Anpressdruck über sechs Wochen eines speziell für die Behandlung des venösen Ulkus entwickelten Kompressionsstrumpfes

VASA ◽  
2003 ◽  
Vol 32 (2) ◽  
pp. 87-90 ◽  
Author(s):  
Jünger ◽  
Häfner
Keyword(s):  
Compression Therapy ◽  
Pressure Profile ◽  
Mean Difference ◽  
Maximum Pressure ◽  
Compression Stocking ◽  
Class Iii ◽  
Interface Pressure ◽  
Working Pressure ◽  
Venous Ulcers ◽  
Compression Bandages

Background: The most important component in the treatment of venous ulcers is compression therapy. The function of compression therapy is the pressure exterted on the extrafascial and intrafascial venous system. Therefore the interface pressure of specially designed compressions stockings for the treatment of venous ulcers are in the focus of interest. Patients and methods: We examined 20 patients (6 men and 14 women) with chronic venous insufficiency in CEAP stages CS0-4EPAS1-3PR. Interface pressure was measured under the Venotrain® Ulcertec over an observation period of six weeks with piezoresistance sensors at four different sites on the lower leg and with the patient in different body positions. Results:Resting pressure supine at the ankle corresponded to compression class III and was constant over the period of six weeks (mean difference 2.8 SD 15.3 mmHg, p = 0.49). Working pressure explained as the quotient of maximum pressure during tiptoing/resting pressure in standing position was initially at the ankle 1.70 SD 0.44 and after 6 weeks 1.44 SD 0.29 (mean difference 0.27 SD 0.42, p < 0.03). Conclusions: The compression stocking maintained a therapeutically effective pressure profile over a period of six weeks. Working interface pressure was comparable to that of short-stretch compression bandages applied by an experienced bandager immediately after application.

scholarly journals Study of Three Interface Pressure Measurement Systems Used in the Treatment of Venous Disease

Sensors ◽  
2020 ◽  
Vol 20 (20) ◽  
pp. 5777
Author(s):  
Gayani K. Nandasiri ◽  
Arash M. Shahidi ◽  
Tilak Dias
Keyword(s):  
Pressure Measurement ◽  
Pressure Sensors ◽  
Compression Therapy ◽  
Pressure Profile ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Interface Pressure ◽  
Measurement Systems ◽  
Compression Bandages ◽  
Pressure Profiles

The aim of the publication is to report the accuracy, repeatability and the linearity of three commercially available interface pressure measurement systems employed in the treatment of venous disease. The advances in the treatment and management of chronic venous disease by compression therapy have led to considerable research interest in interface pressure measurement systems capable of measuring low-pressure ranges (10–60 mmHg). The application of a graduated pressure profile is key for the treatment of chronic venous disease which is achieved by using compression bandages or stockings; the required pressure profiles are defined in standards (BSI, RAL-GZ, or AFNOR) for different conditions. However, achieving the recommended pressure levels and its accuracy is still deemed to be a challenge. Thus, it is vital to choose a suitable pressure measurement system with high accuracy of interface pressure. The authors investigated the sensing performance of three commercially available different pressure sensors: two pneumatic based (AMI and PicoPress®) and one piezoresistive (FlexiForce®) pressure sensors, with extensive experimental work on their performance in terms of linearity, repeatability, and accuracy. Both pneumatic based pressure measurement systems have shown higher accuracy in comparison to the flexible piezoresistive pressure sensors.

Comparison of three pressure monitors used to measure interface pressure under compression bandages

2019 ◽  
Vol 35 (4) ◽  
pp. 262-267 ◽  
Author(s):  
Junjie Ning ◽  
John Fish ◽  
Felix Trinh ◽  
Jihad Abbas ◽  
Andrew Seiwert ◽  
...  
Keyword(s):  
Measurement Accuracy ◽  
Compression Therapy ◽  
Separate Experiment ◽  
Interface Pressure ◽  
Limits Of Agreement ◽  
Pressure Monitor ◽  
Compression Bandages ◽  
Measuring Devices ◽  
The Mean ◽  
User Friendly

Background Measuring the interface pressure produced by compression therapy devices is essential for research and clinical practice. New user-friendly measuring devices, such as Smart Sleeve Pressure Monitor (SSPM) and Juzo Pressure Monitor (JPM) allow longitudinal pressure measurement. However, their accuracy and agreement with well-established usage of the PicoPress (PP) are unknown. The aim of this study is to investigate measurement accuracy of PP, SSPM, and JPM. Methods The three devices were tested in 10 healthy volunteers by applying incrementally increasing pressure from 20 mm Hg to 50 mm Hg using a calibrated sphygmomanometer cuff. The linearity of the response and measurement accuracy were compared among the three devices. In a separate experiment, the three devices were compared by simultaneously recording the interface pressure under bandages immediately after bandaging and after 4 h of wearing the bandage. Results PP had the best performance with the reference of sphygmomanometer, while JPM had better linearity and accuracy than SSPM. The mean difference in the interface pressure under bandages was +13.36 mm Hg between SSPM and PP, and +0.50 mm Hg between JPM and PP. The 95% limits of agreement were −13.92 and +40.64 mm Hg, and −19.83 and +20.84 mm Hg, respectively. Conclusions JPM showed better agreement with both sphygmomanometer and PP compared to SSPM. JPM is a reasonable alternative for monitoring interface pressure continuously.

Compression for the management of venous leg ulcers: which material do we have?

2014 ◽  
Vol 29 (1_suppl) ◽  
pp. 140-145 ◽  
Author(s):  
Hugo Partsch
Keyword(s):  
Time Pressure ◽  
Wide Spectrum ◽  
Compression Therapy ◽  
Venous Hypertension ◽  
Leg Ulcers ◽  
Interface Pressure ◽  
Compression Stockings ◽  
Venous Leg Ulcers ◽  
Compression Bandages ◽  
Hybrid Devices

Compression therapy is the most important basic treatment modality in venous leg ulcers. The review focusses on the materials which are used: 1. Compression bandages, 2. Compression stockings, 3. Self-adjustable Velcro-devices, 4. Compression pumps, 5. Hybrid devices. Compression bandages, usually applied by trained staff, provide a wide spectrum of materials with different elastic properties. To make bandaging easier, safer and more effective, most modern bandages combine different material components. Self-management of venous ulcers has become feasible by introducing double compression stockings (“ulcer kits”) and self-adjustable Velcro devices. Compression pumps can be used as adjunctive measures, especially for patients with restricted mobility. The combination of sustained and intermittent compression (“hybrid device”) is a promising new tool. The interface pressure corresponding to the dosage of compression therapy determines the hemodynamic efficacy of each device. In order to reduce ambulatory venous hypertension compression pressures of more than 50 mm Hg in the upright position are desirable. At the same time pressure should be lower in the resting position in order to be tolerated. This prerequisite may be fulfilled by using inelastic, short stretch material including multicomponent bandages and cohesive surfaces, all characterized by high stiffness. Such materials do not give way when calf muscles contract during walking which leads to high peaks of interface pressure (“massaging effect”).

Stump-socket interface pressure as an aid to socket design in prostheses for trans-femoral amputees—a preliminary study

1997 ◽  
Vol 211 (2) ◽  
pp. 167-180 ◽  
Author(s):  
V S P Lee ◽  
S E Solomonidis ◽  
W D Spence
Keyword(s):  
Pressure Distribution ◽  
Pressure Profile ◽  
Load Cell ◽  
Maximum Pressure ◽  
Interface Pressure ◽  
Preliminary Study ◽  
Socket Interface ◽  
Lateral Walls ◽  
Distributed Pressure

A system for measuring the stump-socket interface pressure was designed and built using a strain gauged type load cell. The system was utilized to study the pressure distribution in the quadrilateral and ischial containment type sockets. Two volunteer trans-femoral amputees fitted with both types of socket participated in the experiments. Pressures were measured while the subjects were standing and during walking. The maximum pressure recorded for standing was 34 kPa and for walking 95 kPa. Comparison made between the two sockets indicated that higher pressures were recorded at the proximal brim of the quadrilateral socket whereas the ischial containment socket produces a more evenly distributed pressure profile. The pressure distribution on the medial and lateral walls of both types of sockets were similar but in the anterior and posterior walls, significant differences were noted. The results obtained from this study were compared with those found in published literature and the biomechanics of the two types of socket is discussed.

An Approach to Determine Pressure Profile Generated by Compression Bandage Using Quasi-Linear Viscoelastic Model

2012 ◽  
Vol 134 (9) ◽  
Author(s):  
Bipin Kumar ◽  
Apurba Das ◽  
R. Alagirusamy
Keyword(s):  
Viscoelastic Model ◽  
Compression Therapy ◽  
Pressure Profile ◽  
Relaxation Behavior ◽  
Model Parameters ◽  
Compression Bandage ◽  
Interface Pressure ◽  
Linear Viscoelastic ◽  
Linear Viscoelastic Model ◽  
Different Levels

Understanding the stress relaxation behavior of the compression bandage could be very useful in determining the behavior of the interface pressure exerted by the bandage on a limb during the course of the compression treatment. There has been no comprehensive study in the literature to investigate the pressure profile (interface pressure with time) generated by a compression bandage when applied at different levels of strain. The present study attempts to describe the pressure profile, with the use of a quasi-linear viscoelastic model, generated by a compression bandage during compression therapy. The quasi-linear viscoelastic (QLV) theory proposed by Fung (Fung, 1972, “Stress Strain History Relations of Soft Tissues in Simple Elongation,” Biomechanics: Its Foundations and Objectives, Y. C. Fung, N. Perrone, and M. Anliker, eds., Prentice-Hall, Englewood Cliffs, NJ, pp. 181–207). was used to model the nonlinear time- and history-dependent relaxation behavior of the bandage using the ramp strain approach. The regression analysis was done to find the correlation between the pressure profile and the relaxation behavior of the bandage. The parameters of the QLV model, describing the relaxation behavior of the bandage, were used to determine the pressure profile generated by the bandage at different levels of strain. The relaxation behaviors of the bandage at different levels of strain were well described by the QLV model parameters. A high correlation coefficient (nearly 0.98) shows a good correlation of the pressure profile with the stress relaxation behavior of the bandage.The prediction of the pressure profile using the QLV model parameters were in agreement with the experimental data. The pressure profile generated by a compression bandage could be predicted using the QLV model describing the nonlinear relaxation behavior of the bandage. This new application of the QLV theory helps in evaluating the bandage performance during compression therapy as scientific wound care management.

Lymphedema and lipedema - an overview of conservative treatment

VASA ◽  
2011 ◽  
Vol 40 (4) ◽  
pp. 271-279 ◽  
Author(s):  
Wagner
Keyword(s):  
Conservative Treatment ◽  
General Practitioners ◽  
Subcutaneous Tissue ◽  
Compression Therapy ◽  
Compression Stocking ◽  
Lymph Drainage ◽  
Intensive Phase ◽  
Manual Lymph Drainage ◽  
Causal Therapy

Lymphedema and lipedema are chronic progressive disorders for which no causal therapy exists so far. Many general practitioners will rarely see these disorders with the consequence that diagnosis is often delayed. The pathophysiological basis is edematization of the tissues. Lymphedema involves an impairment of lymph drainage with resultant fluid build-up. Lipedema arises from an orthostatic predisposition to edema in pathologically increased subcutaneous tissue. Treatment includes complex physical decongestion by manual lymph drainage and absolutely uncompromising compression therapy whether it is by bandage in the intensive phase to reduce edema or with a flat knit compression stocking to maintain volume.

The treatment of venous leg ulcers with a specifically designed compression stocking kit

Phlebologie ◽  
2008 ◽  
Vol 37 (04) ◽  
pp. 191-197 ◽  
Author(s):  
V. Mattaliano ◽  
G. Mosti ◽  
V. Gasbarro ◽  
M. Bucalossi ◽  
W. Blättler ◽  
...  
Keyword(s):  
Patient Characteristics ◽  
Compression Stocking ◽  
Leg Ulcers ◽  
Compression Stockings ◽  
Venous Leg Ulcers ◽  
Venous Ulcers ◽  
Time To Completion ◽  
Validated Questionnaire ◽  
First Choice ◽  
Ankle Movement

SummaryTraditionally, venous leg ulcers are treated with firm nonelastic bandages. Medical compression stockings are not the first choice although comparative studies found them equally effective or superior to bandages. Patients, methods: We report on a multi-center randomized trial with 60 patients treated with either short stretch multi-layer bandages or a two-stocking system (Sigvaris® Ulcer X® kit). Three patients have been excluded because their ankle movement was restricted to the extent that they could not put on the stockings and 1 patient withdrew consent. Patient characteristics and ulcer features were evenly distributed. The proportion of ulcers healed within 4 months and the time to completion of healing were recorded. Subjective appraisal was assessed with a validated questionnaire. Results: Complete wound closure was achieved in 70.0% (21 of 30) with bandages and in 96.2% (25 of 26) with the ulcer X kit (p = 0.011). Ulcers with a diameter of up to about 4cm healed twice as rapidly, the larger ones as fast with the stocking kit as with bandages. The sum of problems encountered with bandages was significantly greater than that observed with the stocking kit (p < 0.0001). Pain at night and in the morning was absent with stockings but reported by 40% and 20% in the bandage group, respectively. The cardinal features associated with delayed or absent healing were ulcer size and pain. Conclusions: Common venous ulcers can readily be treated with the ulcer X compression kit provided the ankle movement allow its painless donning. Bandages, even when applied by the most experienced staff are less effective and cause more problems.

Healing venous ulcers with different modalities of leg compression

Phlebologie ◽  
2006 ◽  
Vol 35 (05) ◽  
pp. 349-355 ◽  
Author(s):  
E. O. Brizzio ◽  
G. Rossi ◽  
A. Chirinos ◽  
I. Cantero ◽  
G. Idiazabal ◽  
...  
Keyword(s):  
Wound Care ◽  
Univariate Analysis ◽  
Compression Therapy ◽  
Healing Time ◽  
Clinical Parameters ◽  
Compression Stockings ◽  
Local Pressure ◽  
Ulcer Size ◽  
Venous Ulcers ◽  
Unexpected Findings

Summary Background: Compression therapy (CT) is the stronghold of treatment of venous leg ulcers. We evaluated 5 modalities of CT in a prospective open pilot study using a unique trial design. Patients and methods: A group of experienced phlebologists assigned 31 consecutive patients with 35 venous ulcers (present for 2 to 24 months with no prior CT) to 5 different modalities of leg compression, 7 ulcers to each group. The challenge was to match the modality of CT with the features of the ulcer in order to achieve as many healings as possible. Wound care used standard techniques and specifically tailored foam pads to increase local pressure. CT modalities were either stockings Sigvaris® 15-20, 20-30, 30-40 mmHg, multi-layer bandages, or CircAid® bandaging. Compression was maintained day and night in all groups and changed at weekly visits. Study endpoints were time to healing and the clinical parameters predicting the outcome. Results: The cumulative healing rates were 71%, 77%, and 83% after 3, 6, and 9 months, respectively. Univariate analysis of variables associated with nonhealing were: previous surgery, presence of insufficient perforating and/or deep veins, older age, recurrence, amount of oedema, time of presence of CVI and the actual ulcer, and ulcer size (p <0.05-<0.001). The initial ulcer size was the best predictor of the healing-time (Pearson r=0.55, p=0.002). The modality of CT played an important role also, as 19 of 21 ulcers (90%) healed with stockings but only 8 of 14 with bandages (57%; p=0.021). Regression analysis allowed to calculate a model to predict the healing time. It compensated for the fact that patients treated with low or moderate compression stockings were at lower risk of non-healing. and revealed that healing with stockings was about twice as rapid as healing with bandages. Conclusion: Three fourths of venous ulcers can be brought to healing within 3 to 6 months. Healing time can be predicted using easy to assess clinical parameters. Irrespective of the initial presentation ulcer healing appeared more rapid with the application of stockings than with bandaging. These unexpected findings contradict current believes and require confirmation in randomised trials.

Radiofrequency ablation for markedly incompetent perforators versus compression therapy in the management of post-phelebtic venous ulcers: A randomized controlled trial

Vascular ◽  
2021 ◽  
pp. 170853812110100
Author(s):  
Mohamed Shukri Abdelgawad ◽  
Amr M El-Shafei ◽  
Hesham A Sharaf El-Din ◽  
Ehab M Saad ◽  
Tamer A Khafagy ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Radiofrequency Ablation ◽  
Controlled Trial ◽  
Compression Therapy ◽  
Randomized Controlled ◽  
Venous Ulcers ◽  
Group A ◽  
Group B ◽  
To Receive

Background Venus ulcers developed mainly due to reflux of incompetent venous valves in perforating veins. Patients and methods In this randomized controlled trial, 119 patients recruited over two years, with post-phelebtic venous leg ulcers, were randomly assigned into one of two groups: either to receive radiofrequency ablation of markedly incompetent perforators (Group A, n = 62 patients) or to receive conventional compression therapy (Group B, n = 57 patients). Follow-up duration required for ulcer healing continued for 24 months post randomization. Results Statistically significant shorter time to healing (ulcer complete healing or satisfactory clinical improvement) between both groups (56 patients, 90.3% of cases in Group A versus 44 patients 77.2% of cases in Group B) over the follow-up period of 24 months was attained ( p  = 0.001). Also, significantly different ulcer recurrence was recorded between both groups, 8 patients (12.9%) in Group A versus 19 patients (33.3%) in Group B ( p = 0.004). Conclusion In absence of deep venous obstruction, the monopolar radiofrequency ablation for incompetent perforators is a feasible and effective method that surpasses the traditional compression protocol for incompetent perforator-induced venous ulcers in terms of time required for healing even in the presence of unresolved deep venous valvular reflux.

scholarly journals Inlay-Retained Dental Bridges—A Finite Element Analysis

2021 ◽  
Vol 11 (9) ◽  
pp. 3770
Author(s):  
Monica Tatarciuc ◽  
George Alexandru Maftei ◽  
Anca Vitalariu ◽  
Ionut Luchian ◽  
Ioana Martu ◽  
...  
Keyword(s):  
Finite Element ◽  
Young Patients ◽  
Maximum Pressure ◽  
Class Iii ◽  
Element Analysis ◽  
Dental Prostheses ◽  
Abutment Teeth ◽  
Fixed Dental Prostheses ◽  
Implant Therapy ◽  
The Stability

Inlay-retained dental bridges can be a viable minimally invasive alternative when patients reject the idea of implant therapy or conventional retained full-coverage fixed dental prostheses, which require more tooth preparation. Inlay-retained dental bridges are indicated in patients with good oral hygiene, low susceptibility to caries, and a minimum coronal tooth height of 5 mm. The present study aims to evaluate, through the finite element method (FEM), the stability of these types of dental bridges and the stresses on the supporting teeth, under the action of masticatory forces. The analysis revealed the distribution of the load on the bridge elements and on the retainers, highlighting the areas of maximum pressure. The results of our study demonstrate that the stress determined by the loading force cannot cause damage to the prosthetic device or to abutment teeth. Thus, it can be considered an optimal economical solution for treating class III Kennedy edentation in young patients or as a provisional pre-implant rehabilitation option. However, special attention must be paid to its design, especially in the connection area between the bridge elements, because the connectors and the retainers represent the weakest parts.

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