Relevance of stiffness of compression material on venous hemodynamics and edema

Abstract

Elastic and inelastic stockings or bandages may provide the same degree of compression pressure in the resting supine position but inelastic material provides much greater compression pressure in the standing or working position. For elastic compression to have the same effect in the standing or exercising state would require a degree of compression in the resting position that would be intolerable. Studies have shown that this applies to reduction of reflux and improved venous pumping although both appear to have a similar effect for reducing edema.

Can heterogeneous compression textile design reshape skin pressures? A fundamental study

“…In our HCS design in condition II, the external squeezing forces caused by shorter stretch compression shells set at posterior muscle regions would enhance internal ambulatory pressure gradient distributions and improve venous hemodynamics, which can be expected based on a number of existing clinical studies on the use of short-stretch bandages. 35,36 In addition, our study demonstrates that increasing the proportions of panels with higher elastic moduli from 12.8-87.5% can elevate skin pressures at the posterior calves by 2.0-37.2 %. However, the degree of elevation in skin pressures under the present conditions are still limited due to the lack of muscle volume variation while standing still.…”

“…In our HCS design in condition II, the external squeezing forces caused by shorter stretch compression shells set at posterior muscle regions would enhance internal ambulatory pressure gradient distributions and improve venous hemodynamics, which can be expected based on a number of existing clinical studies on the use of short-stretch bandages. 35,36…”

Reality of outpatient care with medical compression stockings

“…Es überwiegt also die Einheitsverordnung gegenüber einer patientenindividuellen Versorgung. Dies ist wenig zufriedenstellend, da der höhere Arbeitsdruck, den starke Strumpfqualitäten erzeugen können, bei vielen Patienten notwendig ist, um das venöse Volumen und den venösen Reflux zu begrenzen und die venöse Pumpfunktion zu verbessern (7).…”

“…gibt lediglich Hinweise zur differenzierten KKL-Anwendung. Jedoch hätten wir aufgrund des hohen BMI und der Erkrankungsschwere vieler Patienten eine deutlich häufigere Verschreibung mittlerer und starker Strumpfqualitäten erwartet (6,7). Auch Anziehhilfen wurden angesichts des Alters und des BMIs der Studienteilnehmer sowie der Häufigkeit von Begleiterkrankungen wie Wirbelsäulenproblemen und Arthrose nur selten verordnet.…”

Stiffness of compression devices

“…Elastic material, exerting a sustained pressure, not very different between supine and standing position or during muscle exercise, shows a small improvement on the impaired venous hemodynamics which is always significantly smaller than that from inelastic material. 16,17 Actually stiff materials exerting strong or very strong pressure showed to be clinically effective in ulcer treatment 16,18,19 when a significant impact on venous hemodynamics is very important and also in lymphoedema. 20 Pressure and stiffness can be critically reduced in some areas of the leg with concave rather than convex shape as this is the case in the retro-malleolar space.…”