Do we still need compression bandages? Haemodynamic effects of compression stockings and bandages

Abstract

Objective: To compare haemodynamic data obtained with elastic compression stockings and inelastic compression material applied with different pressure ranges on the lower extremities. Methods: Haemodynamic effects of compression therapy were demonstrated by measuring venous flow velocity, venous volume, venous reflux and venous pumping function using radioisotopes, phlebography, water displacement volumetry, duplex, air plethysmography, foot volumetry and phlebodynamometry. Results: Light-compression stockings are able to increase venous blood flow velocity in the supine position and to prevent leg swelling after prolonged sitting and standing. In the upright position an interface pressure of more than 50 mmHg is needed for an intermittent occlusion of incompetent veins and for a reduction of ambulatory venous hypertension during walking. Such high interface pressures may rather be achieved by short-stretch, multilayer bandages than by an elastic stocking. Conclusion: Elastic compression stockings exerting interface pressures up to 40 mmHg are effective in preventing or reducing oedema. Multilayer compression bandages with a pressure over 40 mmHg additionally improve severely disturbed venous pumping function.

Influence of Different Materials in Multicomponent Bandages on Pressure and Stiffness of the Final Bandage

“…An ideal compression bandage would exert a low and tolerable pressure in the supine position and a high pressure in the standing and walking position counteracting the hydrostatic intravenous pressure. As we know from several experiments, venous narrowing of leg veins may be achieved in the supine position by an external pressure of about 15 mmHg, while in the standing position a pressure of around 40 mmHg is necessary 1,2 …”

“…Interface pressure and stiffness are the deciding characteristics of a bandage. High interface pressure influences venous hemodynamics by narrowing or even occluding the venous lumen thereby reducing venous reflux 1–4 . Stiffness characterizes the distensibility of a textile.…”

“…High interface pressure influences venous hemodynamics by narrowing or even occluding the venous lumen thereby reducing venous reflux. [1][2][3][4] Stiffness characterizes the distensibility of a textile. An inelastic bandage has a high stiffness, when compared with an elastic bandage.…”

Relevance of stiffness of compression material on venous hemodynamics and edema

“…In particular compression has been proven effective in reducing venous volume, reflux, venous pumping function, edema and, consequently, ambulatory venous hypertension. [2][3][4][5][6][7][8] Compression may be applied to the leg by different materials: elastic stockings, elastic and inelastic bandages, and/or velcro-banddevices. The main differences between these materials are the exerted pressure and the elastic properties which can influence their hemodynamic effects.…”

Advanced textiles for wound compression

“…18 In a further study, Partsch 19 compared the different haemodynamic effects that are achieved when using compression stockings and compression bandages. Initial narrowing of the veins occurred at a pressure of 30-40 mm Hg in both the sitting and standing positions and complete occlusion occurred at 20-25 mm Hg (supine position), 50-60 mm Hg (sitting position), and at 70 mm Hg (standing position).…”