Cutaneous vasomotion in patients with chronic venous insufficiency and the influence of compression therapy

Abstract

We investigated in patients with chronic venous insufficiency (CVI) and after compression therapy the fluxmotion within characteristic frequency bands, which were described earlier by Bračič and Stefanovska (Bull. Math. Biol. 60 (1998), 919-935).Therefore, the frequency spectra of laser Doppler flux data of the 36 patient's legs were compared with 41 legs of healthy subjects. In addition, 14 patients with CVI wore a compression stocking (interface pressure: 25-32 mmHg) or compression bandages and were measured after 4 weeks therapy. Data were analyzed by means of a Wavelet packet transformation (a combination of the Daubechies filter of order 4 and the Haar filter).We found significant differences between the patients and the healthy subjects in the frequency intervals of myogenic 0.06-0.16 Hz, respiratory 0.16-0.6 Hz and heart activity 0.6-1.6 Hz (p < 0.05, Mann-Whitney U test). Furthermore, the main energy peak height in these frequency intervals increased with the severity of venous disease and was highest in patients with venous leg ulceration. Compression therapy had a significant influence in myogenic vessel activity, which has been proved by a positive frequency shift of 20% (p = 0.007, one-sided by the exact Wilcoxon test).In venous disease fluxmotion was increased. Compression therapy over a period of 4 weeks improved myogenic vessel activity.

Efficacy of subcutaneous lidocaine injection in venous insufficiency: a prospective, randomized, controlled study, and new treatment protocol

“…Among patients with CVI, edema accumulates around the muscle and bone as much as it accumulates in subcutaneous adipose tissues and the skin 31 ) . Since subcutaneous lidocaine injection can resolve edema in the subcutaneous adipose tissue and intradermal edema, measurement of the leg circumference could have been used to assess the success of treatment.…”

Effects of Intermittent Pneumatic Compression on Reduction of Postoperative Lower Extremity Edema and Normalization of Foot Microcirculation Flow in Patients Undergoing Arterial Revascularization

“…The smallest changes were observed when IPC was applied to the foot only. However, an increase in flow was observed when calf compression was applied, particularly when foot compression and calf compression were applied simultaneously [ 15 – 18 ]. In our study protocol the foot IPC was applied – in the further studies, the calf length IPC in the same treatment model should be evaluated.…”

Safety and Efficacy of Mild Compression (18–25 mm Hg) Therapy in Patients with Diabetes and Lower Extremity Edema

“…37 Measurement of toe pulsation to detect macrocirculation and laser Doppler flowmetry to assess microcirculation of the dermal capillary system all demonstrated positive effects on the capillary system after two weeks of compression therapy 38 and may have significant positive effects on overall microperfusion. 39 Limitations of the study include the small sample size, the inability to ensure patient compliance to wearing the diabetic compression socks, human imprecision with girth measurements, the inability to have all patients assessed at the same time of day, and that the ABI was the primary evaluation for LE vascularity. While the ABI remains one of the cornerstones of the assessment process aimed at reducing bandage-pressure damage and is recommended by the American Diabetes Association Consensus as an initial assessment of vascularity in patients with diabetes, its accuracy can be affected by variations in systolic pressure and calcifications of the vessels commonly seen in patients with diabetes.…”