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A Journal on Physiopathology and Therapy of Chronic Cutaneous Ulcers
Official Journal of the Italian Association for Cutaneous Ulcers
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Acta Vulnologica 2009 December;7(4):197-205
Compression therapy in patients with reduced mobility following thopic lesions of the lower limbs
Clinica MD Barbantini, Lucca, Italia
Aim. Immobility or reduced mobility have always been considered the main indication for elastic compression as this kind of compression would be “active” in the resting position. Aim of our work was to examine if elastic compression is really more effective compared with inelastic in patients with restricted mobility.
Methods. In 20 patients (10 males, 10 females age 75.4± 8.2, range 65-82 years) with reduced mobility we applied an elastic and inelastic bandage with the same pressure of 40 mmHg in the supine position and measured the interface pressure exerted in supine, sitting and standing position and during active and passive muscle contraction. The difference between standing and supine pressure as well as between sitting and supine position and between muscular systole and diastole during active and passive contraction was also measured.
Results. Elastic and inelastic bandages exert similar resting pressure. Inelastic bandage produces pressure peaks in the sitting and standing position and during the muscular systole much higher compared with elastic material (P<0.001). As a consequence the differences between standing and supine pressure, sitting and supine pressure and from muscular systole and diastole are much higher with inelastic compression (P<0.001).
Conclusion. Results show that elastic bandage is not more effective than inelastic bandage. Both bandages can exert an “active” resting pressure. During the muscular contraction, even when passive, inelastic bandage produces higher pressure, compared with elastic, (the so called “massage effect”). This produces a greater hemodynamic effect: the increase of ejection fraction is directly correlated to the systolic pressure and “massage effect”. The concept that only elastic compression is effective in supine position in patients with reduced mobility is a misconception.