Abstract
Compression therapy is the principal treatment for leg ulcers associated with venous disease. The efficacy of compression therapy can be variable, which may in part be owing to the degree of compression applied. However, if the mechanism of action of this treatment could be better understood, it might be possible to improve its efficacy. It is not clear whether assessment of the degree of compression should be made under static or dynamic conditions, or both. A review of methods used previously suggests the need for a new method of assessment allowing continuous monitoring, even during movement. A system for continuous static and dynamic measurements of compression is described. Using an air chamber and manometer to test the system, agreement within ±3 mmHg is observed. The system is applied to investigate changes in forces, expressed as pressure, under bandages and compression stockings. Application of five bandage systems by experienced nurses to a volunteer shows a marked variation in applied pressure. During short periods of walking, rapid changes in pressure under compression stockings are observed, including some transients of less than 0.25 s. The method is simple to apply and may help to understand further the mechanism of action of compression therapy.
Similar content being viewed by others
References
Back, T. L., Padberg, F. T., Araki, C. T., Thompson, P. N., andHobson, R. W. (1995): ‘Limited range of motion is a significant factor in venous ulceration’,J. Vasc. Surg.,22, pp. 519–523
Baker, S. R., Stacey, M. C., Jopp-McKay, A. G., Hoskin, S. E., andThompson, P. J. (1991): ‘Epidemiology of chronic venous ulcers’,Br. J. Surg.,78, pp. 864–867
Baker, S. R., Stacey, M. C., Singh, G., Hoskin, S. E., andThompson, P. J. (1992): ‘Aetiology of chronic leg ulcers’,Eur. J. Vasc. Surg.,6, pp. 245–251
Barbenel, J. C., andSocklingham, S. (1990): ‘Device for measuring soft tissue interface pressures’,J. Biomed. Eng.,12, pp. 519–522
Blair, S. D., Wright, D. D. I., Backhouse, C. M., Riddle, E., andMcCollum, C. N. (1988): ‘Sustained compression and healing of chronic venous ulcers’,Br. Med. J.,297, pp. 1159–1161
Callum, M. J., Ruckley, C. V., Dale, J. J., andHarper, D. R. (1987): ‘Hazards of compression treatment of the leg: an estimate from Scottish surgeons’,Br. Med. J.,295, p. 1382
Coleridge Smith, P. D., Sarin, S., Hasty, J., andScurr, J. H. (1990): ‘Sequential gradient pneumatic compression enhances venous ulcer healing: A randomized trial’,Surgery,108, pp. 871–875
Dale, J., Callum, M., andRuckley, C. V. (1983): ‘How efficient is a compression bandage?’,Nursing Times, November 16, pp. 49–51
Fletcher, A., Cullum, N., andSheldon, T. (1997): ‘A systematic review of compression treatment for venous leg ulcers’,Br. Med. J.,315, pp. 576–580
Harding, K. G., andLeaper, D. J. (1994): ‘The hospital management of venous ulceration’,Curr. Practice Surg.,6, pp. 8–11
Horner, J., Fernandes é Fernandes, J., Nicolaides, A. N. (1980): ‘Value of graduated compression stockings in deep venous insufficiency’,Br. Med. J.,34, pp. 81–87
Lawrence, D., andKakkar, V. V. (1980): ‘Graduated, static, external compression of the lower limb: a physiological assessment’,Br. J. Surg.,67, pp. 119–121
Logan, R. A., Thomas, S., Harding, E. F., andCollyer, C. J. (1992): ‘A comparison of sub-bandage pressures produced by experienced and inexperienced bandagers’,J. Wound Care,1, pp. 23–26
McCulloch, J. M., Marler, K. C., Neal, M. B., andPhifer, T. J. (1994): ‘Intermittent pneumatic compression improves venous ulcer healing’. Advances in Wound Care,7, pp. 22–26
Moffatt, C. J., Franks, P. J., Oldroyd, M., Bosanquet, N., Brown, P., Greenhalgh, R. M., andMcCollum, C. N. (1992): ‘Community clinics for leg ulcers and impact on healing’,Br. Med. J.,305, pp. 1389–1392
Moneta, G. L., Nehler, M. R., Chitwood, R. W., andPorter, J. M. (1995): ‘The natural history, pathophysiology and nonoperative treatment of chronic venous insufficiency’,in Rutherford, R. B. (Ed.): ‘Vascular surgery’ (W. B. Saunders, Philadelphia) 4th edn.
Nelson, E. A., Ruckley, C. V., andBarbenel, J. C. (1995): ‘Improvement in bandaging technique following training’,J. Wound Care,4, pp. 181–184
Nelson, E. A. (1996): ‘Compression bandaging in the treatment of venous leg ulcers’,J. Wound Care,5, pp. 415–418
Nelzén, O., Bergqvist, D., andLindhagen, A. (1994): ‘Venous and non-venous leg ulcers: clinical history and appearance in a population study’,Br. J. Surg.,81, pp. 182–187
Nicolaides, A. N., Hussein, M. K., Szendro, G., Christopoulos, D., Vasdekis, S., andClarke, H. (1993): ‘The relation of venous ulceration with ambulatory venous pressure measurements’,J. Vasc. Surg.,17, pp. 414–9
Partsch, H., andHorakova, M. A. (1994): ‘Compression stockings for the treatment of venous leg ulcers’,Wien. Med. Wschr.,144, pp. 242–249
Raj, T. B., Goddard, M., andMakin, G. S. (1980): ‘How long do compression bandages maintain their pressure during ambulatory treatment of varicose veins?’,Br. J. Surg.,97, pp. 122–124
Sarin, S., Scurr, J. H., andColeridge Smith, P. D. (1992): ‘Mechanism of action of external compression on venous function’,Br. J. Surg.,79, pp. 499–502
Sawada, Y. (1993): ‘Alterations in pressure under elastic bandages: Experimental and clinical evaluation’,J. Dermatol.,20, pp. 767–772
Shami, S. K., Shields, D. A., Scurr, J. H., andColeridge Smith, P. D. (1992): ‘Leg ulceration in venous disease’,Postgrad. Med. J.,68, pp. 779–785
Shaw, J. A., andMurray, D. G. (1982): ‘The relationship between pressure and soft-tissue pressure in the thigh’,J. Bone Joint Surg.,64, pp. 1148–1151
Socklingham, S., Barbenel, J. C., andQueen, D. (1990): ‘Ambulatory monitoring of the pressures beneath compression bandages’,Care Sci. Pract.,8, pp. 75–78
Steinberg, M. D., andCooke, E. D. (1993): ‘Design and evaluation of a device for measurement of interface pressure’,J. Biomed. Eng.,15, pp. 464–468
Stemmer, R., Marescaux, J., andFurderer, C. (1980): ‘Die Kompressionbehandlung der unteren Extremitaten speziell durch Kompressionstrümpfe’,Der Hautarzt,31, pp. 355–365
Stillwell, G. K. (1973): ‘The law of Laplace’,Mayo Clin. Proc.,48, pp. 863–869
Tennant, W. G., Park, K. G. M., andRuckley, C. V. (1988): ‘Testing compression bandages’,Phlebology,3, pp. 55–61
Thomas, S. (1996): ‘High-compression bandages’,J. Wound Care,5, pp. 40–43
Wertheim, D., Melhuish, J., Trenary, K., Shutler, S., Williams, R., andHarding, K. (1996): ‘Assessment of forces associated with compression therapy under static and dynamic conditions’,Proc. 18th Ann. Int. Conf. IEEE Eng. Med. Biol. Soc. Amsterdam, October
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wertheim, D., Melhuish, J., Williams, R. et al. Measurement of forces associated with compression therapy. Med. Biol. Eng. Comput. 37, 31–34 (1999). https://doi.org/10.1007/BF02513262
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02513262