Graded compression stockings in elective orthopaedic surgery

Best, Alistair; Williams, S.; Crozier, A.; Bhatt, Raj; Gregg, P. J.; Hui, AC

doi:10.1302/0301-620x.82b1.9694

Cited by 50 publications

(15 citation statements)

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“…In this study, we found that not all tested compression stockings have the claimed pressure gradients, which agrees with the results from other studies. 17,25,26 Although all tested GCSs exerted the negative pressure gradients from ankle to thigh level, the calf pressures applied by some GCSs with moderate and high pressure classes were 88.1 to 93.3% of their ankle pressures, which was much higher than the specifications of the European standards. This could be related to a number of factors.…”

Section: Pressure Gradientsmentioning

confidence: 85%

“…This might be one of the reasons for recurrence of venous ulceration even if the patients did wear their elastic compression stockings. 16,17 In recent studies, Best and colleagues found that 98% of the compression stockings tested failed to produce the ideal pressure gradient and more than half produced a tourniquet effect, which was associated with a significantly higher incidence of deep venous thrombosis. 17 Meanwhile, the exact mechanisms of action of GCSs remain controversial, if not unclear.…”

Section: The Research Grant Council Provided Funding For This Researcmentioning

confidence: 99%

“…16,17 In recent studies, Best and colleagues found that 98% of the compression stockings tested failed to produce the ideal pressure gradient and more than half produced a tourniquet effect, which was associated with a significantly higher incidence of deep venous thrombosis. 17 Meanwhile, the exact mechanisms of action of GCSs remain controversial, if not unclear. [18][19][20][21][22] Obviously, it is necessary to examine and quantify the distribution and magnitude of pressure applied by stockings to ensure pressure comfort and medical function.…”

Section: The Research Grant Council Provided Funding For This Researcmentioning

confidence: 99%

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Objective Evaluation of Skin Pressure Distribution of Graduated Elastic Compression Stockings

Liu

Kwok

et al. 2005

Dermatologic Surgery

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BACKGROUND. The beneficial effects of graduated elastic compression stockings (GCSs) have been demonstrated. However, their pressure performances are variable and unstable in practical applications owing to many influencing factors. Comprehensive assessment of skin pressure profiles may help elucidate the mechanisms of action of compression stockings.OBJECTIVE. The objective of this study was to quantify and objectively evaluate the magnitude and distribution of skin pressure applied by different GCSs and to analyze the possible reasons influencing the stocking pressure performances.METHODS. Six healthy females were required to wear eight kinds of GCSs with different pressure levels while standing upright. The skin pressures of 16 different positions located in four heights and four directions of the lower limb were measured and recorded by FlexiForce interface pressure sensors (Tekscan, Inc., Boston, MA, USA) and a multichannel measuring system. RESULTS. The pressure gradients, pressure levels, and testing locations significantly influenced skin pressure (p < .001). All tested GCSs exerted the highest pressure at the ankle region, and the pressure gradually decreased toward the thigh, which follows the gradient design of GCSs. However, many of them failed to produce the perfect pressure gradients from the ankle region to the calf region. Obviously, reversed pressure gradients occurred in the medial side of the leg, where the pressure at the ankle region was lower than that on the prominent part of the calf by 36% on average. GCSs with higher pressure levels applied higher skin pressure on the lower limb. The pressure at the anterior side was far higher than that in the medial and lateral directions. The distribution patterns of skin pressure at transverse sections were similar to the anatomic outlines of cross sections of the leg. The measured average ankle pressure of all tested GCSs did not reach the pressures specified by the manufacturers. CONCLUSION. Skin pressure distributions and magnitudes applied by GCSs were significantly influenced by the locations of testing points in terms of height and direction, which are determined by the specific anatomic structure and body shape of individual human legs and potentially influenced by the pressure sensor and testing methods.

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Section: Pressure Gradientsmentioning

confidence: 85%

Section: The Research Grant Council Provided Funding For This Researcmentioning

confidence: 99%

Section: The Research Grant Council Provided Funding For This Researcmentioning

confidence: 99%

See 1 more Smart Citation

Objective Evaluation of Skin Pressure Distribution of Graduated Elastic Compression Stockings

Liu

Kwok

et al. 2005

Dermatologic Surgery

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show abstract

“…On the other hand, excessive ankle interface pressures could cause skin necrosis and thrombosis. [7][8][9] In the international literature, a large range of pressures are reported to be effective. Lower pressures (10-30 mmHg) are said to be sufficient after sclerotherapy of telangiectasias, in symptomatic varicose veins including those associated with pregnancy, and for the prevention of edema and deep venous thrombosis.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 Band-like constrictions due to compression therapy can increase the risk of deep vein thrombosis. 9 Whereas the quality of a compression bandage depends on the experience and skill of the bandager, 10 patients should be able to easily use optimally fitted compression stockings, which should always exert their effects optimally on the affected leg.…”

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confidence: 99%