Skip to main content
Log in

Experimental Investigation of Pressure Applied on the Lower Leg by Elastic Compression Bandage

  • Published:
Annals of Biomedical Engineering Aims and scope Submit manuscript

Abstract

Compression therapy with stockings or bandages is the most common treatment for venous or lymphatic disorders. The objective of this study was to investigate the influence of bandage mechanical properties, application technique and subject morphology on the interface pressure, which is the key of this treatment. Bandage stretch and interface pressure measurements (between the bandage and the leg) were performed on 30 healthy subjects (15 men and 15 women) at two different heights on the lower leg and in two positions (supine and standing). Two bandages were applied with two application techniques by a single operator. The statistical analysis of the results revealed: no significant difference in pressure between men and women, except for the pressure variation between supine and standing positions; a very strong correlation between pressure and bandage mechanical properties (p < 0.00001) and between pressure and bandage overlapping (p < 0.00001); a significant pressure increase from supine to standing positions (p < 0.0001). Also, it showed that pressure tended to decrease when leg circumference increased. Overall, pressure applied by elastic compression bandages varies with subject morphology, bandage mechanical properties and application technique. A better knowledge of the impact of these parameters on the applied pressure may lead to a more effective treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7

Similar content being viewed by others

References

  1. Agu, O., G. Hamilton, and D. Baker. Graduated compression stockings in the prevention of venous thromboembolism. Br. J. Surg. 86(8):992–1004, 1999.

    Article  CAS  PubMed  Google Scholar 

  2. Al Khaburi, J., A. A. Dehghani-Sanij, E. A. Nelson, and J. Hutchinson. Effect of bandage thickness on interface pressure applied by compression bandages. Med. Eng. Phys. 34(3):378–385, 2012.

    Article  PubMed  Google Scholar 

  3. Benigni, J. P., J. F. Uhl, A. Cornu-Thénard, and E. Blin. Compression bandages: influence of techniques of use on their clinical efficiency and tolerance. Int. Angiol. 27(1):68–73, 2008.

    CAS  PubMed  Google Scholar 

  4. Bhattacharya, S., T. Shaikh, and R. Purushottam Solao. Development of prototype bandage lapper for constant tension bandaging required for effective medical-clinical treatments. J. Tissue Viability 21(2):54–63, 2012.

    Article  PubMed  Google Scholar 

  5. Brizzio, E., F. Amsler, B. Lun, and W. Blättler. Comparison of low-strength compression stockings with bandages for the treatment of recalcitrant venous ulcers. J. Vasc. Surg. 51(2):410–416, 2010.

    Article  PubMed  Google Scholar 

  6. Coull, A., D. Tolson, and J. McIntosh. Class-3c compression bandaging for venous ulcers: comparison of spiral and figure-of-eight techniques. J. Adv. Nurs. 54(3):274–283, 2006.

    Article  PubMed  Google Scholar 

  7. Damstra, R. J., and H. Partsch. Prospective, randomized, controlled trial comparing the effectiveness of adjustable compression Velcro wraps versus inelastic multicomponent compression bandages in the initial treatment of leg lymphedema. J. Vasc. Surg. Venous Lymphat. Disord. 1(1):13–19, 2013.

    Article  Google Scholar 

  8. Danielsen, L., S. Munk Madsen, L. Henriksen, J. Sindrup, and L. J. Petersen. Subbandage pressure measurements comparing a long-stretch with a short-stretch compression bandage. Acta Derm. Venereol. 78:201–204, 1998.

    Article  CAS  PubMed  Google Scholar 

  9. Hafner, J., W. Lüthi, H. Hänssle, G. Kammerlander, and G. Burg. Instruction of compression therapy by means of interface pressure measurement. Dermatol. Surg. 26(5):481–488, 2000.

    Article  CAS  PubMed  Google Scholar 

  10. Hanna, R., S. Bohbot, and N. Connolly. A comparison of interface pressures of three compression bandage systems. Br. J. Nurs. Mark Allen Publ. 17(20):S16–S24, 2008.

    Article  Google Scholar 

  11. Hirai, M., K. Niimi, H. Iwata, et al. A comparison of interface pressure and stiffness between elastic stockings and bandages. Phlebology 24(3):120–124, 2009.

    Article  CAS  PubMed  Google Scholar 

  12. Huston, R. L. Principles of Biomechanics. Boca Raton: CRC Press, 2009.

    Google Scholar 

  13. Lattimer, C. R., E. Kalodiki, M. Kafeza, M. Azzam, and G. Geroulakos. Quantifying the degree graduated elastic compression stockings enhance venous emptying. Eur. J. Vasc. Endovasc. Surg. 47(1):75–80, 2014.

    Article  CAS  PubMed  Google Scholar 

  14. Milic, D. J., S. S. Zivic, D. C. Bogdanovic, et al. The influence of different sub-bandage pressure values on venous leg ulcers healing when treated with compression therapy. J. Vasc. Surg. 51(3):655–661, 2010.

    Article  PubMed  Google Scholar 

  15. Mosti, G., and V. Mattaliano. Simultaneous changes of leg circumference and interface pressure under different compression bandages. Eur. J. Vasc. Endovasc. Surg. 33(4):476–482, 2007.

    Article  CAS  PubMed  Google Scholar 

  16. Mosti, G., and H. Partsch. Inelastic bandages maintain their hemodynamic effectiveness over time despite significant pressure loss. J. Vasc. Surg. 52(4):925–931, 2010.

    Article  PubMed  Google Scholar 

  17. Mosti, G., and H. Partsch. Bandages or double stockings for the initial therapy of venous oedema? A randomized, controlled pilot study. Eur. J. Vasc. Endovasc. Surg. 46(1):142–148, 2013.

    Article  CAS  PubMed  Google Scholar 

  18. Mosti, G., and H. Partsch. Improvement of venous pumping function by double progressive compression stockings: higher pressure over the calf is more important than a graduated pressure profile. Eur. J. Vasc. Endovasc. Surg. 47(5):545–549, 2014.

    Article  CAS  PubMed  Google Scholar 

  19. O’Meara, S., N. Cullum, E. A. Nelson, and J. C. Dumville. Compression for venous leg ulcers. In: Cochrane Database of Systematic Reviews, edited by The Cochrane Collaboration, and S. O’Meara. Chichester: Wiley, 2012.

    Google Scholar 

  20. Partsch, H. The use of pressure change on standing as a surrogate measure of the stiffness of a compression bandage. Eur. J. Vasc. Endovasc. Surg. 30(4):415–421, 2005.

    Article  CAS  PubMed  Google Scholar 

  21. Partsch, H. The static stiffness index: a simple method to assess the elastic property of compression material in vivo. Dermatol. Surg. 31(6):625–630, 2005.

    Article  CAS  PubMed  Google Scholar 

  22. Partsch, H., and G. Mosti. Comparison of three portable instruments to measure compression pressure. Int. Angiol. 29(5):426–430, 2010.

    CAS  PubMed  Google Scholar 

  23. Partsch, B., and H. Partsch. Calf compression pressure required to achieve venous closure from supine to standing positions. J. Vasc. Surg. 42(4):734–738, 2005.

    Article  PubMed  Google Scholar 

  24. Partsch, H., M. Clark, S. Bassez, et al. Measurement of lower leg compression in vivo: recommendations for the performance of measurements of interface pressure and stiffness: consensus statement. Dermatol. Surg. 32(2):224–232, 2006; (discussion 233).

    CAS  PubMed  Google Scholar 

  25. Raj, T. B., M. Goddard, and G. S. Makin. How long do compression bandages maintain their pressure during ambulatory treatment of varicose veins? Br. J. Surg. 67(2):122–124, 1980.

    Article  CAS  PubMed  Google Scholar 

  26. Rimaud, D., R. Convert, and P. Calmels. In vivo measurement of compression bandage interface pressures: the first study. Ann. Phys. Rehabil. Med. 57(6–7):394–408, 2014.

    Article  CAS  PubMed  Google Scholar 

  27. Rohan, P.-Y., P. Badel, B. Lun, D. Rastel, and S. Avril. Prediction of the biomechanical effects of compression therapy on deep veins using finite element modelling. Ann. Biomed. Eng. 43(2):314–324, 2015.

    Article  PubMed  Google Scholar 

  28. Thomas, S. The use of the Laplace equation in the calculation of sub-bandage pressure. Eur. Wound Manage. Assoc. 3:21–23, 2003.

    Google Scholar 

  29. Thomas, S. Practical limitations of two devices used for the measurement of sub-bandage pressure: implications for clinical practice. J. Wound Care. 23(6):300–313, 2014.

    Article  CAS  PubMed  Google Scholar 

  30. Thomas, S., and P. Fram. Laboratory-based evaluation of a compression-bandaging system. Nurs. Times. 99(40):24–28, 2003.

    PubMed  Google Scholar 

  31. The International Lymphoedema Framework. Best Practice for the Management of Lymphoedema, 2nd edn.

Download references

Conflict of interest

Thuasne is a compression bandage manufacturer.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fanette Chassagne.

Additional information

Associate Editor Amit Gefen oversaw the review of this article.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chassagne, F., Martin, F., Badel, P. et al. Experimental Investigation of Pressure Applied on the Lower Leg by Elastic Compression Bandage. Ann Biomed Eng 43, 2967–2977 (2015). https://doi.org/10.1007/s10439-015-1352-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10439-015-1352-1

Keywords

Navigation