On the Treatment of Ulcers of the Leg without Rest

A high‐resolution tape sensor improves the accuracy of applied pressure profiles during lower‐leg bandaging – results from a study using a fibre‐optic sensing tape

“…• we observed that, on average, the pressure gradient achieved by practitioners in blinded trials was inverse with respect to the target and showed a high-pressure region at the mid-calf, whereas the gradient achieved in sensor-guided trials closely followed the target. The correlation to the target gradient from R 2 = 0⋅62 (blind) to 0⋅93 (guided) with a decrease in variance amongst participants from 46% to 4⋅6% by using feedback from the sensor of a bandage may cause localised pressure concentrations that interrupt circulation and can cause open wounds (4).…”

“…This statement still holds true today for many medical indications. For example, a region of high pressure around the leg may cause swelling in the foot and ankle, and a high‐pressure point on one edge of a bandage may cause localised pressure concentrations that interrupt circulation and can cause open wounds .…”

“…Compression bandaging is a recognised treatment for lymphoedema and a mainstay practice in the treatment of venous leg ulcers , deep vein thromboses and venous insufficiency . Its importance as a treatment of lymphoedema is highlighted in the first very first edition of the British Medical Journal in an article by T. Hunt in 1857. Hunt describes the proper application of a bandage to treat an oedematous limb as one of the most difficult operations to perform in surgery and states that a ‘carelessly’ applied bandage may cause more harm than good.…”

A curvature-independent high-resolution pressure sensor provides sub-bandage pressure measurement in accordance with Laplace’s law

“…The skill of the practitioner in the application of compression bandages as well as the change of tension in the bandages over time is therefore of paramount importance, as this defines the dose of the treatment and is akin to the prescription of a drug dose for pharmaceutical interventions. The importance of dose in compression bandaging is highlighted by its inclusion in the very first issue of the British Medical Journal, where Hunt [5] describes the proper application of a bandage to treat an oedematous limb as one of the most difficult operations to perform in surgery stating that, 'a carelessly applied bandage may do more harm than good'. Excess pressure may inhibit blood flow and cause swelling in the ankle and foot, while a localised pressure hotspots will cause discomfort and may cause open wounds [5].…”

“…The importance of dose in compression bandaging is highlighted by its inclusion in the very first issue of the British Medical Journal, where Hunt [5] describes the proper application of a bandage to treat an oedematous limb as one of the most difficult operations to perform in surgery stating that, 'a carelessly applied bandage may do more harm than good'. Excess pressure may inhibit blood flow and cause swelling in the ankle and foot, while a localised pressure hotspots will cause discomfort and may cause open wounds [5].…”