Objective Evaluation of Skin Pressure Distribution of Graduated Elastic Compression Stockings

Abstract

Background The beneficial effects of graduated elastic compression stockings (GCSs) have been demonstrated. However, their pressure performances are variable and unstable in practical applications owing to many influencing factors. Comprehensive assessment of skin pressure profiles may help elucidate the mechanisms of action of compression stockings. Objective The objective of this study was to quantify and objectively evaluate the magnitude and distribution of skin pressure applied by different GCSs and to analyze the possible reasons influencing the stocking pressure performances. Methods Six healthy females were required to wear eight kinds of GCSs with different pressure levels while standing upright. The skin pressures of 16 different positions located in four heights and four directions of the lower limb were measured and recorded by FlexiForce interface pressure sensors (Tekscan, Inc., Boston, MA, USA) and a multichannel measuring system. Results The pressure gradients, pressure levels, and testing locations significantly influenced skin pressure (p < .001). All tested GCSs exerted the highest pressure at the ankle region, and the pressure gradually decreased toward the thigh, which follows the gradient design of GCSs. However, many of them failed to produce the perfect pressure gradients from the ankle region to the calf region. Obviously, reversed pressure gradients occurred in the medial side of the leg, where the pressure at the ankle region was lower than that on the prominent part of the calf by 36% on average. GCSs with higher pressure levels applied higher skin pressure on the lower limb. The pressure at the anterior side was far higher than that in the medial and lateral directions. The distribution patterns of skin pressure at transverse sections were similar to the anatomic outlines of cross sections of the leg. The measured average ankle pressure of all tested GCSs did not reach the pressures specified by the manufacturers. Conclusion Skin pressure distributions and magnitudes applied by GCSs were significantly influenced by the locations of testing points in terms of height and direction, which are determined by the specific anatomic structure and body shape of individual human legs and potentially influenced by the pressure sensor and testing methods.