Multilayer Compression Bandaging Research Articles

Work-Related Musculoskeletal Disorders Risk Assessment during Manual Lymphatic Drainage with Compressive Bands among Physiotherapists.

Complete decongestive therapy is the standard treatment for lymphedema. Manual lymphatic drainage and short-stretch multilayer compression bandaging are two daily stages of complete decongestive therapy during which physiotherapists work with patients. The aim of this study was to assess the risks of musculoskeletal disorders to which physiotherapists are exposed during these two phases. Five physiotherapists performed five 20 min manual lymphatic drainages, followed by the compression bandaging phase. From the video recordings, 8477 postures defined by 13 joint angles were grouped into clusters using hierarchical cluster analysis. The risk of musculoskeletal disorders in physiotherapists' postures was assessed using ergonomic tools. Seven clusters, called generic postures (GP), were identified and defined throughout the mean joint angle values and standard deviation. Four seated GPs were found for the drainage phase, and three standing GPs were identified for the bandaging phase. This phase corresponded to a quarter of the total duration. The GP's ergonomic scores ranged from 4.51 to 5.63 and from 5.08 to 7.12, respectively, for the Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA). GP1, GP3, and GP4 presented the highest ergonomic scores (RULA scores: 5.27 to 5.63; REBA scores: 6.25 to 7.12). The most affected areas were the neck (flexion > 20° for all GPs), trunk (flexion between 25 and 30° for GP2, and GP7 during the bandaging phase and GP4 during the drainage phase), and shoulder (flexion and abduction >20° for all GPs except GP5). These results highlighted that the two complete decongestive therapy phases could be described as a combination of GP. Ergonomic assessment showed that compression bandaging as well as drainage phases expose physiotherapists to moderate musculoskeletal disorder risks that require "further investigation and change soon".

The Randomized Controlled Study of Low-Level Laser Therapy, Kinesio-Taping and Manual Lymphatic Drainage in Patients With Stage II Breast Cancer-Related Lymphedema.

To compare the effects of low-level laser therapy, kinesio-taping and manual lymphatic drainage (MLD) on the affected arm volume, quality of life, arm function, neuropathic pain and shoulder mobility in patients with stage II breast cancer-related lymphedema. Forty-five breast cancer patients with stage II lymphedema were included. The patients were randomized to three groups and treated with MLD, kinesio-taping or low-level laser therapy. After these different therapeutic modalities, all patients received multilayer compression bandaging, lymphedema remedial exercises, skin care, and a patient education program by the same lymphedema therapist. All treatments were applied 5-days a week for three weeks. The lymphedema compression garments were prescribed to all patients and follow-up visits were planned at the end of the treatment, and at four and 12 weeks. The efficacy of the treatments was evaluated by volumetric calculations based on circumferential measurements using the formula for a truncated cone, in addition to goniometric assessments for shoulder joint ROM, and questionnaires: Quick-disability of arm, shoulder and hand for arm disability; pain-detect for neuropathic pain; and quality of life for arm lymphedema (LYMQOL-arm). The baseline patient and disease characteristics, and outcome measures were similar between groups. All treatment modalities were found to be effective in decreasing arm volume, and improving quality of life, upper extremity disability and neuropathic pain. The percentage of decreased arm volume or treatment success was better in kinesio-taping group than in the MLD group at the end of the treatment, and at four and 12 weeks after treatment (p = 0.009, p = 0.039, and p = 0.042, respectively). Kinesio-taping led to better results than MLD and was similarly effective compared with low-level laser in stage II breast cancer-related lymphedema at the twelfth week of follow-up. Kinesio-taping and low-level laser should be considered as alternative treatments in early-moderate stages of lymphedema. After these modalities, multi-layer compression and compression bandaging remain cornerstones of lymphedema treatment.

Arguments regarding the management of post-mastectomy sequels

The purpose of this paper is to highlight a less illustrated topic in Romanian bibliographic resources. According to the World Health Organization reports, breast cancer is one of the most common types of cancer worldwide. The sequelae of mastectomy are systematised as follows: conditions secondary to the application of local radiotherapy, systemic conditions after oncological treatment and psychosocial conditions. The most common side effect of the treatment applied for breast cancer is lymphoedema and, according to a study carried out in Pennsylvania, 42% of patients develop lymphoedema. Some authors classify it into mild, moderate and severe, but others highlight four stages of lymphoedema development. Physiotherapy has a major role in post-mastectomy recovery and requires various kinetic means, which can be both specific (physical exercise, hydrokinetic therapy, massage, posture) and non-specific (multilayer compression bandage and wearing a compression sleeve). Over time, a lot of clinical studies have been conducted on the implications of physical therapy for post-mastectomy functional recovery. Thus, physical exercise performed during the kinetic programme improves muscle strength, the activity of the cardiorespiratory system and self-esteem. Several authors recommend the practice of aerobic exercise and moderate-intensity exercise twice a week during chemotherapy treatment to prevent the development of lymphoedema.

Lay Caregivers Education in Multicomponent Compression Bandaging in Obese Patients with Lower Limb Edema: A Case-Control Pilot Study.

Background: A report on the usefulness of the instruction of lay carers in multilayer short-stretch compression bandaging within the initial intensive phase physical treatment of mixed-etiology chronic lower limb edema. Methods and Results: In a group of adult obese patients (including 24 females) with venous insufficiency and chronic bilateral lower limb edema, and without a history of physical therapy, 20 (ambulatory managed) were bandaged once daily (four layers, short stretch with cotton tube, and foam padding underneath) for 3 weeks (Monday-Friday) by skilled physiotherapists, and in 20 cases (education group, EG), the patients' lay carers were educated by these physiotherapists according to the same regime during one session. The outcome measures included limb volume (the method of circumference measurement with a tape at 4 cm intervals) after 1, 3, and 6 months, the time to reach the maintenance phase, the frequency of complementary bandaging during this phase, and the sense of self-efficacy (General Self-Efficacy scale, GSEs). No significant differences were noted between the two groups in the baseline measurements of age, body mass, and limb volume. The carers were able to apply compression bandages in all cases during the observation period. The time to reach the maintenance phase was longer in EG (6 vs. 1 weeks; p < 0.001). A similar median reduction in edema volume was observed at the end of the bandaging period, which continued for 3 and 6 months. It was only in EG that further improvement between 1 and 3 months was observed (p = 0.008). All participants represented an equally high optimistic sense of personal competence (GSEs). Conclusions: The instruction of lay carers in bandaging may provide a simple clinically effective solution for lower limb edema management, thus lowering its costs.

Evidence Summary: Venous leg ulcers: Multi-layer compression bandaging

Venous leg ulcers (VLUs) are ulcers that occur on the lower leg due to venous disease. Compression therapy is recognised as gold standard treatment for promoting healing of VLUs.1, 2 The best available evidence indicates that a multi-layer bandaging system that incorporates an elastic bandage is one of the most effective compression therapy types for healing VLUs2-13 (Level 1).

Economic Benefit of a Novel Dual Mode Ambulatory Compression Device for Treatment of Chronic Venous Leg Ulcers

Compression is critical to heal chronic venous leg ulcers (VLUs). A novel dual mode ambulatory pneumatic compression (APC) device was tested in comparison to multilayered compression bandaging systems for the treatment of nonhealing VLUs in a prospective randomized clinical trial (RCT). Patients with VLUs measuring between 2 and 50 cm2 present for 1 to 12 months were randomized to treatment with the APC device (ACT group; Actitouch; Tactile Medical, Minneapolis, Minn] or multilayered compression bandaging (MLB) with either Profore (Smith & Nephew, Memphis, Tenn) or Coban 2 (3M Health Care, St. Paul, Minn) compression systems. Patients in the ACT group were asked to wear the device for sustained or intermittent compression throughout the day and to wear a light compression stocking at night. The ACT group patients were seen every 2 to 3 weeks for follow-up to 16 weeks, allowing more in-home care. The MLB group was seen in the outpatient clinic weekly. Other aspects of VLU care were standardized between the two groups. The primary study objective was to compare wound size reduction at 16 weeks between the two groups in a noninferiority RCT. Secondary objectives assessed the effect of each therapy on medical resource utilization and the direct cost of care. There were 58 patients who were randomized to treatment with either MLB (n = 30) or ACT (n=28). Both groups experienced similar rates of wound healing during the 16-week follow-up period, with ACT group patients decreasing from 4.01 ± 2.4 cm2 to 1.21 ± 2.5 cm2 and MLB-treated wounds decreasing from 7.6 ± 7.9 cm2 to 2.5 ± 6.1 cm2. There was no significant difference between groups in percentage of wound closure, incidence of complete wound healing, or improvement in Venous Clinical Severity Score. ACT-treated wounds had lower utilization of non-study-related clinic visits compared with the MLB cohort (50.0% vs 63.3%, respectively). In addition, there were fewer ACT-scheduled patient visits without any associated complications, resulting in lower direct medical costs compared with the MLB cohort (− difference [−$2733; P = .06]). The trial was halted before full randomization to make improvements to the ACT device to increase the patient’s comfort and usability, as suggested by both participating physicians and patients. In this preliminary RCT, a novel APC device achieved similar VLU wound healing results in comparison to MLB but with lower direct costs. The study has led to important changes in device design that will allow confirmation of these findings in a larger RCT.

Poster 180: Improvement of Refractory Lower Extremity Edema with Multilayered Compression Bandaging: A Case Report

PM&RVolume 10, Issue 9S1 p. S61-S61 Poster 180: Improvement of Refractory Lower Extremity Edema with Multilayered Compression Bandaging: A Case Report Jegy M. Tennison MD, Jegy M. Tennison MD The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesSearch for more papers by this authorEduardo Bruera MD, Eduardo Bruera MDSearch for more papers by this author Jegy M. Tennison MD, Jegy M. Tennison MD The University of Texas MD Anderson Cancer Center, Houston, TX, United StatesSearch for more papers by this authorEduardo Bruera MD, Eduardo Bruera MDSearch for more papers by this author First published: 26 September 2018 https://doi.org/10.1016/j.pmrj.2018.08.192Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume10, Issue9S12018 AAPM&R Annual Assembly AbstractsSeptember 2018Pages S61-S61 RelatedInformation

Clinical and economic impact of compression in the acute phase of deep vein thrombosis

IDEAL DVT study ClinicalTrials.gov number, NCT01429714.

Diuretics Combined With Compression in Resistant Limb Edema of Advanced Disease—A Case Series Report

IntroductionThe extremity edema of advanced disease is a common, multifactorial feature, which impairs patients' activities and quality of life. The most frequently chosen management is based on combined decongestive physiotherapy or pharmacotherapy (with diuretics or steroids). Subcutaneous lymphatic drainage in refractory edema may decrease the swelling, prevent spontaneous lymphorrhea, but also increase the risk of infection. Safe and effective conservative management in diuretics-resistant edemas is lacking. The objective of this prospective, observational study was to assess the effectiveness and tolerability of combined physiotherapeutic and diuretic therapy in edemas refractory to parenteral diuretics. MethodsA group of 19 patients with advanced disease and severe bilateral leg edema resistant to parenteral diuretic therapy were treated for three days with a combination of multilayer short-stretch compression bandaging and furosemide in hypersaline intravenous infusion. ResultsA clinically meaningful decrease in mean limb volume (of 1.52 L; 20.6%; P < 0.0001)—strongly correlating with patients' weight loss (ρ = 0.71; P = 0.0001), with a lowering of the intensity of complaints—was achieved. The treatment was well tolerated, without decreasing the performance status in any patient. Stable levels of blood pressure, laboratory kidney profile (potassium, sodium, creatinine clearance), and serum albumin were observed. Maintenance of the achieved results with a good compliance was seen during an informal follow-up at the hospice. ConclusionThe combination of compression therapy with hypersaline diuretics could be considered as a valuable option for refractory cases of limb edema in advanced disease.

Early ambulation after-grafting of lower extremity burns

ObjectiveEarly ambulation of lower extremity burns that undergo a skin graft may help to avoid some of the complications associated with immobilization. Despite recent evidence supporting early ambulation, post-operative immobilization following lower extremity skin grafting is still a common practice. The purpose of this study was to retrospectively assess the outcomes of lower extremity skin graft cases dressed with a multi-layer compression bandage who were ambulated in the immediate post-operative period. MethodsThis single centre observational study examined patients with a lower extremity burn that received a compressive dressing (Profore™) application immediately after surgical grafting and were ambulated no later than 1day post-operatively. ResultsForty-two burn patients (47 limbs) met inclusion criteria for this study. Of these 42 patients, 25 were operated on as an inpatient. The remaining 17 patients were done on an outpatient basis and discharged the same day of surgery. Mean patient age was 48.2 years and 34 (81.0%) of patients were male. Mean TBSA affected was 5.3% (792cm2). Mean number of procedures was 1 and mean graft take was 98.9%. Nearly all patients were ambulated within 1day of surgery. The graft take rate across all cases was 98.9±2.3%. No patients failed early ambulation with their compressive dressings, were readmitted or underwent repeated skin grafting. ConclusionsThis study demonstrates the excellent graft take rates that can be achieved with immediate ambulation following lower extremity skin grafting and challenges the conventional teaching of post-operative bed rest following lower extremity skin grafting procedures.

Nighttime Bandaging to Reduce Lymphedema Swelling

Multilayer compression bandaging (MLB) for breast cancer-related lymphedema (BCRL) patients may be easier to apply during nighttime sleep. Little is known about the specific effects of nighttime multilayer bandaging (NMLB) alone. In the present study, we examined whether NMLB alone significantly improved the negative symptoms of BCRL such as excessive swelling and an unpleasant feeling. A pre–post study was conducted as a basis for the development of efficient self-care treatment. Eight middle-aged female patients with unilateral upper extremity BCRL voluntarily participated in this study. During the first 2 weeks, the participants were educated and trained in the self-bandaging technique. The participants then wore MLB on the affected extremity for the following seven nights at home from bedtime to the next morning (hereafter referred to as the intervention). We measured the segmental total body water (STBW) volume on the affected upper extremity using bioimpedance spectroscopy and subjective symptoms using a visual analog scale. Each parameter was measured at the beginning and end of the intervention periods. It was found that the STBW volume on the affected upper extremity decreased significantly during intervention. The mean STBW volume reduction was 0.088 L (p = .047, 95% CI [0.001, 0.175] L]). Subjective symptoms related to swelling (i.e., tightness, heaviness, and fullness) decreased significantly during intervention (p < .05). In conclusion, decrease in the STBW volume and subjective symptoms on the affected upper extremity were observed at the end of the intervention. These results suggest that NMLB reduces both swelling and swelling-related symptoms of BCRL.

ECAMulticapa: Effectiveness of double-layered compression therapy for healing venous ulcers in primary care: a Study Protocol.

BackgroundChronic venous insufficiency, in its final stage can cause venous ulcers. Venous ulcers have a prevalence of 0.5 % to 0.8 % in the general population, and increases starting at 60 years of age. This condition often causes increased dependency in affected individuals, as well as a perceived reduced quality of life and family overload.Local Treating chronic venous ulcers has 2 components: topically healing the ulcer and controlling the venous insufficiency. There is evidence that compressive therapy favours the healing process of venous ulcers. The studies we have found suggest that the use of multilayer bandage systems is more effective than the use of bandages with a single component, these are mostly using in Spain. Multilayer compression bandages with 2 layers are equally effective in the healing process of chronic venous ulcers as 4-layer bandages and are better tolerated and preferenced by patients. More studies are needed to specifically compare the 2-layer bandages systems in the settings where these patients are usually treated.Method/designRandomised, controlled, parallel, multicentre clinical trial, with 12 weeks of follow-up and blind evaluation of the response variable.The objective is to assess the efficacy of multilayer compression bandages (2 layers) compared with crepe bandages, based on the incidence of healed venous ulcers in individuals treated in primary care nursing consultations, at 12 weeks of follow-up.The study will include 216 individuals (108 per branch) with venous ulcers treated in primary care nursing consultations.The primary endpoint is complete healing at 12 weeks of follow-up. The secondary endpoints are the degree of healing (Resvech.2), quality of life (CCVUQ-e), adverse reactions related to the healing process. Prognosis and demographic variables are also recorder.Effectiveness analysis using Kaplan-Meier curves, a log-rank test and a Cox regression analysis. The analysis was performed by intention to treat.DiscussionThe study results can contribute to improving the care and quality of life of patients with venous ulcers, decreasing healing times and healthcare expenditure and contributing to the consistent treatment of these lesions.Trial registrationThis study has been recorded in the Clinical Trials.gov site with the code NCT02364921. 17 February 2015.

Liquid transmission characteristics of padding bandages under pressure.

Padding is an essential component in a multilayer compression bandaging system, used inside the compression bandage through which substantial amount of pressure is exerted on the limb of patient for treatment of venous leg ulcers. As a result, the liquid transmission behavior of padding is also critical in managing body fluids or sweat exuded from the affected limb, reducing the excessive moisture build-up around the wound and thereby ensuring comfort to and hence a better compliance from the patients. This study investigates the in-plane fluid transport characteristics of needle-punched nonwoven padding bandages. It first reviewed the existing studies related to the problems, and discussed their limits and possible improvements in dealing with complex fluid transport issues in textile porous media. The measurement of fluid transport under different pressure levels was then done using a newly designed apparatus capable of simultaneously tracing the liquid in-plane spreading along different directions, and obtaining several transport characteristics of a testing sample, e.g. the liquid flow anisotropy, the rate of movement, the area of wet surface with time, etc. Also the effects of several important factors, such as the levels of pressure applied, the specimen bulk density, and needling density of the padding products, have been experimentally investigated. In addition, based on an extended Lucas-Washburn theory, we calculated the liquid flow distance, both instantaneous speed and a more useful time-averaged speed v(av) at any given direction, and also defined a flow anisotropy index I(A) as a convenient parameter to represent the material flow anisotropy. The applications of v(av) and I(A) to actual samples have demonstrated the usefulness of these parameters in characterizing the flow nature and behavior of the materials.

Prognostic factors related to delayed healing of venous leg ulcer treated with compression therapy

The basic goal of this research was to determine and evaluate the prognostic factors related to the delay of venous ulcer healing in patients treated with multilayer compression bandage.

Foot &amp; Ankle

The October 2014 Foot &amp; Ankle Roundup360 looks at: multilayer compression bandaging superior for post-traumatic ankle oedema; compression stockings for ankle fractures; weight bearing ok in Achilles tendon ruptures; MRI findings can predict ankle sprain symptoms; salvage for malreduced ankle fractures; locking fibular plates are more expensive; is fixation better early or late in pilon fractures?; and calcaneal fracture fixation not for subtalar arthropathy

A prospective, open, multicentre study to evaluate a new gelling fibre dressing containing silver in the management of venous leg ulcers.

This study investigated the performance of a new gelling fibre dressing containing silver (DURAFIBER™ Ag; Smith & Nephew, Hull, UK) in moderate to highly exuding venous leg ulcers with one or more clinical signs of infection. Fourteen patients with venous leg ulceration of median ulcer duration 12·5 weeks, recruited from three centres in South Africa, received treatment with the new dressing for a maximum of 8 weeks. Multilayer compression bandaging was used for all patients, at the majority of assessments. The objectives of this study were to assess the clinical acceptability of the dressing in terms of the following characteristics: antimicrobial properties, the progress of the wound towards healing, wear time, exudate management, conformability, patient comfort, pain on application, pain on removal and dressing integrity. The new dressing was rated as clinically acceptable for all characteristics, for all 14 patients (100%). It was easy to apply and remove; in 96·8% of removals, the dressing stayed intact on removal and could be removed in one piece. Fifty per cent of the wounds healed within the 8‐week study duration; between baseline and final assessment, the median percentage reduction in wound area was 98·2% and the median percentage reduction in devitalised tissue was 78%. Exudate levels and wound pain were significantly improved at final assessment compared to baseline assessment, and an increase in the number of patients with healthy peri‐wound skin between baseline and final assessment was observed. A reduction in bioburden and signs of clinical infection and an improvement in quality of life were observed over the 8‐week period. The average wear time was 6·4 days. This study supports the use of new dressing in the management of moderately to highly exuding venous leg ulcers with clinical signs of infection.

High Frequency and Noncontact Low Frequency Ultrasound Therapy for Venous Leg Ulcer Treatment: a Randomized Controlled Study

Background: Ultrasound therapy can be utilized to manage chronic wounds including venous leg ulcers (VLUs). Objectives: A randomized controlled clinical study was conducted to compare the effectiveness of standard treatment and standard treatment plus either high frequency ultrasound (HFU) or noncontact low-frequency ultrasound (NCLFU) on VLU outcomes. Patients and Methods: Ninety outpatients (47 men, 43 women; average age, 38.3 [SD, 11.5] years) were randomly assigned into either of the standard care (n = 30), HFU (n = 30) or NCLFU groups (n = 30). Standard care included multilayered compression bandaging (40 mm Hg of pressure at the ankle graduated to 17 mm Hg to 20 mm Hg below the knee) nonadherent dressing and regular debridement. Standard care dressing changes and ultrasound therapy were provided three times per week for 3 months or until healing. HFU delivers high intensity (0.5 1 W/cm2) high frequency (1 3 MHz) ultrasound for 5 to 10 minutes and NCLFU delivers low-intensity (0.1 0.8 W/cm2) low frequency (40 kHz) ultrasound for 4-10 minutes. Patients were followed until healing. Wound size wound pain and lower leg edema was assessed at baseline and after 2 and 4 months. Data were analyzed using Student's t test ANOVA, chi square or Fisher s exact test. P value of less than 0.05 was considered significant. Results: Initial wound measurements were 9.60 cm2 (SD 5.54) 9.86 cm2 (SD 3.95) and 10.01 cm2 (SD 4.58) for the standard treatment HFU and NCLFU groups respectively. After 4 months measurements were reduced to 4.28 cm2 (SD 2.80) 3.23 cm2 (SD 2.39) and 2.72 cm2 (SD 2.16) for the standard treatment HFU and NCLFU groups respectively which was statistically significant (P = 0.04). All wounds were healed after an average of 8.50 (SD 2.17) 6.86 (SD 2.04) and 6.65 (SD 1.59) months in the standard treatment, HFU and NCLFU groups respectively (P = 0.001). Differences in the amount of edema and pain rating scores were also significant at the 4th month follow up visit (P = 0.05). Conclusions: Outcomes of both methods of ultrasound therapy were better than standard care alone, and some differences between the two ultrasound therapy groups were observed, but they were not statistically significant.

Effect of Multi-layer Compression Bandage Systems on Leg Ulcers Associated with Chronic Venous Insufficiency

Giriş: Kronik venöz yetmezliğe bağlı bacak ülserleri yüksek prevalans ve tedavi için yüksek maliyet açısından çok önemli bir sağlık problemidir. Venöz bacak ülserlerinin tedavisinde çok katlı kompresyon bandaj sistemleri altın standarttır. Çalışmamızın amacı çok katlı kompresyon bandaj sistemin kronik venöz yetmezliğe bağlı oluşan venöz bacak ülserlerinin tedavisinde etkinliğini araştırmaktır. Hastalar ve Yöntem: Kliniğimize başvuran bacak ülserli ardışık 19 hasta değerlendirildi ve dört hasta periferik arter hastalığı nedeniyle çalışmadan çıkarıldı. Toplam 15 hasta çalışmaya dahil edildi. Hastaların CEAP sınıflandırmaları yapıldı ve tüm hastalar aynı CEAP sınıfına dahildi. Hastalara Betaven® çok katlı kompresyon bandajı uygulandı. Hastalar yara iyileşmeleri açısından takip edildi. Hastaların ülser boyutları planimetrik olarak ölçülerek değerlendirildi. Takip kriteri olarak yara iyileşmesi, yara alanında azalma esas alındı. Bulgular: Kliniğimizde toplam 12 erkek ve üç kadın hastaya çok katlı bandaj sistemi uygulandı. Hastaların yaş ortalaması 38.2 ± 4.2 idi. Hastaların ülser boyutları planimetrik olarak ölçüldü. Ülser boyutlar 4-10 cm² idi. Hastaların ülserleri yedi hastada medial malleol ayak bileği seviyesinde, üç tanesi lateral malleol düzeyinde, dört tanesi bacak ön yüzde bir tanesi bacak lateral yüzeydeydi. Hastalarda ortalama 5.1 ± 2.1 yıldır kronik venöz yetmezlik bulunmaktaydı. Hastaların CEAP sınıflaması C6, Ep, As2,3-p18, Pr2,3, 18 şeklindeydi. Ortalama tedavi süresi 6 ± 2 hafta olarak gerçekleşti ve bir hasta dışında tüm hastalarda tam iyileşme sağlandı. Bu hasta da rekonstrüksiyon amacıyla plastik cerrahi kliniğine yönlendirildi. Sonuç: Çok katlı kompresyon bandaj sistemleri intersisyel doku basıncını artırarak venöz dönüşü artırır ve venöz hipertansiyonu azaltarak kronik venöz yetmezliğe bağlı oluşan venöz bacak ülserlerinin tedavisinde etkili olur. Bu etkisi kısa sürede ortaya çıkmakta hem düşük maliyetle tedavi edilmekte hem de işgücü kaybının önüne geçilmektedir

Assessment of moisture management performance of multilayer compression bandages

The moisture management property of compression bandages is a critical factor influencing the state of well-being and compliance of patients with venous and lymphatic disorders. The thermal resistance and water vapor transmission rate of compression bandages were assessed using a limb model, which allows bandage application under tension and provides valuable insight on moisture distribution across the entire ensemble under simulated wear conditions. The performance of eight commercially available two- and four-layer compression bandages was evaluated based on measurement of physical parameters, such as thickness and mass per area, moisture sorption, air permeability, water vapor permeability, and moisture distribution during the simulated wear test. The gravimetrically determined water vapor transmission of the different bandages varied from 279 to 341 g m−2 h−1. Low air permeability of padding or cohesive can indicate possible moisture barrier properties, which could cause undesirable moisture accumulation inside the bandage. Robust reproducibility of the test, along with rapidity and ease of manipulation, allows comparison between the individual products and could provide the basis of dressing performance standardization.

An experimental study of prescribed walking in the management of venous leg ulcers

To determine the relationship between the level of patient activity in the form of walking and the rate of venous leg ulcer (VLU) healing. Forty patients with newly diagnosed VLUs were recruited to the study a nd randomly allocated to either control or exercise groups. All patients were treated with multilayer compression bandaging for 12 weeks, or until their ulcer had fully healed. Daily stepping rate was recorded at initial assessment and following 4 weeks of treatment. Participants in the exercise group were encouraged to increase their daily steps with a target of 10 000 steps per day. The control group were n ot asked to change their daily steps. In total, 33% of the exercise group achieved an average of 10 000 steps per day. Participants who took more steps at both the baseline and 4-week assessment healed more quickly than those who took fewer steps (p=0.052 and p=0.008 for baseline and week 4, respectively). Sixty-seven per cent of the participants who increased their daily steps had venous ulcers, which were healed by week 8, compared with 35% of those who did not. Participants who took more steps per day showed faster venous ulcer healing times when compared with those who took fewer steps, emphasising the benefit of walking in this patient group. Further studies are necessary to confirm these early findings. There were no external sources of funding for this study. The authors have no conflict of interest to declare.