lymphedema.
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Affiliation(s)
- Heather Hettrick
- College of Health Care Sciences, 2814Nova Southeastern University, Ft. Lauderdale FL, USA
| | - Suzie Ehmann
- 23765Grand Strand Medical Center, Myrtle Beach, SC, USA
| | - Brandy McKeown
- International Lymphedema and Wound Training Institute, Tifton, GA, USA
| | - Dean Bender
- 576988American Vein and Lymphatic Society, Chicago, IL, USA
| | - John Blebea
- Department of Surgery, 367854Central Michigan University College of Medicine, Saginaw, MI, USA
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7
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Effects of leg compression and calf muscle contraction by active ankle motion on venous hemodynamics in sitting individuals. Phlebology 2022; 37:361-366. [DOI: 10.1177/02683555221077741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives To clarify the effects of compression and active ankle motion on venous hemodynamics in healthy sitting individuals. Methods In the sitting position, 14 participants performed plantar flexion and dorsiflexion of the ankle for 3 s each without compression. Changes in the calf volume were recorded using air plethysmography. Subsequently, the process was repeated with the application of tubular elastic bandage (TEB), followed by anti-thrombotic stocking (ATS). Results The median interface pressure at the calf was 16 mmHg with TEB and 21 mmHg with ATS. Without compression ( N), the median venous volume was 76 mL. This was reduced to 58 mL with TEB and 56 mL with ATS ( p < .01 vs. N for both). On the other hand, ejection volume by plantar flexion in N (27 mL) was not significantly changed with TEB (31 mL) or ATS (31 mL). Also, ejection volume by dorsiflexion in N (53 mL, p < .001 vs. plantar flexion) was not significantly changed with TEB (53 mL, p < .01 vs. plantar flexion) or ATS (41 mL, p < .05 vs. plantar flexion). Conclusions The venous volume, which is defined as the change in enclosed calf volume from elevation to dependency, in the sitting position reduced similarly with TEB and ATS; however, the ejection volumes did not change significantly. Dorsiflexion exerted a larger ejection volume than plantar flexion in the sitting position.
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8
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Benigni JP, Balet F, Guidet B, Tacca O. Statischer Stiffness-Index von zwei Multikomponenten-Bandagen-Kompressionssystemen: Ergebnisse einer randomisierten kontrollierten Studie an gesunden Probanden. PHLEBOLOGIE 2021. [DOI: 10.1055/a-1487-4194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Zusammenfassung
Zweck Vergleich der Leistung von zwei Mehrkomponenten-Kompressionssystemen.
Methoden In dieser randomisierten, kontrollierten Studie wurden beide Beine von 25 gesunden Probanden nach dem Zufallsprinzip entweder mit einem Kompressionssystem der neuen Generation (UrgoK1, eine einzige Binde) oder einem etablierten System (UrgoK2, zwei Binden) als Kontrolle bandagiert. Beide Systeme wurden Tag und Nacht getragen. Arbeits- und Ruhegrenzflächendruck wurden unmittelbar nach dem Anlegen und nach 4 h, 24 h, 48 h und 72 h gemessen und der Static Stiffness Index (SSI) berechnet.
Ergebnisse Nach 4 Stunden wurden mit beiden Systemen ähnlich hohe Arbeitsdrücke und mäßige Ruhedrücke registriert. Im Zeitverlauf folgten die Druckänderungen und des SSI den gleichen Kurven. Nach 48 h wurde ein SSI ≥ 10 mmHg bei 88 % der getesteten und 76 % der Kontrollsysteme erreicht, was die Nichtunterlegenheit des Testsystems bestätigt (p = 0,016). Beide Systeme wiesen gute Halteeigenschaften auf und waren gut verträglich, aber das getestete System wurde von der Mehrheit der Probanden als deutlich angenehmer empfunden und schließlich dem Kontrollsystem vorgezogen.
Schlussfolgerung Das neue Kompressionssystem erreichte ähnliche Leistungen wie die Kontrolle, aber seine bessere Akzeptanz könnte ein Vorteil für die Patientencompliance sein. Diese vielversprechenden Ergebnisse müssen in einer klinischen Studie an Patienten mit Unterschenkelulcera und/oder Ödemen bestätigt werden.
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Affiliation(s)
| | | | - Bérengère Guidet
- Klinische Projektleiterin, Intertek Clinical Research Services, Paris, Frankreich
| | - Olivier Tacca
- Direktor der Abteilung für präklinische und klinische Forschung, Urgo Research Innovation and Development, Chenôve, Frankreich
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9
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Gebruers N, Hendriks JMH, Tjalma W, Verbelen H, Van Soom T, van Breda E, De Vrieze T. Pressure Curves, Static and Dynamic Stiffness of Different Two-Component Compression Systems for the Treatment of Chronic Edema of the Lower Limbs. Lymphat Res Biol 2021; 20:335-341. [PMID: 34463159 DOI: 10.1089/lrb.2021.0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Compression is a cornerstone modality in edema treatment. Different types of bandages are available in clinical practice. Short-stretch bandages are commonly used; however, newer technologies such as the two-component compression system are available as well. This study assesses the pressure curves and static and dynamic stiffness (Static Stiffness Index [SSI] and Dynamic Stiffness Index [DSI]) of two different two-component compression systems, Coban and CoFlex, for edema treatment. Methods and Results: For this prospective cohort study, 12 healthy volunteers were recruited. The healthy volunteers wore both two-component compression systems for 48 hours. Pressure sensors (PicoPress®; Microlab, Italy) were placed at 10 and 25 cm above the internal malleolus and 10 pressure readings were used to obtain pressure curves. The SSI and DSI were assessed. Additionally, comfort (ICC compression questionnaire) and adverse events were assessed as well. Both two-component compression systems exert a sufficient amount of sub-bandage pressure, although CoFlex exerts systematically significantly lower pressure in comparison with Coban. This difference in sub-bandage pressure remains constant over 48 hours. Both two-component compression systems are sufficiently stiff (stiffness >15 mmHg) and remain stiff over time. Conclusions: Both two-component compression systems have pressure curves that are high enough to motivate their use in the treatment of chronic edema. Additionally, both systems were found to be comfortable and have clinically effective SSI and DSI values.
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Affiliation(s)
- Nick Gebruers
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI-MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Oedema Clinic, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
| | - Jeroen M H Hendriks
- Oedema Clinic, Antwerp University Hospital and University of Antwerp, Edegem, Belgium.,Department of Medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Thoracic and Vascular Surgery, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Wiebren Tjalma
- Oedema Clinic, Antwerp University Hospital and University of Antwerp, Edegem, Belgium.,Department of Medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Multidisciplinary Breast Clinic Antwerp, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Hanne Verbelen
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI-MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Timia Van Soom
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI-MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Eric van Breda
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI-MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Tessa De Vrieze
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI-MOVANT), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Mechanical and Morphological Assessment of an Innovative Textile for Patient Positioning Applications: Comparison to Two Standard Bandage Systems. MATERIALS 2021; 14:ma14061508. [PMID: 33808789 PMCID: PMC8003422 DOI: 10.3390/ma14061508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/10/2021] [Accepted: 03/17/2021] [Indexed: 11/24/2022]
Abstract
In the healthcare environment, bandage systems are versatile medical devices to position and fix patients’ torsos or extremities. In this study, the mechanical and morphological properties of an innovative patient position system, iFix, were assessed and compared to two commercially available bandages. Morphological properties were investigated using a scanning electron microscope (SEM). The iFix bandage showed anisotropic mechanical properties, with a more rigid behavior in the longitudinal direction and a more elastic behavior in the transverse direction. This behavior results from the organization of the fibers visible in the SEM images. All three materials investigated in this study were able to support similar maximum loads. In cases where a rigid fixation of patient limbs or torso is necessary, the authors recommend the usage of iFix. In vivo studies should be carried out to prove safety in a surgical environment before its clinical usage.
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11
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Suehiro K, Morikage N, Harada T, Samura M, Nagase T, Takeuchi Y, Mizoguchi T, Suzuki R, Kurazumi H, Hamano K. Interface Pressures Derived from a Tubular Elastic Bandage. Ann Vasc Dis 2020; 13:410-413. [PMID: 33391559 PMCID: PMC7758598 DOI: 10.3400/avd.oa.20-00136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: We sought to clarify the interface pressure (IP) when using a tubular elastic bandage (TEB) and examine the possibility for TEBs to provide IPs comparable to those provided by anti-thrombotic stockings. Materials and Methods: In 40 healthy patients, IPs were measured at the level of calf at its maximum diameter (C) and transition of the medial gastrocnemius muscle into the Achilles tendon (B1) while a single or double layer of TEBs (17.5 cm in circumference) were applied with the patient in a supine position. Results: Including both the C and B1 levels, circumferences and IPs showed a good correlation (single layer; r=0.72, double layer; r=0.75). The IP obtained with a single layer of TEB at the C level (median, 17 mmHg [range, 12–23 mmHg]) was higher than that at the B1 level (14 mmHg [11–18 mmHg], p<0.001). When double-layer TEB was used, the IP at B1 level increased to 18 (14–23) mmHg (p<0.001 vs. single layer). Conclusion: Considering the characteristics of TEBs and using a single or double layer appropriately, creating a pressure profile mimicking that of an anti-thrombotic stocking seemed to be feasible when using a TEB.
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Affiliation(s)
- Kotaro Suehiro
- Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Noriyasu Morikage
- Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Takasuke Harada
- Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Makoto Samura
- Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Takashi Nagase
- Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Yuriko Takeuchi
- Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Takahiro Mizoguchi
- Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Ryo Suzuki
- Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Hiroshi Kurazumi
- Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Kimikazu Hamano
- Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
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12
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Theory and Practice of Compression Therapy for Treating and Preventing Venous Ulcers. ACTAS DERMO-SIFILIOGRAFICAS 2020. [DOI: 10.1016/j.adengl.2020.10.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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13
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Berszakiewicz A, Sieroń A, Krasiński Z, Cholewka A, Stanek A. Compression therapy in venous diseases: physical assumptions and clinical effects. Postepy Dermatol Alergol 2020; 37:842-847. [PMID: 33603600 PMCID: PMC7874878 DOI: 10.5114/ada.2019.86990] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 04/09/2019] [Indexed: 12/04/2022] Open
Abstract
Compression therapy (CT) is an established treatment method in chronic venous disease. Despite years of clinical experience, choosing the optimum compression therapy, including grade and pressure distribution, which determine the efficacy of treatment poses a challenge. The paper discusses CT physical assumptions (stiffness, elasticity, static and dynamic stiffness indices), clinical effects and contraindications to CT.
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Affiliation(s)
- Andrzej Berszakiewicz
- Department of Internal Medicine, Angiology and Physical Medicine, Specialist Hospital No. 2, Bytom, Poland
- Fresenius Dialysis Centre No. 38 in Oswiecim, Fresenius Nephrocare Polska, Oswiecim, Poland
| | - Aleksander Sieroń
- Department of Internal Medicine, Angiology and Physical Medicine, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Bytom, Poland
| | - Zbigniew Krasiński
- Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Armand Cholewka
- Department of Medical Physics, Chelkowski Institute of Physics, University of Silesia, Katowice, Poland
| | - Agata Stanek
- Department of Internal Medicine, Angiology and Physical Medicine, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Bytom, Poland
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14
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Lantis JC, Barrett C, Couch KS, Ehmann S, Greenstein E, Ostler M, Tickner A. A dual compression system: preliminary clinical insights from the US. J Wound Care 2020; 29:S29-S37. [PMID: 32924806 DOI: 10.12968/jowc.2020.29.sup9.s29] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
There is growing evidence on an interconnection between the venous and lymphatic systems in venous leg ulceration, and the possible effects of prolonged oedema and lymphatic impairment in delayed wound healing. Compression therapy is a widely accepted treatment for venous and lymphatic disorders, as it decreases recurrence rates and prolongs the interval between recurrences. Compression bandages improve venous return, increase the volume and rate of venous flow, reduce oedema and stimulate anti-inflammatory processes. The pressure at the interface (IP) of the bandage and the skin is related to the elastic recoil of the product used and its resistance to expansion. The pressure difference between the IP in the supine and standing positions is called the static stiffness index (SSI). Elastic materials provide little resistance to muscle expansion during physical activity, resulting in small pressure differences between resting and activity, with an SSI <10mmHg. Stiff, inelastic materials with a stretch of <100% resist the increase of muscle volume during physical activity, producing higher peak pressures, an SSI of >10mmHg and a greater haemodynamic benefit than elastic systems. UrgoK2 is a novel dual-layer high-compression system consisting of an inelastic (short stretch) and elastic (long stretch) bandage, resulting in sustained tolerable resting pressure and elevated working pressures over extended wear times. It is indicated for the treatment of active venous leg ulcers and the reduction of chronic venous oedema. Each bandage layer has a visual aid to enable application at the correct pressure level. Published European studies have assessed this compression system, exploring its consistency of application, tolerability and efficacy. This article presents the first reports of health professionals' clinical experience of using the compression system in the US, where it has been recently launched. Initial feedback is promising.
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Affiliation(s)
- John C Lantis
- Mount Sinai Morningside and West Hospitals, Icahn School of Medicine, New York, US
| | - Christopher Barrett
- The Centers for Wound Healing, Crozer Keystone Health System, Springfield, Pennsylvania, US
| | - Kara S Couch
- George Washington University Hospital, Washington DC, US
| | - Suzie Ehmann
- Atrium Health Stanly, Albemarle, North Carolina, US
| | | | | | - Anthony Tickner
- Saint Vincent Hospital/RestorixHealth, Wound Healing Center, Worcester, Massachusetts, US, and Board of Directors, Massachusetts Foot and Ankle Society
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15
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Conde Montero E, Serra Perrucho N, de la Cueva Dobao P. Theory and Practice of Compression Therapy for Treating and Preventing Venous Ulcers. ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:829-834. [PMID: 32574718 DOI: 10.1016/j.ad.2020.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/21/2020] [Accepted: 03/21/2020] [Indexed: 10/24/2022] Open
Abstract
Compression therapy is the basis for treating the cause of venous ulcers and preventing recurrence. Various systems are currently available for applying compression and adapting them to patients' needs can improve adherence to treatment. Understanding the principles that underlie compression therapy is essential for success. Although this paper focuses mainly on venous ulcers, compression has also proven beneficial for other conditions, such as lymphedema and wounds resulting from injury or inflammation.
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Affiliation(s)
- E Conde Montero
- Servicio de Dermatología. Hospital Universitario Infanta Leonor, Madrid, España.
| | | | - P de la Cueva Dobao
- Servicio de Dermatología. Hospital Universitario Infanta Leonor, Madrid, España
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16
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Fulcher E, Gopee N. Effect of different compression bandaging techniques on the healing rate of venous leg ulcers: a literature review. Br J Community Nurs 2020; 25:S20-S26. [PMID: 32501762 DOI: 10.12968/bjcn.2020.25.sup6.s20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Venous leg ulcers (VLUs) are a common health problem in older adults, for which the widely used method of treatment includes compression therapy. There are various compression bandages and hosiery systems available for use, but it remains unclear as to which types of compression systems are most effective in enabling healing of VLUs. This study aimed to determine which type of the two most commonly used compression bandaging (four-layer and two-layer) is more effective in providing complete ulcer healing of VLUs. Key search terms were identified using the PICO (population, intervention, comparison, outcome) model, with distinct inclusion and exclusion criteria, in a strategic search of electronic databases (e.g. CINAHL and MEDLINE) along with wider sources, including Google Scholar. More studies favoured the four-layer compression system than two-layer for providing better healing rates in the treatment of VLUs, but two-layer bandaging tends to provide a better quality of life and may be more cost-effective, although comorbidities and other factors also need to be considered. In choosing the type of compression bandage for the management of leg ulcers, the healing rate achieved by the chosen bandage needs to be carefully monitored, while also taking into consideration other factors such as the quality of life for the patient.
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Affiliation(s)
- Emily Fulcher
- Staff Nurse, University Hospitals Coventry and Warwickshire NHS Trust
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17
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Jindal R, Balet F, Filori P, Kaur T, Dhillon S, Thapa S, Chaudhary P. Interest of a standardized treadmill test to evaluate pressure drops and stiffness indices under short stretch bandages. INDIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY 2020. [DOI: 10.4103/ijves.ijves_37_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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19
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Compression therapy in venous diseases: current forms of compression materials and techniques. Postepy Dermatol Alergol 2019; 37:836-841. [PMID: 33603599 PMCID: PMC7874882 DOI: 10.5114/ada.2019.86991] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 04/09/2019] [Indexed: 11/23/2022] Open
Abstract
Compression therapy (CT) is an established treatment method in chronic venous disease (CVD). The paper presents information on different CT forms with indications and contraindications based on expert consensuses from recent years. A high prevalence of CVD implies continuous development of compression materials, systems and techniques as well as measurement methods. The article aims at reviewing available literature on the development of compression therapy techniques.
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20
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Cooper-Stanton G. Adjustable compression devices for chronic oedema and lipoedema: purpose, selection and application. Br J Community Nurs 2019; 24:278-282. [PMID: 31166780 DOI: 10.12968/bjcn.2019.24.6.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Garry Cooper-Stanton
- Clinical Nurse Specialist Lymphoedema, Walsall Healthcare NHS Trust; Lecturer, School of Nursing and Midwifery, University of Birmingham; Queen's Nurse
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21
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Bjork R, Ehmann S. S.T.R.I.D.E. Professional Guide to Compression Garment Selection for the Lower Extremity. J Wound Care 2019; 28:1-44. [DOI: 10.12968/jowc.2019.28.sup6a.s1] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The following supplement is a rare example of a paper that combines clinical experience and theoretical knowledge on textiles used in compression therapy. The authors' intention is to propose a decision support system for choosing specific compression devices, which can be adjusted to counteract the individual signs and symptoms in an optimally adopted way. The document concentrates on compression devices which can be self-applied by the patients—compression stockings and adjustable wraps. The acronym ‘S.T.R.I.D.E.’, incorporating both textile characteristics and clinical presentation, stands for: Shape, Texture, Refill, Issues, Dosage and Etiology. The intent of the mnemotechnical value is to highlight that successful compression includes more than dosage alone. In addition to dosage, etiology and patient presentation need to be incorporated, including a patient's physical ability to use compression effectively as part of the daily routine, thereby promoting adherence. The suggested algorithms provide a valuable guide to stride across the important, but still underestimated field of medical compression therapy and will help to put the prescription of a specific product on a more rational basis. Enjoy reading! Hugo Partsch Emeritus Professor Medical University of Vienna, Austria
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Affiliation(s)
- Robyn Bjork
- International Lymphedema and Wound Training Institute, Alaska, US
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22
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Arslanbekov MM, Demekhova MY, Efremova OI, Zolotukhin IA. Compression Sleeves for Full Legs: New Hosiery for Venous Patients. ACTA ACUST UNITED AC 2019. [DOI: 10.17116/flebo201913041301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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23
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Partsch H. Reliable self-application of short stretch leg compression: Pressure measurements under self-applied, adjustable compression wraps. Phlebology 2018; 34:208-213. [PMID: 30099955 DOI: 10.1177/0268355518793467] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM Self-application of properly performed compression bandages is generally considered as problematic. Therefore, the aim of this study was to measure the pressure of self-applied short stretch adjustable compression wrap compression systems (Juxta fit™) and to compare the results with the pressure achieved by bandaging other legs using the same material. METHODS In the two training courses for nurses, specifically interested in leg ulcer treatment, the new bandage type of adjustable compression wrap was explained and workshops were organized, in which the interface pressure achieved by Juxta fit™ was measured. In the first course, the nurses applied the compression system to each other, and in the second course, another group did it on their own legs. Bandagers were instructed to apply the system strongly, with a target range of more than 50-60 mmHg. RESULTS In the first course with mutual application ( n = 34), the median pressure at the medial lower leg was 58.5 mmHg (minimal 31, maximal value 137 mmHg), in the second course in which self-application was tested ( n = 36), the corresponding values were 61.5 mmHg (minimum 35, maximum 102 mmHg). No pressures less than 30 mmHg were seen on the distal calf in either group. CONCLUSIONS In contrast to short stretch bandages that are frequently applied by bandagers with too low pressure, the adjustable compression wrap devices handled by the patients themselves produce more appropriate and more consistent pressure.
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Affiliation(s)
- Hugo Partsch
- Department of Dermatology, Vienna Medical University, Vienna, Austria
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24
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Karanikolic V, Binic I, Jovanovic D, Golubovic M, Golubovic I, Djindjic N, Petrovic D. The effect of age and compression strength on venous leg ulcer healing. Phlebology 2017; 33:618-626. [PMID: 29262751 DOI: 10.1177/0268355517749112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives The aim of the study is to compare proportions of venous leg ulcers healed in patients treated with two different sub-bandage pressure values in relation to age. Methods The study included 102 outpatients with venous leg ulcers, one group with moderate compression pressure of 35-40 mmHg and the second with high pressure >45 mmHg. Each group was divided into two subgroups according to the age (≥65 vs. <65 years). Computerized planimetry was used to measure the size of the ulcers at 6, 12, 18 and 24 weeks. Results Kaplan-Maier analysis showed high pressure leads to higher proportion of healed venous leg ulcers, compared to moderate pressure, in patients aged ≥65 years (57.6% vs. 28%) and in patients <65 years (53.8% vs. 36%) (p < 0.05). Conclusion The study showed that higher compression pressure leads to higher proportions of venous leg ulcers healed, independent of age and could be safely preferred in older patients.
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Affiliation(s)
- Vesna Karanikolic
- 1 Dermatologic Clinic, Clinical Center Nis, Nis, Serbia.,2 Faculty of Medicine, University of Nis, Nis, Serbia
| | - Ivana Binic
- 1 Dermatologic Clinic, Clinical Center Nis, Nis, Serbia.,2 Faculty of Medicine, University of Nis, Nis, Serbia
| | - Dragan Jovanovic
- 1 Dermatologic Clinic, Clinical Center Nis, Nis, Serbia.,2 Faculty of Medicine, University of Nis, Nis, Serbia
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