Simultaneous changes of leg circumference and interface pressure under different compression bandages.

OBJECTIVES To assess the validity of measuring changes of sub bandage pressure and leg circumference in different body positions for an in vivo characterization of the elastic properties of bandage systems. DESIGN Experimental study. MATERIALS AND METHODS Different compression bandages were applied on the leg. The variations of interface pressure and leg circumference above the inner ankle (that depends on the elastic property of the bandage) were measured simultaneously by a pressure transducer and by strain-gauge plethysmography in 50 patients. Stiffness is defined as the increase of pressure per increase of circumference. RESULTS The most consistent parameter to differentiate elastic from inelastic bandages was the pressure-difference between the standing and the lying position corrected for the actual increase of leg circumference (modified static stiffness index, mSSI; sensitivity and specificity 100%). Neglecting the individual changes of the circumference and considering the pressure difference alone allows a differentiation which is slightly less accurate (sensitivity 100%, specificity 88%) but much simpler to use. CONCLUSIONS The static stiffness index is a useful tool to differentiate elastic from inelastic bandage material even without correction for the individual increase of leg circumference.

[1]  H Partsch,et al.  The use of pressure change on standing as a surrogate measure of the stiffness of a compression bandage. , 2005, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[2]  M. Hirai The effect of posture and exercise on elastic stocking compression at different sites of the leg. , 1999, VASA. Zeitschrift fur Gefasskrankheiten.

[3]  H. Partsch,et al.  Improvement of Ambulatory Venous Hypertension by Narrowing of the Femoral Vein in Congenital Absence of Venous Valves , 1992 .

[4]  R. Spence,et al.  Inelastic versus elastic leg compression in chronic venous insufficiency: a comparison of limb size and venous hemodynamics. , 1996, Journal of vascular surgery.

[5]  M. Jünger,et al.  Interface pressure under a ready made compression stocking developed for the treatment of venous ulcers over a period of six weeks. , 2003, VASA. Zeitschrift fur Gefasskrankheiten.

[6]  M. Clark,et al.  Measurement of Lower Leg Compression In Vivo: Recommendations for the Performance of Measurements of Interface Pressure and Stiffness , 2006, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[7]  P. Nelemans,et al.  The Effect of Medical Elastic Compression Stockings with Different Slope Values on Edema: Measurements Underneath Three Different Types of Stockings , 2000, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[8]  Hugo Partsch,et al.  Calf compression pressure required to achieve venous closure from supine to standing positions. , 2005, Journal of vascular surgery.

[9]  M. Jünger,et al.  The ratio of working pressure to resting pressure under compression stockings: Its significance for the improvement of venous perfusion in the legs , 2001, Phlebologie.

[10]  R. STOLK,et al.  A Method for Measuring the Dynamic Behavior of Medical Compression Hosiery during Walking , 2004, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[11]  H. Partsch,et al.  Does thigh compression improve venous hemodynamics in chronic venous insufficiency? , 2002, Journal of vascular surgery.

[12]  Hugo Partsch,et al.  The Static Stiffness Index: A Simple Method to Assess the Elastic Property of Compression Material In Vivo , 2005, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[13]  A. Mostbeck,et al.  Inelastic leg compression is more effective to reduce deep venous refluxes than elastic bandages. , 1999, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[14]  H. Partsch [Improving the venous pumping function in chronic venous insufficiency by compression as dependent on pressure and material]. , 1984, VASA. Zeitschrift fur Gefasskrankheiten.

[15]  G. Burg,et al.  A comparison of multilayer bandage systems during rest, exercise, and over 2 days of wear time. , 2000, Archives of dermatology.

[16]  M. Hirai,et al.  Changes in Interface Pressure under Elastic and Short-Stretch Bandages during Posture Changes and Exercise , 1998 .