Publication search

BACKGROUND

Pressure loss under short-stretch bandages (SSBs) is a well-known phenomenon and is thought to be related to bandage relaxation and poor quality of application.

AIM

The aim was to demonstrate that therapeutically intended volume reduction of the compressed leg is the most important cause for the loss of bandage pressure.

DESIGN

This was an experimental, controlled comparative study.

METHODS

In 20 patients suffering from lymphedema of the lower extremities and in 9 healthy persons, lower leg volume was measured by water displacement. After application of a pressure measurement device (Kikuhime) at the B1 region, SSBs were applied on one leg according to a standard protocol. Volume and pressure measurements were performed at 0, 2, and 24 hours in supine as well as standing positions.

RESULTS

A significant reduction of leg volume is already achieved 2 hours after bandage application, both in lymphedema patients and in normal controls. A further volume decrease of the lymphedematous legs is observed in the following 24 hours after application of a new bandage (-290 mL). The volume reduction is associated with a significant loss of bandage pressure from initial values over 60 mmHg by 37 and 48% in controls and lymphedema patients, respectively.

CONCLUSIONS

Inelastic, multilayer, multicomponent compression bandages lead to an immediate reduction of leg volume, both in lymphedematous and in normal legs. This therapeutically intended volume reduction seems to be the main reason for the fast decrease of the subbandage pressure. This study was supported by Lohmann & Rauscher, Ltd. Germany.

INTRODUCTION

Chronic venous insufficiency (CVI) is a venous disorder in the lower extremities associated with changes in the skin and subcutaneous tissue. Treatment with short-stretch compression bandages is highly recommended for advanced stages of CVI.

METHODS

The compression systems Rosidal Sys, Porelast, Coban, and Proguide were evaluated in 4 groups of mobile and active patients (n = 18) with CVI stage II or III. Sub-bandage pressures at point B1 were measured in the upright and supine positions 30 min and 12 h after the bandage was applied. Average pressures and values of the static stiffness index (SSI) were calculated for each group.

RESULTS

The Porelast, Rosidal Sys and Coban systems had SSI values in excess of 10 mmHg, 30 min and 12 h after application. The corresponding values for Proguide were below 10 mmHg.

CONCLUSION

Porelast, Rosidal Sys and Coban are very stiff systems, whereas Proguide is more similar to long-stretch compression bandages with a lower degree of stiffness.