Impact of multilayered compression bandages on sub-bandage interface pressure: a model

2011 ◽  
Vol 26 (2) ◽  
pp. 75-83 ◽  
Author(s):  
J Al Khaburi ◽  
E A Nelson ◽  
J Hutchinson ◽  
A A Dehghani-Sanij
Keyword(s):  
Mathematical Model ◽  
Thick Wall ◽  
Compression Bandage ◽  
Leg Ulcers ◽  
Interface Pressure ◽  
Venous Leg Ulcers ◽  
Compression Bandages ◽  
Thick Cylinder ◽  
The Difference ◽  
Interface Pressures

Background Multi-component medical compression bandages are widely used to treat venous leg ulcers. The sub-bandage interface pressures induced by individual components of the multi-component compression bandage systems are not always simply additive. Current models to explain compression bandage performance do not take account of the increase in leg circumference when each bandage is applied, and this may account for the difference between predicted and actual pressures. Objective To calculate the interface pressure when a multi-component compression bandage system is applied to a leg. Method Use thick wall cylinder theory to estimate the sub-bandage pressure over the leg when a multi-component compression bandage is applied to a leg. Results A mathematical model was developed based on thick cylinder theory to include bandage thickness in the calculation of the interface pressure in multi-component compression systems. In multi-component compression systems, the interface pressure corresponds to the sum of the pressures applied by individual bandage layers. However, the change in the limb diameter caused by additional bandage layers should be considered in the calculation. Adding the interface pressure produced by single components without considering the bandage thickness will result in an overestimate of the overall interface pressure produced by the multi-component compression systems. At the ankle (circumference 25 cm) this error can be 19.2% or even more in the case of four components bandaging systems. Conclusion Bandage thickness should be considered when calculating the pressure applied using multi-component compression systems.

Venous Leg Ulcer Healing: A Randomized Prospective Study of Long-Stretch versus Short-Stretch Compression Bandages

1998 ◽  
Vol 13 (2) ◽  
pp. 59-63 ◽  
Author(s):  
L. Danielsen ◽  
S. M. Madsen ◽  
L. Henriksen
Keyword(s):  
Ulcer Healing ◽  
Venous Ulcer ◽  
Positive Influence ◽  
Compression Bandage ◽  
Leg Ulcers ◽  
Venous Leg Ulcer ◽  
Venous Leg Ulcers ◽  
Area Reduction ◽  
Compression Bandages ◽  
Table Analysis

Objective: To compare the efficacy of a long-stretch bandage with that of a short-stretch compression bandage. Design: Prospective evaluation of healing of venous leg ulcers in blindly randomized groups of patients. Setting: Bispebjerg Hospital, Copenhagen, Denmark. Patients: Forty-three patients with venous leg ulcers were included. Forty legs in 40 patients were evaluated at 1 month (34 patients), 6 months (32 patients) or 12 months (27 patients). Interventions: Both types of bandage were used at a width of 10 cm and applied using the same spiral bandaging technique. Main outcome measures: Ulcer healing and ulcer area reduction. Results: Healed ulcers after 1 month were observed in 27% of the long-stretch group and in 5% of the short-stretch group ( p = 0.15); after 6 months the corresponding figures were 50% and 36% ( p = 0.49) and after 12 months 71% and 30% ( p = 0.06). Using life-table analysis the predicted healing rate in the long-stretch group after 12 months was 81% and for the short-stretch group 31% ( p = 0.03). The mean of relative ulcer areas at 1 month was 0.45 for the long-stretch group and 0.72 for the short-stretch group ( p = 0.07), at 6 months the corresponding figures were 0.81 and 0.60 ( p = 0.25) and at 12 months 0.25 and 0.95 ( p = 0.01). Conclusions: The present study appears to indicate a Positive influence of the elasticity of a compression bandage on venous ulcer healing.

Impact of variation in limb shape on sub-bandage interface pressure

2010 ◽  
Vol 26 (1) ◽  
pp. 20-28 ◽  
Author(s):  
J Al Khaburi ◽  
E A Nelson ◽  
J Hutchinson ◽  
A A Dehghani-Sanij
Keyword(s):  
Mathematical Model ◽  
Muscle Activity ◽  
Dynamic Pressure ◽  
Dynamic Stiffness ◽  
Calf Muscle ◽  
Stiffness Index ◽  
Thick Wall ◽  
Cylinder Wall ◽  
Interface Pressure ◽  
Compression Bandages

Background Sub-bandage interface pressure generated by medical compression bandages (MCB) and hosiery changes in mobile patients as they move due to the change in the limb size. However, the amount of variation in the interface pressure is dependent on the stiffness of the compression material. Researchers have proposed several indices to describe this change in interface pressure, including the static stiffness index (SSI) and the dynamic stiffness index (DSI). These indices can also be used to classify compression products. Objectives To explore the different proposed indices to describe the stiffness of a compression material and compare it to the engineering stress-strain modulus which is used for the same purpose; To estimate theoretically the change in the interface pressure which is caused by the change in the limb shape as a consequence of calf muscle activity and the associated transient variation in limb dimensions. Method Use Chord modulus to classify compression material; Use thin and thick cylinder wall theory to estimate the variation in the interface pressure due to changes in the limb shape secondary to muscle contraction; Use tensile test devices to obtain the Chord modulus for two different MCB at two different dynamic ranges. Results Chord modulus (E) describes the change in tension in a dynamic situation, and this is labelled as stiffness in the bandaging literature; Chord modulus, with the help of a mathematical model that was developed based on thick wall cylinder theory, can be used to predict the change in sub-bandage interface pressure caused by the change in limb shape secondary to calf muscle activity; Chord modulus can be used to classify bandages and describe how they will behave when they are applied to a leg. Conclusion The dynamic pressure can be predicted using a simple mathematical model using Chord modulus, which can be calculated in vitro using standard tensile testing equipment. In addition, Chord modulus can be used to classify compression bandages and hosiery.

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”).

Prospective Comparison of Healing Rates and Therapy Costs for Conventional and Four-Layer High-Compression Bandaging Treatments of Venous Leg Ulcers

1998 ◽  
Vol 13 (1) ◽  
pp. 20-24 ◽  
Author(s):  
A. D. Taylor ◽  
R. J. Taylor ◽  
R. W. Marcuson
Keyword(s):  
Treatment Costs ◽  
Leg Ulcers ◽  
Treatment Groups ◽  
Venous Leg Ulcers ◽  
Compression Bandaging ◽  
High Compression ◽  
Prospective Comparison ◽  
Weekly Treatment ◽  
Prescription Form ◽  
The Difference

Objective: To compare healing rates and associated treatment costs of four-layer high-compression bandaging (HCB) and conventional management (CM), as available on FP10, in the treatment of venous leg ulcers. Design: Randomized prospective study in which patients were allocated to one of two treatment groups. Setting: Hospital-based leg ulcer service and community. Patients: Thirty-six patients presenting with venous leg ulcers (30 compilers): 16 patients (nine female) in the HCB group and 14 patients (10 female) in the CM group. Interventions: A 12-week treatment period with either a four-layer HCB regime or CM. Main outcome measures: The significance of the difference between the number of ulcers healed, and associated treatment costs, was investigated using the Mann–Whitney U-test and survival analysis. Results: Four-layer HCB achieves a significantly ( p = 0.003) higher healing rate of ulcers (75% of patients versus 21%) over a 12-week period. Weekly treatment costs for the four-layer therapy was significantly less than that of CM (mean difference in cost = £6.45, 95% CI = £1.22–11.68; p = 0.042). Conclusion: It is more efficacious and economical for nurse specialists to treat patients presenting with leg ulcers with a four-layer HCB regime than for district nurses to carry out the standard palliative treatments available on GP prescription form FP10.

New single-layer compression bandage system for chronic venous leg ulcers

2009 ◽  
Vol 18 (Sup5) ◽  
pp. S4-S18 ◽  
Author(s):  
Gillian A Lee ◽  
Subbiyan Rajendran ◽  
Subhash Anand
Keyword(s):  
Single Layer ◽  
Compression Bandage ◽  
Leg Ulcers ◽  
Venous Leg Ulcers

Which venous leg ulcers will heal with limb compression bandages?

2000 ◽  
Vol 109 (1) ◽  
pp. 15-19 ◽  
Author(s):  
David J Margolis ◽  
Jesse A Berlin ◽  
Brian L Strom
Keyword(s):  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Compression Bandages ◽  
Limb Compression
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