Innovation in compression: smart bandage technology to improve bandage application and monitoring

Although high compression delivered by elastic bandages or hosiery is widely accepted as the standard first line care for patients with venous disease but without significant arterial impairment1-6 the application of bandages in particular is subject to significant variation. In most cases the interface pressure, effectively the compression dose, is not accurately known and is likely to be different from the ideal graduated compression intended on application.7,8 Furthermore, as the dimensions of the affected limb change under the influence of external compression, the interface pressure changes (REF).1 Variability in the application and sustainability of interface pressure is likely to lead to variable clinical efficacy, for example, healing rates. Indeed, the healing rates reported for VLU vary considerably.9-19 Technical solutions to variability in application of bandages include printed ovals or rectangles that change to circles or squares at the correct bandage extension; markings on orthostatic devices that are matched to a scale; bandage application at full stretch. Direct measurement of interface pressure may be used on application and for monitoring20 but pressure is usually measured at only one anatomic location. Despite these solutions bandage application remains variable, and the application of reduced compression by reduced stretch in the presence of arterial impairment is largely semiquantitative at best.