Pressure measurements beneath below-knee amputation stump bandages: Elastic bandaging, the Puddifoot dressing and a pneumatic bandaging technique compared

Abstract

Elastic wrap bandaging is unreliable and dangerous in terms of pressure and pressure distribution (tourniquet effect). The Puddifoot dressing is safe and is less likely to produce a tourniquet effect. The range of pressures it produces is low--possibly too low to achieve ideal moulding or oedema control. A pneumatic bandage achieved a relatively narrow range of pressures between capillary and arteriolar blood pressures. It minimized tourniquet effects and differences between skilled and unskilled bandagers. It is sufficiently promising to merit development.

Pressure Therapy for Hypertrophic Scarring: Preliminary Communication

“…Too much pressure may cause skin breakdown. As Isherwood et al (1975) found, pressure varies with the shape and hardness of a part. For these reasons Robertson & Hodgson (1978)ad vocate the use of a direct method ofmeasurement rather than relying on pressure garment manufacturers' calculations.…”

“…Since Isherwood et al (1975)described their 28 mm sensor, the technique has been modified to allow for the effects ofdistortion on the sensor. The sensor is taped in position and baselines arc taken before and after test readings.…”

“…The first six treatments may involve bandaging which must inevitably produce some occlusion whether or not this is intended. Isherwood et al (1975), using the forerunner of our 28 mm electropneumatic sensor, demonstrated the range of pressures produced under traditional and improved amputation stump bandaging. Experience with crepe bandaging suggests that appreciable pressures are produced.…”

A clinical standard of stump measurement and classification in lower limb amputees

“…It seems to be about 5% in many cases and can cause great problems in prosthetic fitting. This is illustrated by Goldie's et al (1974) liquid pad and Isherwood's (1975) adjusting pad. Increased distal stump circumference was seen in active patients who had been forced to inactivity by their disease and could reinstate their muscle mass by walking postoperatively.…”

Comparison of vacuum‐formed removable rigid dressing with conventional rigid dressing after transtibial amputation

“…The main goal of using a soft dressing is to absorb the fluid from the wound and to prevent edema with a compressive elastic bandage. Elastic bandages have the advantage of being inexpensive but may be associated with serious problems; for example, pressure levels beneath soft dressings can vary over a wide range (Isherwood et al 1975) and, if incorrectly applied, they can lead to complications such as pressure sores and persistent edema (Horne and Abramowicz 1982). To date, there have been no studies showing that soft dressings give results superior to those achieved with rigid or semi-rigid dressings (Smith et al 2003).…”