Do we still need compression bandages? Haemodynamic effects of compression stockings and bandages

Objective: To compare haemodynamic data obtained with elastic compression stockings and inelastic compression material applied with different pressure ranges on the lower extremities. Methods: Haemodynamic effects of compression therapy were demonstrated by measuring venous flow velocity, venous volume, venous reflux and venous pumping function using radioisotopes, phlebography, water displacement volumetry, duplex, air plethysmography, foot volumetry and phlebodynamometry. Results: Light-compression stockings are able to increase venous blood flow velocity in the supine position and to prevent leg swelling after prolonged sitting and standing. In the upright position an interface pressure of more than 50 mmHg is needed for an intermittent occlusion of incompetent veins and for a reduction of ambulatory venous hypertension during walking. Such high interface pressures may rather be achieved by short-stretch, multilayer bandages than by an elastic stocking. Conclusion: Elastic compression stockings exerting interface pressures up to 40 mmHg are effective in preventing or reducing oedema. Multilayer compression bandages with a pressure over 40 mmHg additionally improve severely disturbed venous pumping function.

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