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Satpathy, A., S. Hayes, and S. Dodds. "Is compression bandaging accurate? The routine use of interface pressure measurements in compression bandaging of venous leg ulcers." Phlebology: The Journal of Venous Disease 21, no. 1 (March 1, 2006): 36–40. http://dx.doi.org/10.1258/026835506775971207.
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Objective: To test the use of a low-cost, portable, battery-powered sub-bandage pressure monitor as a part of a quality control measure for graduated compression bandaging in the leg ulcer clinics. Methods: A total of 25 healthy volunteers (mean age 40 years) providing 50 limbs were bandaged with a 4-layer compression bandaging system. Interface pressure was measured by placing pressure sensors on the skin at three points (2 cm above the medial malleolus, on the widest part of the calf and on a point midway between them) in supine and standing positions. A further 16 patients (mean age 62 years) providing 22 limb measurements also participated in this study. Bandages were reapplied in patients with the help of the pressure monitors when the target pressure was not achieved in the first attempt. Results: The interface pressures varied with change of position and movement. With the operator blinded, the target pressure of 35–40 mmHg at the ankle was achieved in only 36% of healthy volunteers (mean±95% confidence interval, 32.3±1.6 mmHg [supine]; 38.4±2.4 mmHg [standing position]). With the help of the pressure monitors, the target pressure was achieved in 78% of the patients. Conclusion: This result suggests that it is important to have a tool that is easy to operate, and available as a part of the quality assurance in connection with treatment and also training of care providers, nurses, etc in how to apply a compression bandage.
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Ruckley, C. V., J. J. Dale, B. Gibson, D. Brown, A. J. Lee, and R. J. Prescott. "Evaluation of Compression Therapy: Comparison of Three Sub-bandage Pressure Measuring Devices." Phlebology: The Journal of Venous Disease 17, no. 2 (June 2002): 54–58. http://dx.doi.org/10.1177/026835550201700203.
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Objective: To compare the consistency of the pressure measurements and the practical aspects of three manometers (Salzman MST; Oxford Talley and Diastron) measuring sub-bandage pressures. Methods: Five bandages (tubular elastic straight, tubular elastic graduated, short stretch non-elastic, long stretch elastic, cohesive elastic) were applied to standard models comprising foam-covered 9.5 cm, 12.5 cm diameter plastic tubes and a cone by a single expert bandager using a standard spiral technique with 50% overlap for the non-tubular bandages (NTB). The probes of all three machines were positioned at equidistant points around the circumference of each model at three levels corresponding to the ankle, gaiter and mid-calf measuring points of the MST probe. Two readings were taken for each of three separate applications of each bandage. Statistical analysis utilised ANOVA with Bartlett's test. Results. A total of 135 readings were made for each machine and 81 for each type of bandage. Mean pressures among the five bandages types ranged from 12.2 to 35.5 mmHg. A pressure gradient was apparent when NTB bandaging the straight tubes (means 24.7, 23.5, 22.4 mmHg) but not with the cone. There was a statistically significant difference between the three machines (Bartlett's test 23.6, p<0.0001), with the lowest variances for the MST and similar variances for the Oxford and Diastron. Conclusion. In terms of measurement variance this experiment indicates that the MST is the preferred machine for future experiments.
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Ruckley, C. V., J. J. Dale, B. Gibson, D. Brown, A. J. Lee, and R. J. Prescott. "Multi-layer compression: comparison of four different four-layer bandage systems applied to the leg." Phlebology: The Journal of Venous Disease 18, no. 3 (September 1, 2003): 123–29. http://dx.doi.org/10.1258/026835503322381324.
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Objective: To compare on standardized laboratory models the performance of four commercially available four-layer bandage systems. Methods: Four experienced bandagers applied each of the four systems [Profore® Regular (Smith & Nephew, Hull, UK), Ultra Four (Robinsons, Chesterfield, UK), System 4 (SSL International, Knutsford, UK) and K-Four® (Parema, Loughborough, UK)] to two models: a 12.5 cm diameter padded cylinder and a 9.5-14.5 cm padded cone. Bandages were applied individually in single layers and as a completed system using standard application techniques. Pressures were measured by the Borgnis Medical Stocking Tester at positions corresponding to ankle, gaiter and mid-calf areas as determined by the pressure sensor. Results: A total of 768 observations were made: 384 for each model, 192 for each bandaging system, 192 for each bandager and 128 for each measuring point. The increase in pressure produced by each additional layer was in the range of 50-60% of the pressure achieved by the same bandage when used as a single layer. Each bandage system and each bandager produced a gradient of final mean pressure irrespective of whether the bandage was applied to a cylinder or a cone. However, there were no significant differences in the gradients between the four bandage systems or between the four bandagers. There were significant differences in the final pressures achieved among the bandage systems when applied as completed systems (mean: Profore® = 42 mmHg; System 4 = 45 mmHg; K-Four® = 48 mmHg; and Ultra Four = 51 mmHg; P<0.001). Conclusions: These results challenge a commonly-held assumption concerning the additive effect of pressures generated by successive bandage layers. When applied as part of a multi-layered system each bandage adds just over half the pressure achieved by the same bandage when applied alone. The four completed systems produced pressures within a range appropriate for ulcer therapy, although there were significant differences in mean pressures. This capability of the systems to produce different pressures could be clinically important in the hands of inexperienced bandagers or with patients at risk of pressure damage..
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Davies, CE, G. Woolfrey, N. Hogg, J. Dyer, A. Cooper, J. Waldron, R. Bulbulia, MR Whyman, and KR Poskitt. "Maggots as a wound debridement agent for chronic venous leg ulcers under graduated compression bandages: A randomised controlled trial." Phlebology: The Journal of Venous Disease 30, no. 10 (October 8, 2014): 693–99. http://dx.doi.org/10.1177/0268355514555386.
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Objectives Slough in chronic venous leg ulcers may be associated with delayed healing. The purpose of this study was to assess larval debridement in chronic venous leg ulcers and to assess subsequent effect on healing. Methods All patients with chronic leg ulcers presenting to the leg ulcer service were evaluated for the study. Exclusion criteria were: ankle brachial pressure indices <0.85 or >1.25, no venous reflux on duplex and <20% of ulcer surface covered with slough. Participants were randomly allocated to either 4-layer compression bandaging alone or 4-layer compression bandaging + larvae. Surface areas of ulcer and slough were assessed on day 4; 4-layer compression bandaging was then continued and ulcer size was measured every 2 weeks for up to 12 weeks. Results A total of 601 patients with chronic leg ulcers were screened between November 2008 and July 2012. Of these, 20 were randomised to 4-layer compression bandaging and 20 to 4-layer compression bandaging + larvae. Median (range) ulcer size was 10.8 (3–21.3) cm2 and 8.1 (4.3–13.5) cm2 in the 4-layer compression bandaging and 4-layer compression bandaging + larvae groups, respectively (Mann–Whitney U test, P = 0.184). On day 4, median reduction in slough area was 3.7 cm2 in the 4-layer compression bandaging group ( P < 0.05) and 4.2 cm2 ( P < 0.001) in the 4-layer compression bandaging + larvae group. Median percentage area reduction of slough was 50% in the 4-layer compression bandaging group and 84% in the 4-layer compression bandaging + larvae group (Mann–Whitney U test, P < 0.05). The 12-week healing rate was 73% and 68% in the 4-layer compression bandaging and 4-layer compression bandaging + larvae groups, respectively (Kaplan–Meier analysis, P = 0.664). Conclusions Larval debridement therapy improves wound debridement in chronic venous leg ulcers treated with multilayer compression bandages. However, no subsequent improvement in ulcer healing was demonstrated.
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Al Khaburi, J., E. A. Nelson, J. Hutchinson, and A. A. Dehghani-Sanij. "Impact of multilayered compression bandages on sub-bandage interface pressure: a model." Phlebology: The Journal of Venous Disease 26, no. 2 (March 2011): 75–83. http://dx.doi.org/10.1258/phleb.2010.009081.
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Background Multi-component medical compression bandages are widely used to treat venous leg ulcers. The sub-bandage interface pressures induced by individual components of the multi-component compression bandage systems are not always simply additive. Current models to explain compression bandage performance do not take account of the increase in leg circumference when each bandage is applied, and this may account for the difference between predicted and actual pressures. Objective To calculate the interface pressure when a multi-component compression bandage system is applied to a leg. Method Use thick wall cylinder theory to estimate the sub-bandage pressure over the leg when a multi-component compression bandage is applied to a leg. Results A mathematical model was developed based on thick cylinder theory to include bandage thickness in the calculation of the interface pressure in multi-component compression systems. In multi-component compression systems, the interface pressure corresponds to the sum of the pressures applied by individual bandage layers. However, the change in the limb diameter caused by additional bandage layers should be considered in the calculation. Adding the interface pressure produced by single components without considering the bandage thickness will result in an overestimate of the overall interface pressure produced by the multi-component compression systems. At the ankle (circumference 25 cm) this error can be 19.2% or even more in the case of four components bandaging systems. Conclusion Bandage thickness should be considered when calculating the pressure applied using multi-component compression systems.
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Fousekis, Konstantinos, Evdokia Billis, Charalampos Matzaroglou, Konstantinos Mylonas, Constantinos Koutsojannis, and Elias Tsepis. "Elastic Bandaging for Orthopedic- and Sports-Injury Prevention and Rehabilitation: A Systematic Review." Journal of Sport Rehabilitation 26, no. 3 (May 2017): 269–78. http://dx.doi.org/10.1123/jsr.2015-0126.
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Context:Elastic bandages are commonly used in sports to treat and prevent sport injuries.Objective:To conduct a systematic review assessing the effectiveness of elastic bandaging in orthopedic- and sports-injury prevention and rehabilitation.Evidence Acquisition:The researchers searched the electronic databases MEDLINE, CINAHL, SPORTDiscus, EMBASE, and Physiotherapy Evidence Database (PEDro) with keywords elastic bandaging in combination, respectively, with first aid, sports injuries, orthopedic injuries, and sports injuries prevention and rehabilitation. Research studies were selected based on the use of the term elastic bandaging in the abstract. Final selection was made by applying inclusion and exclusion criteria to the full text. Studies were included if they were peer-reviewed clinical trials written in English on the effects of elastic bandaging for orthopedic-injury prevention and rehabilitation.Evidence Synthesis:Twelve studies met the criteria and were included in the final analysis. Data collected included number of participants, condition being treated, treatment used, control group, outcome measures, and results. Studies were critically analyzed using the PEDro scale.Conclusions:The studies in this review fell into 2 categories: studies in athletes (n = 2) and nonathletes (n = 10). All included trials had moderate to high quality, scoring ≥5 on the PEDro scale. The PEDro scores for the studies in athletes and nonathletes ranged from 5 to 6 out of 10 and from 5 to 8 out of 10, respectively. The quality of studies was mixed, ranging from higher- to moderate-quality methodological clinical trials. Overall, elastic bandaging can assist proprioceptive function of knee and ankle joint. Because of the moderate methodological quality and insufficient number of clinical trials, further effects of elastic bandaging could not be confirmed.
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Callam, M. J., D. R. Harper, J. J. Dale, D. Brown, B. Gibson, R. J. Prescott, and C. V. Ruckley. "Lothian and Forth Valley Leg Ulcer Healing Trial, Part 2: Knitted Viscose Dressing versus a Hydrocellular Dressing in the Treatment of Chronic Leg Ulceration." Phlebology: The Journal of Venous Disease 7, no. 4 (December 1992): 142–45. http://dx.doi.org/10.1177/026835559200700403.
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Objective: To compare a new ‘advanced’ hydrocellular Polyurethane dressing (HPD) (Allevyn) with a traditional simple non-adherent knitted viscose dressing (KDV) (Tricotex) in the treatment of chronic venous leg ulcers. Design: A randomized trial of factorial design, with interaction testing, to allow the evaluation of two different therapeutic components (dressing and bandages) within a single trial. The treatment period was 12 weeks or until healing, whichever occurred sooner. Setting: The Leg Ulcer Clinics of Edinburgh and Falkirk and District Royal Infirmaries, Scotland. Patients: 132 patients with chronic venous leg ulcers were randomized, 66 to HPD and 66 to KVD. Principal exclusions were patients with diabetes, rheumatoid disease or Doppler ankle/brachial pressure indices of less than 0.8. There were 28 withdrawals (15 KVD, 13 HPD). These were considered as treatment failures. Interventions: Dressings and bandaging were applied by specialist leg ulcer nurses using standard techniques throughout, the bandaging being randomized to either elastic or non-elastic multilayer systems. Main outcome measure: The principal end-point was ulcer healing. Also monitored were healing rates, pain and the frequency of dressing changes. Results: Pain relief was significantly better in the HPD group ( p=0.01). Thirty-one (47%) of the HPD patients healed within 12 weeks compared with only 23 (35%) of the those treated with KVD (95% confidence limits for difference, −5% to +29%). The higest healing rates (61% for all ulcers and 74% for those less than 10 cm2) were observed in the subgroup in which HPD was used in combination with an elastic bandaging system. Conclusion: Patients treated with HPD did significantly better in terms of pain relief, although the higher healing rates observed in this group failed to reach significance at the 5% level.
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Callam, M. J., D. R. Harper, J. J. Dale, D. Brown, B. Gibson, R. J. Prescott, and C. V. Ruckley. "Lothian and Forth Valley Leg Ulcer Healing Trial, Part 1: Elastic versus Non-Elastic Bandaging in the Treatment of Chronic Leg Ulceration." Phlebology: The Journal of Venous Disease 7, no. 4 (December 1992): 136–41. http://dx.doi.org/10.1177/026835559200700402.
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Objective: To determine whether elastic or non-elastic bandaging is more effective in healing chronic venous ulcers. Design: Randomized trial with factorial design and interaction analysis, enabling independent evaluation of both bandaging and dressings within the single-trial format. The duration of treatment was 12 weeks or until ulcer-healing, whichever occurred sooner. Setting: The Leg Ulcer Clinics of Edinburgh and Falkirk and District Royal Infirmaries, Scotland. Patients: 132 patients with chronic leg ulcers and clinical evidence of chronic venous disease, and excluding those with Doppler ultrasound ankle/brachial pressure indices of less than 0.8, diabetes or rheumatoid disease. There were 28 withdrawals who were classified for analysis as treatment failures. Interventions: Elastic or non-elastic multilayer bandage systems were applied using similar application techniques by a team of trained nurse specialists. All other treatments were standardized, including the randomization of dressings to either a knitted viscose or a hydrocellular polyurethane dressing. Main outcome measure: Complete ulcer healing. Results: In the elastic group 35 out of 65 ulcers (54%) healed within 12 weeks compared with 19 out of 67 (28%) in the non-elastic group (95% confidence limits for percentage healed, 9% to 42%). Ulcer pain was also reported significantly less often in the elastic group (48% of visits versus 29%; p=0.03). Conclusion: When applied by similar multilayer bandaging techniques, elastic bandaging was significantly better than non-elastic bandaging in the treatment of chronic venous leg ulcer.
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Gardon-Mollard, C. "Tubular Compression in the Treatment of Venous Ulcers of the Leg: A New Graduated Tubular Device." Phlebology: The Journal of Venous Disease 15, no. 3-4 (December 2000): 169–74. http://dx.doi.org/10.1177/026835550001500317.
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Background: Compression treatment remains an effective method of healing of venous ulceration. Traditional bandaging techniques require considerable nursing time to apply. Elastic stockings are comfortable but patients find these difficult to put on over dressings. Aim: To develop a tubular compression bandage system that can be easily applied to patients with venous leg ulceration. Methods: A tubular bandage has been designed (Tubulcus) which applies 30-40 mmHg compression at the ankle with graduated compression above this. An applicator system has been designed (Tricolore) which allows the compression bandage to be applied over ulcer dressings. The device has been evaluated on a cylindrical former and an anatomical model of a leg, in order to assess its suitability for clinical trials. It has been compared with three types of compression bandage. Results: The tubular bandaging system provides sustained compression to be applied to leg ulcers whilst facilitating dressing changes. The graduated compression profile achieved with this system is more easily obtained than when using any of the three types of bandage. Conclusion: A system of application of elastic compression has been designed specifically for use in patients with venous ulceration. Clinical trials are now required to demonstrate the efficacy of this system.
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Ashby, Rebecca L., Rhian Gabe, Shehzad Ali, Pedro Saramago, Ling-Hsiang Chuang, Una Adderley, J. Martin Bland, et al. "VenUS IV (Venous leg Ulcer Study IV) – compression hosiery compared with compression bandaging in the treatment of venous leg ulcers: a randomised controlled trial, mixed-treatment comparison and decision-analytic model." Health Technology Assessment 18, no. 57 (September 2014): 1–294. http://dx.doi.org/10.3310/hta18570.
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BackgroundCompression is an effective and recommended treatment for venous leg ulcers. Although the four-layer bandage (4LB) is regarded as the gold standard compression system, it is recognised that the amount of compression delivered might be compromised by poor application technique. Also the bulky nature of the bandages might reduce ankle or leg mobility and make the wearing of shoes difficult. Two-layer compression hosiery systems are now available for the treatment of venous leg ulcers. Two-layer hosiery (HH) may be advantageous, as it has reduced bulk, which might enhance ankle or leg mobility and patient adherence. Some patients can also remove and reapply two-layer hosiery, which may encourage self-management and could reduce costs. However, little robust evidence exists about the effectiveness of two-layer hosiery for ulcer healing and no previous trials have compared two-layer hosiery delivering ‘high’ compression with the 4LB.ObjectivesPart I To compare the clinical effectiveness and cost-effectiveness of HH and 4LB in terms of time to complete healing of venous leg ulcers.Part II To synthesise the relative effectiveness evidence (for ulcer healing) of high-compression treatments for venous leg ulcers using a mixed-treatment comparison (MTC).Part III To construct a decision-analytic model to assess the cost-effectiveness of high-compression treatments for venous leg ulcers.DesignPart I A multicentred, pragmatic, two-arm, parallel, open randomised controlled trial (RCT) with an economic evaluation.Part II MTC using all relevant RCT data – including Venous leg Ulcer Study IV (VenUS IV).Part III A decision-analytic Markov model.SettingsPart I Community nurse teams or services, general practitioner practices, leg ulcer clinics, tissue viability clinics or services and wound clinics within England and Northern Ireland.ParticipantsPart I Patients aged ≥ 18 years with a venous leg ulcer, who were willing and able to tolerate high compression.InterventionsPart I Participants in the intervention group received HH. The control group received the 4LB, which was applied according to standard practice. Both treatments are designed to deliver 40 mmHg of compression at the ankle.Part II and III All relevant high-compression treatments including HH, the 4LB and the two-layer bandage (2LB).Main outcome measuresPart I The primary outcome measure was time to healing of the reference ulcer (blinded assessment).Part II Time to ulcer healing.Part III Quality-adjusted life-years (QALYs) and costs.ResultsPart I A total of 457 participants were recruited. There was no evidence of a difference in time to healing of the reference ulcer between groups in an adjusted analysis [hazard ratio (HR) 0.99, 95% confidence interval (CI) 0.79 to 1.25;p = 0.96]. Time to ulcer recurrence was significantly shorter in the 4LB group (HR = 0.56, 95% CI 0.33 to 0.94;p = 0.026). In terms of cost-effectiveness, using QALYs as the measure of benefit, HH had a > 95% probability of being the most cost-effective treatment based on the within-trial analysis.Part II The MTC suggests that the 2LB has the highest probability of ulcer healing compared with other high-compression treatments. However, this evidence is categorised as low to very low quality.Part III Results suggested that the 2LB had the highest probability of being the most cost-effective high-compression treatment for venous leg ulcers.ConclusionsTrial data from VenUS IV found no evidence of a difference in venous ulcer healing between HH and the 4LB. HH may reduce ulcer recurrence rates compared with the 4LB and be a cost-effective treatment. When all available high-compression treatments were considered, the 2LB had the highest probability of being clinically effective and cost-effective. However, the underpinning evidence was sparse and more research is needed. Further research should thus focus on establishing, in a high-quality trial, the effectiveness of this compression system in particular.Trial registrationCurrent Controlled Trials ISRCTN49373072.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 18, No. 57. See the NIHR Journals Library website for further project information.
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Franks, P. J., M. Moody, C. J. Moffatt, J. Patton, L. Bradley, D. Chaloner, and J. Stevens. "Quality of life in a trial of short stretch versus four-layer bandaging in the management of chronic venous ulceration." Phlebology: The Journal of Venous Disease 19, no. 2 (June 1, 2004): 87–91. http://dx.doi.org/10.1258/026835504323080371.
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Objective: To evaluate health-related quality of life (HRQoL) in a prospective randomized trial of patients suffering from venous ulceration comparing a generic four-layer elastic bandage (4LB) with a new cohesive short stretch bandage system (CSSB). Methods: Randomized prospective open parallel groups trial in community leg ulcer clinics within twelve trusts in England and Northern Ireland. Patients newly presenting for treatment suffering from chronic venous ulceration, with ankle brachial pressure index (ABPI) >0.8 were entered into the trial. Patients were asked to complete the Nottingham Health Profile (NHP) at entry, at end of trial period (withdrawal or healing), and at 24 weeks. Principal analysis was the comparison of final NHP scores using linear regression with baseline scores entered as a covariate. Results: In all, 154 of the 156 patients who entered the trial completed the initial questionnaire, with 139/154 (90.2%) patients completing at least one follow-up questionnaire. Improvements were noted for all scores after 24 weeks. The improvements were significantly greater in the 114 patients whose ulcers had healed compared with the 40 whose ulcers remained open in the domains of bodily pain (mean difference [d]=13.2, 95% CI 3.6-22.9, P =0.008), emotional reactions (d=10.5, 95% CI 2.8-18.1, P =0.007) and social isolation (d=8.5, 95% CI 1.2-15.9, P =0.024). There were similar mean scores between the 72 patients treated with the 4LB and the 82 patients treated with CSSB for all domains of the NHP, the largest adjusted difference favoured CSSB for energy (d=3.6, 95% CI-4.3-11.4, P =0.37). Conclusions: Patients suffering from leg ulceration show improvements in perceived health following effective ulcer management. The two bandage systems achieved similar improvements in perceived health over 24 weeks.
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BPharm, Steve Thomas. "Bandages and bandaging." Nursing Standard 4, no. 39 (June 26, 1990): 4–6. http://dx.doi.org/10.7748/ns.4.39.4.s66.
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Krishnamoorthy, Latha, Keith Harding, David Griffiths, Keith Moore, David Leaper, Keith Poskitt, R. Gary Sibbald, et al. "The clinical and histological effects of Dermagraft® in the healing of chronic venous leg ulcers." Phlebology: The Journal of Venous Disease 18, no. 1 (March 1, 2003): 12–22. http://dx.doi.org/10.1258/026835503321236858.
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Objective: Pilot study to assess the safety and effectiveness of Dermagraft® when used in conjunction with multi-layer compression bandage therapy (Profore™) compared with multilayer compression only in the treatment of chronic venous leg ulcers. Design: Open-label, prospective, multicentre, randomized, controlled clinical trial. Methods: Patients aged at least 18 years with leg ulceration of venous aetiology were screened for inclusion in the trial. Patients with arterial disease (ankle brachial pressure index <0.7) and causes of ulceration other than venous disease were excluded. Patients were randomized into four groups. Three active treatment groups received Dermagraft® in combination with compression bandaging, Profore™: Group 1, 12 pieces of Dermagraft (one per week for 12 weeks); Group 2, four pieces of Dermagraft (Weeks 0, 1, 4, 8); Group 3, one piece of Dermagraft (Week 0). The control group was treated with compression bandaging alone (Group 4). The study was not powered to detect statistical differences in healing rates. Adverse events were reported according to national guidelines. There was no statistical analysis of adverse event data. Results: In all 53 patients were randomized, of whom 47 completed the study per protocol. At 12 weeks complete healing of the ulcer, analysed by 'intention-to-treat' (ITT) was 15% using Profore alone, 7% using single application Dermagraft and Profore (Group 3), compared with 38% using multiple applications of Dermagraft and Profore (Groups 1 and 2). At study discontinuation, the median percentage reduction in wound area was 81.4% for Group 1, 88.6% for Group 2, 59.4% for Group 3 and 78.1% for Group 4. No major safety issues were identified during the course of the study. Conclusions: The results of the pilot study indicate that four pieces of Dermagraft are the optimal application frequency to take forward to further clinical trials. Further studies are required to confirm these data, and these should be powered to detect whether there are statistical differences in healing rates and safety between different regimens.
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Sermsathanasawadi, Nuttawut, Tanakorn Tarapongpun, Rattana Pianchareonsin, Nattawut Puangpunngam, Chumpol Wongwanit, Khamin Chinsakchai, Pramook Mutirangura, and Chanean Ruangsetakit. "Customizing elastic pressure bandages for reuse to a predetermined, sub-bandage pressure: A randomized controlled trial." Phlebology: The Journal of Venous Disease 33, no. 9 (December 25, 2017): 627–35. http://dx.doi.org/10.1177/0268355517746434.
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Objective A randomized clinical trial was performed to compare the effectiveness of unmarked bandages and customized bandages with visual markers in reproducing the desired sub-bandage pressure during self-bandaging by patients. Method Ninety patients were randomly allocated to two groups (“customized bandages” and “unmarked bandages”) and asked to perform self-bandaging three times. The achievement of a pressure between 35 and 45 mmHg in at least two of the three attempts was defined as adequate quality. Results Adequate quality was achieved by 33.0% when applying the unmarked bandages, and 60.0% when applying the customized bandages ( p = 0.02). Use of the customized bandage and previous experience of bandaging were independent predictors for the achievement of the predetermined sub-bandage pressure ( p = 0.005 and p = 0.021, respectively). Conclusion Customized bandages may achieve predetermined sub-bandage pressures more closely than standard, unmarked, compression bandages. Clinical trials registration ClinicalTrials.gov (NCT02729688). Effectiveness of a Pressure Indicator Guided and a Conventional Bandaging in Treatment of Venous Leg Ulcer. https://clinicaltrials.gov/ct2/show/NCT02729688
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Cilliers, Louise, and François Retief. "Orthopedics in the Graeco - Roman era." Suid-Afrikaanse Tydskrif vir Natuurwetenskap en Tegnologie 28, no. 2 (September 6, 2009): 87–100. http://dx.doi.org/10.4102/satnt.v28i2.63.
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In this study the evolutionary development of orthopedics (management of diseases of bones and joints), which commenced in early Mesopotamia and Egypt, is followed through Classical times.The Greek infl uence probably commenced in the 6thcentury BC with Democedes of Croton who cured the Persian king’s dislocated ankle. The Corpus Hippocraticum laid the foundation of orthopedic practice in antiquity. Although knowledge of anatomy was limited, its four books on orthopedics (The Nature of Bones, Mochlicon, On Fractures, On Joints) count amongst the outstanding contributions of Hippocratic writers. In systematic manner the general recognition and management of fractures and dislocations are covered, followed by the handling of individual lesions. Hippocrates differentiated between closed and open fractures (with overlaying skin wounds). Closed fractures were reduced to as normal a position as possible – manually where possible, but with large bones and in the presence of formidable muscle mass, mechanical traction was often employed (e.g. the Hippocratic bench and the bizarre succusion ladder for spinal deformities). There is no mention of the use of analgetic drugs. After application of cerate (mixture of olive oil, soda and pitch) to the skin, the fracture was immobilized by a combination of plasters and compresses (often fi rmed up with gum-mixtures) – but never very fi rmly. On the 3rd, 6/7th, 9thand 12th days the bandaging was removed, the lesion inspected and if considered necessary, re-aligned, A variety of splints were then applied. Strict bed rest was enforced, as well as a light diet (no wine or meat for 10 days). It was believed that fractures of the feet, clavicle, ribs and jaw healed after 20 days, of the forearm after 30 days, and fractures of the upper arm and leg after 40 days. Open fractures were considered very serious injuries, and reduced very carefully. Protruding bone fragments were removed (sawn off if necessary) and the wound was covered with black cerate, compresses and light bandages. Pressure and heavy splints were thought to induce infection and gangrene and thus avoided. Dislocations were reduced as soon and as effectively as possible, before muscle spasm set in. As with fractures manual reduction was, where necessary, complemented by mechanical traction. After extensive washing of the joint area with warm water, cerate was applied to the wound and specialised bandaging (even splints) ensured immobilization. Open dislocations like open fractures were considered very serious and reduction was not attempted. Again all pressure bandaging was avoided. A non-functional joint was commonly the end result. The management of 18 specifi c fractures is described in detail. Jaw fractures were fi xed by the binding of contiguous teeth. Fractures of the spinal column clearly presented a major problem. Although knowledge of spinal anatomy was surprisingly good, the diagnosis of fractures was very difficult and its association with spinal curvatures presented almost insurmountable problems of management. It was recognized that rib fractures could cause serious damage to the lung and pleura. Complex problems caused by arm fractures involving the elbow or shoulder joints, and combined radius and ulna fractures, are addressed. Femur fractures presented major problems and permanent leg deformity was very common. Open femur fractures were extremely serious and Hippocrates even stated that a physician who could ethically avoid becoming involved in treating such an injury, should do so. Fractures of femur necks were not recognised. The Hippocratic work, Wounds of the head, dealing with fractures of the skull, is not covered in this study.Management of the major joints are individually described. Seven different techniques of reducing a dislocated shoulder joint are mentioned The original description of the management of the dislocation of the wrist and hand is lost. Proper reduction of hip-dislocation was essential to avoid muscle atrophy and life-long limping, and was achieved by intricate mechanical suspension. Strangely enough, lateral dislocation of the knee was a common occurrence and not seen as a serious problem. Congenital club feet were effectively treated by prolonged fi xation in the correct position by way of tight bandaging with compresses stiffened in glue-mixtures.There is abundant skeletal evidence of osteo-arthritis in Neolithic man, but no clear description of it in the Corpus Hippocraticum. Gout is repeatedly mentioned in the Corpus but without detailed descriptions of the disease. In the Roman era authors like Heliodorus, Antyllus and Celsus in particular, wrote authoritatively on orthopedic subjects, Osteo-archaeological evidence is that fractures were treated expertly in the Roman army. Conditions consistent with degenerative osteoarthritis and true gout (as podagra and chiragra) were described by Celsus and Aretaeus of Cappadocia. Soranus, Rufus of Ephesus and Galen also wrote on orthopedic subjects. We will today differ from many statements made in the Corpus Hippocraticum, but it is clear that the orthopedic basis laid by those documents was not seriously challenged for 1 000 years.
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Aboalasaad, Abdelhamid R. R., Brigita Kolčavová Sirková, and Zuhaib Ahmad. "Influence of Tensile Stress on Woven Compression Bandage Structure and Porosity." Autex Research Journal 20, no. 3 (September 18, 2020): 263–73. http://dx.doi.org/10.2478/aut-2019-0027.
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AbstractWoven compression bandage (CB) is one of the elastic textiles that exert pressure on muscles. With a defined tensile strength, it is possible to create the required compression on the given body parts. This work aims to investigate the relationship between woven fabric deformation, porosity, and tensile stress properties of three main types of woven CBs. All bandage samples are applied on human leg using two- and three-layer bandaging techniques. Bandage porosity is calculated for all frames at different weave angles using NIS software. Woven bandage construction parameters which are given by the preparation of warp and weft yarns, twist, count, and density along with woven fabric weave, type of weaving, and finishing process are the main factors that influence the bandage properties. Several methods considering thread distributions have been developed to determine the woven fabric's porosity during the tensile stress. Experimental results confirm that bandage porosity is directly proportional to the bandage extension and weave angle that ranges from 44° to 90°. The novelty of candidate study is to introduce practical remarks to the patient for optimizing the required bandage pressure by suitable extension or applied tension or weave angle for two- and three-layer bandaging systems.
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Finnie, Alison. "Bandages and bandaging techniques for compression therapy." British Journal of Community Nursing 7, no. 3 (March 2002): 134–42. http://dx.doi.org/10.12968/bjcn.2002.7.3.10212.
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Magazinovic, N., J. Phillips-Tumer, and G. V. Wilson. "Assessing nurses' knowledge of bandages and bandaging." Journal of Wound Care 2, no. 2 (March 2, 1993): 97–101. http://dx.doi.org/10.12968/jowc.1993.2.2.97.
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Winston, Ken R., Elizabeth Trinidad, C. Corbett Wilkinson, and Lori A. McBride. "Cerebrospinal fluid shunt operations without cranial bandaging." Journal of Neurosurgery: Pediatrics 3, no. 6 (June 2009): 511–15. http://dx.doi.org/10.3171/2009.2.peds08296.
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Object Cranial bandages are commonly applied over scalp incisions immediately after cerebrospinal fluid (CSF) shunt surgery, putatively to prevent complications, particularly infection. These bandages require resources, consume the time of healthcare workers, and incur non-negligible expenses. It is therefore both reasonable and important to examine the efficacy of cranial bandaging. Methods The combined experience of 3 neurosurgeons over 6.75 years with using no cranial bandaging after operations for implantation or revision of CSF shunts is the basis of this report. These data were prospectively accrued and retrospectively analyzed. Results The infection rate was 4.2% (95% CI 3.1–5.6%) for 1064 operations performed without postoperative cranial bandaging after either shunt insertion or revision surgery through clean or clean-contaminated wounds. The age distribution extended from premature infants through adults 77 years of age. Conclusions The results of this investigation support the position that bandaging scalp wounds after CSF shunt implantation or revision surgery adds no benefit beyond the easier, simpler, faster, and cheaper practice of using antibiotic ointment as a dressing without bandaging.
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Tennant, W. G., K. G. M. Park, and C. V. Ruckley. "Testing Compression Bandages." Phlebology: The Journal of Venous Disease 3, no. 1 (March 1988): 55–61. http://dx.doi.org/10.1177/026835558800300108.
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Compression bandaging is the mainstay of the treatment of chronic venous leg ulcers. Using the Borgnis Medical Stocking Tester, six bandages in common use; (Blue Line, J-Press, Medirip, Elastocrepe, Crepe, and Elastoplast), were studied for the pressures attained, and the ability to sustain pressure. Each bandage was applied 10 times by one of two observers using a standard technique. Pressure measurements were taken hourly for 4h. The pressure exerted by Crepe fell by 63%, and that exerted by Elastoplast fell by 40% over the 4-h test period. Medirip and Blue Line gave the best sustained support. Bandages available on the UK drug tariff are in the main unsatisfactory for the treatment of chronic venous disease.
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Smith, P. D. Coleridge, J. H. Scurr, and K. P. Robinson. "Optimum Methods of Limb Compression following Varicose Vein Surgery." Phlebology: The Journal of Venous Disease 2, no. 3 (September 1987): 165–72. http://dx.doi.org/10.1177/026835558700200309.
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It has been shown that bandages rapidly lose their ability to compress the leg in ambulant patients. However, they are still widely used following varicose vein surgery. We have measured the compression produced by crepe bandages, elastocrepe bandages or graduated high compression stockings following varicose vein surgery. Pressures exerted by the bandages and stockings were measured during the first 24 h following operation. Initially the bandages exerted greater pressures than the stockings. However, the bandaging techniques lost 13-38% of their compression in the first hour and 29–48% in 24 h compared with 3-5% for the compression stocking. Further testing of the bandages on a standard wooden leg and a commercial fabric testing machine confirmed that the loss of compression in the bandaged groups was due to the poor elastic qualities of crepe and elastocrepe bandages. The stockings provided a more constant compression with maintained graduation compared with the bandages.
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McMurran, A. E. L., I. Khan, S. Mohamad, M. Shakeel, and H. Kubba. "Should the duration of head bandaging be reduced after pinnaplasty? A systematic review." Journal of Laryngology & Otology 128, no. 11 (October 13, 2014): 948–51. http://dx.doi.org/10.1017/s0022215114002114.
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AbstractBackground:It is common practice to use head bandages for 7–10 days following pinnaplasty. However, head bandages are often troublesome for patients and can lead to serious complications.Method:A systematic review was performed to evaluate the use of head bandages after pinnaplasty. A search of Medline, Embase (Ovid) and CINAHL (EBSCO collections), the Cochrane Library, Pubmed (US National Library of Medicine) and Google Scholar identified 34 related articles. Of these, 14 were deemed relevant and 2 randomised controlled trials, 1 cohort study, 3 case series and 1 literature review met the inclusion criteria.Results:The two randomised controlled trials show no statistically significant difference in complications when a head bandage was used for the standard 7–10 days, for 24 hours or not at all. The three case series show that using a head bandage for 24 hours or not at all are safe alternatives. The review article recommended that when head bandages are applied after pinnaplasty it should be for the shortest duration possible.Conclusion:Based on the available evidence, not using a head bandage at all or using one for a maximum of 24 hours following pinnaplasty is recommended.
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Lentner, A., F. Späth, and V. Wienert. "Limitation of Movement in the Ankle and Talo-Calcaneonavicular Joints Caused by Compression Bandages." Phlebology: The Journal of Venous Disease 12, no. 1 (March 1997): 25–30. http://dx.doi.org/10.1177/026835559701200105.
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Objective: To investigate whether compression bandages cause a change in mobility, possibly a restriction in the ankle and talo-calcaneonavicular joint. Design: Comparative studies of mobility in the ankle and talo-calcaneonavicular joints using a special, graduated measuring device, both with and without compression bandages. Four different bandage systems with two different compression bandages were used in each case. Setting: University hospital. Subjects: Ten healthy volunteers. Main outcome measures: Ankle joint mobility with and without compression bandages. Results: All bandages greatly restricted mobility in both the ankle and talo-calcaneonavicular joint. The extent of this restriction depended on the bandage systems and material: thick bandages led to worse results than thin products. Conclusions: It must be assumed that long-term therapy with compression bandages may be partly responsible for the finding of ‘arthrogenic congestive syndrome’ (arthropathica ulcerosa). Because previous studies have shown that medical compression stockings cause very little restriction of mobility, patients with chronic venous insufficiency should, in the long term, be treated with compression stockings and not bandages.
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Viljakka, Timo. "Mechanics of knee and ankle bandages." Acta Orthopaedica Scandinavica 57, no. 1 (January 1986): 54–58. http://dx.doi.org/10.3109/17453678608993216.
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Utrilla-Rodríguez, Elia, María Jesús Guerrero-Martínez-Cañavete, Manuel Albornoz-Cabello, and Pedro V. Munuera-Martínez. "Corrective Bandage for Conservative Treatment of Metatarsus Adductus: Retrospective Study." Physical Therapy 96, no. 1 (January 1, 2016): 46–52. http://dx.doi.org/10.2522/ptj.20140443.
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Background Metatarsus adductus (MA) is the most common congenital foot deformity observed in children. Objectives The aims of this study were: (1) to analyze the evolution of a corrective bandage for semirigid MA in newborns and (2) to recommend the age interval at which to start treatment of MA with the corrective bandage alone, without the need of splints. Design An observational clinical study was conducted. Methods The study was conducted at Virgen Macarena University Hospital in Seville, Spain. Children born with semirigid MA at the hospital during the years 2010–2011 were included. Corrective bandaging was applied to all children until clinical correction of the deformity. Sex, laterality of the deformity, weight and length of the newborn, age at the start of treatment, antecedents related to the pregnancy and birth, type of treatment (bandaging, splints), and correction or no correction with bandaging alone were recorded. Age differences at the start of the bandaging treatment between children whose deformity was corrected with and without the need of splints were examined. The receiver operating characteristic curve method was applied to analyze the predictive ability of the age at the start of bandaging treatment relative to whether the deformity was corrected or not corrected with bandaging alone. Results The bandage achieved complete correction in 68.1% of the children and corrected the deformity more frequently in girls compared with boys. Of the 56 children who began the treatment within the first month of life, 92.8% achieved correction of the foot deformity with the corrective bandaging alone. Limitations Patients' follow-up time was only 2 years, so it was only feasible to analyze the corrective bandaging method over the short term and medium term. Conclusions Corrective bandages showed high effectiveness, particularly in girls, and overall when started within the first month of life.
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Cai, Lin. "Precise engineering of silver loaded polyvinyl alcohol nanogels for wound nursing care systems in operation room." Materials Express 11, no. 1 (January 1, 2021): 85–92. http://dx.doi.org/10.1166/mex.2021.1872.
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This study was designed to establish the composition of wound bandages based on silver nanoparticle (AgNP)loaded polyvinyl alcohol (PVA) nanogels. The AgNP nanogel (Ag-nGel) was fabricated by the fructose-mediated reduction of silver nitrate solutions within the PVA matrix. The influence of different experimental limitations on PVA nanogel formations were examined. The nanogel particle sizes were evaluated by transmission electron microscopy and determined to range from ∼10–50 nm. Additionally, glycerol were added to the Ag-nGels, and the resulting compositions (Ag-nGel-Glu) were coated on cotton fabrics to generate the wound bandaging composite. The cumulative drug release profile of the silver from the bandage was found to be ∼38% of the total loading after two days. Additionally, antibacterial efficacy was developed for gram positive and negative microorganisms. Moreover, we examined in vivo healing of skin wounds formed in mouse models over 21 days. In contrast to the untreated wounds, rapid healing was perceived in the Ag-nGel-Glu-treated wound with less damaging. These findings indicate that Ag-nGel-Glu-based bandaging materials could be a potential candidate for wound bandaging applications in the future.
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Partsch, Hugo. "Compression for the management of venous leg ulcers: which material do we have?" Phlebology: The Journal of Venous Disease 29, no. 1_suppl (May 2014): 140–45. http://dx.doi.org/10.1177/0268355514528129.
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Compression therapy is the most important basic treatment modality in venous leg ulcers. The review focusses on the materials which are used: 1. Compression bandages, 2. Compression stockings, 3. Self-adjustable Velcro-devices, 4. Compression pumps, 5. Hybrid devices. Compression bandages, usually applied by trained staff, provide a wide spectrum of materials with different elastic properties. To make bandaging easier, safer and more effective, most modern bandages combine different material components. Self-management of venous ulcers has become feasible by introducing double compression stockings (“ulcer kits”) and self-adjustable Velcro devices. Compression pumps can be used as adjunctive measures, especially for patients with restricted mobility. The combination of sustained and intermittent compression (“hybrid device”) is a promising new tool. The interface pressure corresponding to the dosage of compression therapy determines the hemodynamic efficacy of each device. In order to reduce ambulatory venous hypertension compression pressures of more than 50 mm Hg in the upright position are desirable. At the same time pressure should be lower in the resting position in order to be tolerated. This prerequisite may be fulfilled by using inelastic, short stretch material including multicomponent bandages and cohesive surfaces, all characterized by high stiffness. Such materials do not give way when calf muscles contract during walking which leads to high peaks of interface pressure (“massaging effect”).
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Tamoue, Ferdinand, and Andrea Ehrmann. "First principle study: parametric investigation of the mechanics of elastic and inelastic textile materials for the determination of compression therapy efficacy." Textile Research Journal 88, no. 21 (August 10, 2017): 2506–15. http://dx.doi.org/10.1177/0040517517725123.
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Vascular diseases are among the most common diseases in the world. Whether acute or chronic cases, compression therapy by bandaging is a well-known treatment for the majority of these diseases. In the textile processing of bandages, the influence of material chemistry (e.g. viscosity), the laws of physics (e.g. resiliency), and the medical requirements in the therapy must be taken into account. Furthermore, knowledge of the textile material helps us to understand why bandages do or do not have the desired effect. This paper provides a study of the Dynamic Hysteresis Coefficient (DHC) and lengthening, allowing the examination of compression bandage systems used in phlebology and lymphology using a novel measurement parameter. Compression bandage systems were subjected to a dynamic hysteresis test on a dynamometer, enabling estimation of the DHC and the lengthening (Δ L2) after five consecutive cycles. Evaluation of the findings indicates that the therapeutical stiffness index of the compression bandages can be reliably estimated using this new method. These findings show that inelastic compression bandage systems with elastomers can achieve a sustainable compression therapy over several days. DHC and Δ L2 are proven to be highly reliable parameters for comparing different compression bandage systems.
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Mattaliano, V., G. Mosti, V. Gasbarro, M. Bucalossi, W. Blättler, F. Amsler, St Mancini, and F. Mariani. "The treatment of venous leg ulcers with a specifically designed compression stocking kit." Phlebologie 37, no. 04 (2008): 191–97. http://dx.doi.org/10.1055/s-0037-1622230.
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SummaryTraditionally, venous leg ulcers are treated with firm nonelastic bandages. Medical compression stockings are not the first choice although comparative studies found them equally effective or superior to bandages. Patients, methods: We report on a multi-center randomized trial with 60 patients treated with either short stretch multi-layer bandages or a two-stocking system (Sigvaris® Ulcer X® kit). Three patients have been excluded because their ankle movement was restricted to the extent that they could not put on the stockings and 1 patient withdrew consent. Patient characteristics and ulcer features were evenly distributed. The proportion of ulcers healed within 4 months and the time to completion of healing were recorded. Subjective appraisal was assessed with a validated questionnaire. Results: Complete wound closure was achieved in 70.0% (21 of 30) with bandages and in 96.2% (25 of 26) with the ulcer X kit (p = 0.011). Ulcers with a diameter of up to about 4cm healed twice as rapidly, the larger ones as fast with the stocking kit as with bandages. The sum of problems encountered with bandages was significantly greater than that observed with the stocking kit (p < 0.0001). Pain at night and in the morning was absent with stockings but reported by 40% and 20% in the bandage group, respectively. The cardinal features associated with delayed or absent healing were ulcer size and pain. Conclusions: Common venous ulcers can readily be treated with the ulcer X compression kit provided the ankle movement allow its painless donning. Bandages, even when applied by the most experienced staff are less effective and cause more problems.
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Roaldsen, K. S., B. Elfving, J. K. Stanghelle, and E. Mattsson. "Effect of multilayer high-compression bandaging on ankle range of motion and oxygen cost of walking." Phlebology: The Journal of Venous Disease 27, no. 1 (August 2, 2011): 5–12. http://dx.doi.org/10.1258/phleb.2011.010084.
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Objective To evaluate the effects of multilayer high-compression bandaging on ankle range of motion, oxygen consumption and subjective walking ability in healthy subjects. Method A volunteer sample of 22 healthy subjects (10 women and 12 men; aged 67 [63–83] years) were studied. The intervention included treadmill-walking at self-selected speed with and without multilayer high-compression bandaging (Proforeº), randomly selected. The primary outcome variables were ankle range of motion, oxygen consumption and subjective walking ability. Results Total ankle range of motion decreased 4% with compression. No change in oxygen cost of walking was observed. Less than half the subjects reported that walking-shoe comfort or walking distance was negatively affected. Conclusion Ankle range of motion decreased with compression but could probably be counteracted with a regular exercise programme. There were no indications that walking with compression was more exhausting than walking without. Appropriate walking shoes could seem important to secure gait efficiency when using compression garments.
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Vaes, P., H. De Boeck, F. Handelberg, and P. Opdecam. "Comparative radiologic study of the influence of ankle joint bandages on ankle stability." American Journal of Sports Medicine 13, no. 1 (January 1985): 46–50. http://dx.doi.org/10.1177/036354658501300108.
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Aboalasaad, Abdelhamid R. R., Z. Skenderi, S. Brigita Kolčavová, and Amany A. S. Khalil. "Analysis of Factors Affecting Thermal Comfort Properties of Woven Compression Bandages." Autex Research Journal 20, no. 2 (May 13, 2020): 178–85. http://dx.doi.org/10.2478/aut-2019-0028.
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AbstractCompression bandage (CB) as a porous material should provide both graduated pressure and thermal comfort properties to enable air permeability, heat transfer, and liquid perspiration out of the human body. The main factors affecting thermal comfort properties are the temperature difference between environment and skin, yarns’ structure and material, fabric thickness, porosity, areal density, number of fabric layers, trapped air, and fabric structure. Thermal resistance (Rct) and water vapor resistance (Ret) are evaluated for four types of woven CBs. All bandage types were applied at the range of extension (10–80%) using both two- and three-layer bandaging on thermal foot model (TFM). Rct values are compared with measured results by the Alambeta instrument, whereas Ret test is performed on the Permetest device. Thermal resistance is significantly decreased when increasing the bandage extension from 10 to 40%, then it is slightly increased by increasing the extension from 40 to 60%, after that it is decreased especially at 80% extension due to lower bandage thickness and higher compression.
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Yang, D., Y. K. Vandongen, and M. C. Stacey. "The Influence of Minimal-Stretch and Elasticated Bandages on Calf Muscle Pump Function in Patients with Chronic Venous Disease." Phlebology: The Journal of Venous Disease 14, no. 1 (March 1999): 3–8. http://dx.doi.org/10.1177/026835559901400102.
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Objective: To evaluate the influence of minimal-stretch and elasticated bandages on calf muscle pump function in patients with chronic venous disease. Design: An open, randomised, crossover study. Setting: University Department of Surgery, Fremantle Hospital, Perth, Australia. Subjects: Twenty patients with chronic venous disease and recently healed chronic venous ulcers. Method: Five different bandaging regimens were applied on each patient, and calf muscle pump function was assessed by using air plethysmography. Results: There was no significant difference in the venous filling index (VFI) and ejection fraction (EF) between the five different bandage regimens, and also no significant difference in four of the five bandage regimens over a 7-day period ( p>0.05). However, the VFI was significantly reduced and the EF was not significantly altered after the application of both elasticated and minimal-stretch bandages ( p<0.05, = p>0.05 respectively). Conclusion: All the bandage regimens used in this study have a similar influence on calf muscle pump function, and may therefore have a similar effect on the healing of chronic venous ulcers.
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Brizzio, E. O., G. Rossi, A. Chirinos, I. Cantero, G. Idiazabal, F. Amsler, and W. Blättler. "Healing venous ulcers with different modalities of leg compression." Phlebologie 35, no. 05 (2006): 349–55. http://dx.doi.org/10.1055/s-0037-1622150.
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Summary Background: Compression therapy (CT) is the stronghold of treatment of venous leg ulcers. We evaluated 5 modalities of CT in a prospective open pilot study using a unique trial design. Patients and methods: A group of experienced phlebologists assigned 31 consecutive patients with 35 venous ulcers (present for 2 to 24 months with no prior CT) to 5 different modalities of leg compression, 7 ulcers to each group. The challenge was to match the modality of CT with the features of the ulcer in order to achieve as many healings as possible. Wound care used standard techniques and specifically tailored foam pads to increase local pressure. CT modalities were either stockings Sigvaris® 15-20, 20-30, 30-40 mmHg, multi-layer bandages, or CircAid® bandaging. Compression was maintained day and night in all groups and changed at weekly visits. Study endpoints were time to healing and the clinical parameters predicting the outcome. Results: The cumulative healing rates were 71%, 77%, and 83% after 3, 6, and 9 months, respectively. Univariate analysis of variables associated with nonhealing were: previous surgery, presence of insufficient perforating and/or deep veins, older age, recurrence, amount of oedema, time of presence of CVI and the actual ulcer, and ulcer size (p <0.05-<0.001). The initial ulcer size was the best predictor of the healing-time (Pearson r=0.55, p=0.002). The modality of CT played an important role also, as 19 of 21 ulcers (90%) healed with stockings but only 8 of 14 with bandages (57%; p=0.021). Regression analysis allowed to calculate a model to predict the healing time. It compensated for the fact that patients treated with low or moderate compression stockings were at lower risk of non-healing. and revealed that healing with stockings was about twice as rapid as healing with bandages. Conclusion: Three fourths of venous ulcers can be brought to healing within 3 to 6 months. Healing time can be predicted using easy to assess clinical parameters. Irrespective of the initial presentation ulcer healing appeared more rapid with the application of stockings than with bandaging. These unexpected findings contradict current believes and require confirmation in randomised trials.
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Whitaker, J., A. Williams, D. Pope, R. Elwell, M. Thomas, H. Charles, and J. Muldoon. "Clinical audit of a lymphoedema bandaging system: a foam roll and cohesive short stretch bandages." Journal of Wound Care 24, no. 3 (March 2, 2015): 83–94. http://dx.doi.org/10.12968/jowc.2015.24.3.83.
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Jonker, Leon, Jane Todhunter, Lesley Robinson, and Stacey Fisher. "Open-label, randomised, multicentre crossover trial assessing two-layer compression bandaging for chronic venous insufficiency: results of the APRICOT trial." British Journal of Community Nursing 25, Sup6 (June 2, 2020): S6—S13. http://dx.doi.org/10.12968/bjcn.2020.25.sup6.s6.
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Compression bandaging is the mainstay therapy for chronic venous insufficiency and venous leg ulcers, but patient compliance can be challenging due to associated discomfort. The study discussed here aimed to compare AndoFlex TLC Calamine and Coban2 compression bandaging in relation to patient comfort and pruritus symptomology, with severity of pruritus as the primary outcome. This was a multi-centre, prospective, non-blinded, randomised controlled crossover trial involving 39 randomised patients with chronic venous insufficiency patients. In two periods, the patients wore AndoFlex TLC Calamine or Coban2 for 3 weeks each. No significant differences in validated pruritus outcome measures were observed, including a non-significant treatment effect for the severity of pruritus scale (n=35 trial completers; p-value=0.24, Wilcoxon test). However, after trying both bandages, 21 of the 35 patients (60%) definitely preferred AndoFlex TLC Calamine, whereas 4 patients (11%) definitely preferred Coban2. Thus, AndoFlex TLC Calamine compression bandage therapy was preferred by most patients, although this observation could not be confirmed using validated patient-reported outcome measures for pruritus. Further research is indicated to establish if patient preference translates into favourable clinical outcomes. ISRCTN number: ISRCTN95282887
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Partsch, H., R. J. Damstra, D. J. Tazelaar, S. Schuller-Petrovic, A. J. Velders, M. J. M. de Rooij, R. R. M. Tjon Lim Sang, and D. Quinlan. "Multizentrische randomisierte und kontrollierte Studie zum Vergleich von Four layer Bandagen und Kurzzugbinden des venösen Ulkus." Vasa 30, no. 2 (May 1, 2001): 108–13. http://dx.doi.org/10.1024/0301-1526.30.2.108.
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Background: Aim of the study was to compare the healing rates of venous ulcers obtained with four-layer bandages (4LB) versus short stretch bandages (SSB). Design: Multicentre, randomised controlled trial performed in 5 centres of the Netherlands and in 2 centres in Austria ("PADS-study" = Profore™ Austrian Dutch Study). Patients and methods: 112 patients (53 treated with 4LB and 59 treated with SSB) completed at least one post-treatment follow-up, 90 completed the study. Bandaging and ulcer assessment was performed at weekly intervals. Randomisation was carried out for each centre and was stratified according to the size (more or less than 10 cm2) of the ulcerated area. Local therapy consisted of plain absorbing, non-adherent dressings. Time to complete healing was recorded up to a maximum of 16 weeks. The two treatment-groups were comparable regarding their baseline-characteristics. Results: In total 33/53 (62%) of ulcer-patients were healed in the 4LB group, compared with 43/59 (73%) in the SSB group (difference 11%, 95% CI –28% to 7%). 77% of the ulcers with an initial area less than 5cm2 healed as compared with 33% of the larger ulcers. The different healing rates in the centres could be explained by the different sizes of the treated ulcers. Based on Kaplan-Meier estimates the median healing time was 57 days for the 4LB (95% CI 47–85 days) and 63 days for the SSB (95% CI 43–70 days). Conclusion: The ulcer healing rate and the median healing time did not differ among the two types of bandages. The main discriminant criterion for healing was the initial ulcer size. In centres who are experienced users of short-stretch bandages, no statistically significant different healing rates of venous ulcers could be found after 4LB or SSB.
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Sikka, Monica Puri, Subrato Ghosh, and Arunangshu Mukhopadhyay. "Geometry of the bandaging procedure and its application while wrapping bandages for treatment of leg ulcers." Journal of Biomedical Science and Engineering 06, no. 12 (2013): 1186–90. http://dx.doi.org/10.4236/jbise.2013.612148.
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Sermsathanasawadi, Nuttawut, Choedpong Chatjaturapat, Rattana Pianchareonsin, Nattawut Puangpunngam, Chumpol Wongwanit, Khamin Chinsakchai, Chanean Ruangsetakit, and Pramook Mutirangura. "Use of customised pressure-guided elastic bandages to improve efficacy of compression bandaging for venous ulcers." International Wound Journal 14, no. 4 (August 9, 2016): 636–40. http://dx.doi.org/10.1111/iwj.12656.
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Fulcher, Emily, and Neil Gopee. "Effect of different compression bandaging techniques on the healing rate of venous leg ulcers: a literature review." British Journal of Community Nursing 25, Sup6 (June 2, 2020): S20—S26. http://dx.doi.org/10.12968/bjcn.2020.25.sup6.s20.
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Venous leg ulcers (VLUs) are a common health problem in older adults, for which the widely used method of treatment includes compression therapy. There are various compression bandages and hosiery systems available for use, but it remains unclear as to which types of compression systems are most effective in enabling healing of VLUs. This study aimed to determine which type of the two most commonly used compression bandaging (four-layer and two-layer) is more effective in providing complete ulcer healing of VLUs. Key search terms were identified using the PICO (population, intervention, comparison, outcome) model, with distinct inclusion and exclusion criteria, in a strategic search of electronic databases (e.g. CINAHL and MEDLINE) along with wider sources, including Google Scholar. More studies favoured the four-layer compression system than two-layer for providing better healing rates in the treatment of VLUs, but two-layer bandaging tends to provide a better quality of life and may be more cost-effective, although comorbidities and other factors also need to be considered. In choosing the type of compression bandage for the management of leg ulcers, the healing rate achieved by the chosen bandage needs to be carefully monitored, while also taking into consideration other factors such as the quality of life for the patient.
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Muhammad, S. T., M. Abdurrahman, D. O. Avazi, B. Usman, E. G. Emmanuel, M. H. Sulaiman, P. H. Mamman, et al. "Management of Diffuse Necrotic Cutaneous Wound in a Dog." Sahel Journal of Veterinary Sciences 17, no. 2 (June 29, 2020): 49–52. http://dx.doi.org/10.54058/saheljvs.v17i2.133.
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A one-year-old male Terrier dog weighing 22 kg was presented to the Ahmadu Bello University Veterinary Teaching Hospital (ABUVTH), Zaria, Nigeria, with complaints of sloughing of the skin and purulent discharges from an injured (sloughed) shoulder. Clinical examination revealed normal vital parameters, extensive necrotized skin on the dorsum extending from loin to the right shoulder and enlarged superficial lymph nodes. Blood and wound swab samples were evaluated in the clinical haematology and Microbiology Laboratories of the ABUVTH, respectively. The Pathology result showed leucocytosis due to neutrophilia and monocytosis. Staphylococcus aureus was isolated from the wound swab. The wound was managed by wet-to-dry bandaging technique using topical antiseptics (Para-chloroaniline solution, chlorhexidine and povidone iodine), improvised non-adhesive protective membrane (polyethylene) applied at the wound-bandage interface, bandages along with adhesive tape and systemic antibiotics. Healing occurred uneventfully within 6 weeks of the intervention. The paper discusses the detail of the management initiated and how it greatly influenced the skin wound healing in dogs. In conclusion, proper initial assessment of wounds and appropriate treatment through rigorous wound assessment and bandaging are critical to success in the wound healing and restoration of tissue integrity. This management intervention could be further investigated in animals in order to improve the quality of cutaneous wounds management.
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Talbot, Thomas R., Jody Peters, Lihan Yan, Peter F. Wright, and Kathryn M. Edwards. "Optimal Bandaging of Smallpox Vaccination Sites to Decrease the Potential for Secondary Vaccinia Transmission Without Impairing Lesion Healing." Infection Control & Hospital Epidemiology 27, no. 11 (November 2006): 1184–92. http://dx.doi.org/10.1086/508827.
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Objective.To assess the optimal method for covering smallpox vaccination sites to prevent transmission of vaccinia.Design.Randomized, nonblinded clinical trial.Setting.Tertiary care medical center.Participants.Vaccinia-naive and vaccinia-experienced volunteers.Interventions.After vaccination, study participants were randomized to receive 1 of 3 types of bandage: gauze, occlusive with gauze lining, or foam. Vaccination sites were assessed every 3 to 5 days until the lesion healed. During each visit, specimens were obtained from the vaccination site, the bandage surface before removal, and the index finger contralateral to the vaccination site and were cultured for vaccinia. Time to lesion healing was assessed.Results.All 48 vaccinia-naive and 47 (87%) of 54 vaccinia-experienced participants developed a vesicle or pustule at the injection site 6-11 days after vaccination. Fourteen (14%) of 102 participants had bandage cultures positive for vaccinia. All but 1 of these vaccinia-positive cultures were of a bandage from participants randomized to the gauze bandage group, and all but 3 were of bandages from vaccinia-naive participants. No finger-specimen cultures were positive for vaccinia. One episode of neck autoinoculation occurred in a vaccinia-naive individual who had vaccinia recovered from his gauze bandage on multiple visits. The foam bandage was associated with more local adverse effects (skin irritation and induration). The time to healing did not differ among the bandage groups.Conclusions.The potential for transmission of vaccinia from a vaccination site is greater if the site is covered by gauze than if it is covered by occlusive or foam bandages. Use of an occlusive bandage with a gauze lining is the best choice for coverage of smallpox vaccination sites because of a reduced potential for vaccinia transmission and a lower reactogenicity rate. Bandage choice did not affect vaccination lesion healing.
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Roush, J. K., K. L. Bilicki, G. Baker Baker, and M. D. Unis. "Effect of bandaging on postoperative swelling after tibial plateau levelling osteotomy." Veterinary and Comparative Orthopaedics and Traumatology 23, no. 04 (2010): 240–44. http://dx.doi.org/10.3415/vcot-09-04-0046.
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Summary Objective: To compare the effects of bandaging on immediate postoperative swelling using a modified Robert-Jones bandage after tibial plateau levelling osteotomy (TPLO) in dogs. Study design: Prospective case series. Methods: Dogs undergoing a TPLO were randomly placed into two groups. Group 1 received a modified Robert-Jones bandage postoperatively for a 24 hour period and Group 2 was not bandaged. Hindlimb circumference was measured at the level of the mid-patella, the distal aspect of the tibial crest, the midpoint of the tibial diaphysis and the hock. Measurements were recorded and compared in each group preoperatively and at 24 hours and 48 hours post-operatively. Interobserver variability was compared between the two observers. Results: There was no significant difference in postoperative swelling, as measured by the percentage change in circumference, between bandaged and unbandaged operated limbs after the TPLO at 24 and 48 hours at any site. Some significant differences in measurement at particular sites were observed between the two different observers, but there was a significant linear correlation at all sites between observers. The observer with the least experience consistently had slightly higher measurements at these sites. Clinical relevance: The use of a modified Robert-Jones bandage after TPLO did not prevent statistically significant postoperative swelling, and thus may not be indicated for this purpose. Postoperative bandages placed to control swelling after other small animal orthopaedic procedures should be evaluated individually for efficacy.
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Shamir, MH, R. Shahar, and DE Johnston. "Semirigid external fixation for repair of fractures in young animals." Journal of the American Animal Hospital Association 32, no. 6 (November 1, 1996): 521–26. http://dx.doi.org/10.5326/15473317-32-6-521.
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An alternative method for external coaptation of fractures in young animals utilizes tongue depressors incorporated in a bandage consisting of a thick layer of cotton padding, gauze bandaging, and adhesive tape. This method was used in 13 cases with fractures of the tibia or the radius and ulna, some of which were open. Five cases (four dogs and a cat) had displaced fractures, and eight cases had either nondisplaced or only mildly displaced fractures. Size of the animal was not considered a limiting factor. Bandages were examined periodically. All fractures healed uneventfully, and the splints were removed 21-to-44 days after application. This method of external coaptation proved to be easy to apply and modify during the healing process and was applicable to a wide variety of fractures with good results.
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Torres-Lacomba, María, Beatriz Navarro-Brazález, Virginia Prieto-Gómez, Jean Claude Ferrandez, Jean Yves Bouchet, and Helena Romay-Barrero. "Effectiveness of four types of bandages and kinesio-tape for treating breast-cancer-related lymphoedema: a randomized, single-blind, clinical trial." Clinical Rehabilitation 34, no. 9 (June 24, 2020): 1230–41. http://dx.doi.org/10.1177/0269215520935943.
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Objective: To compare the effects of four types of bandages and kinesio-tape and determine which one is the most effective in women with unilateral breast cancer-related lymphoedema. Design: Randomized, single-blind, clinical trial. Setting: Physiotherapy department in the Women’s Health Research Group at the University of Alcalá, Madrid, Spain. Subjects: A total of 150 women presenting breast-cancer-related lymphoedema. Interventions: Participants were randomized into five groups ( n = 30). All women received an intensive phase of complex decongestive physiotherapy including manual lymphatic drainage, pneumatic compression therapy, therapeutic education, active therapeutic exercise and bandaging. The only difference between the groups was the bandage or tape applied (multilayer; simplified multilayer; cohesive; adhesive; kinesio-tape). Main measurements: The main outcome was percentage excess volume change. Other outcomes measured were heaviness and tightness symptoms, and bandage or tape perceived comfort. Data were collected at baseline and finishing interventions. Results: This study showed significant differences between the bandage groups in absolute value of excess volume ( P < 0.001). The most effective were the simplified multilayer (59.5%, IQR = 28.7) and the cohesive bandages (46.3%, IQR = 39). The bandages/tape with the least difference were kinesio-tape (4.9%, IQR = 17.7) and adhesive bandage (21.7%, IQR = 17.9). The five groups exhibited a significant decrease in symptoms after interventions, with no differences between groups. In addition, kinesio-tape was perceived as the most comfortable by women and multilayer as the most uncomfortable ( P < 0.001). Conclusion: Simplified multilayer seems more effective and more comfortable than multilayer bandage. Cohesive bandage seems as effective as simplified multilayer and multilayer bandage. Kinesio taping seems the least effective.
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Vaes, P., C. Eechaute, M. Cnudde, and D. Beckwée. "Effect of two ankle braces and two ankle bandages on ankle inversion mobility during passive inversion stress. A comparative study." Physiotherapy 101 (May 2015): e1565-e1566. http://dx.doi.org/10.1016/j.physio.2015.03.1566.
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Barwell, J. R., M. Taylor, J. Deacon, C. Davies, M. R. Whyman, and K. R. Poskitt. "Ankle Motility is a Risk Factor for Healing of Chronic Venous Leg Ulcers." Phlebology: The Journal of Venous Disease 16, no. 1 (March 2001): 38–40. http://dx.doi.org/10.1177/026835550101600110.
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Objective: To investigate the effect of ankle motility on chronic venous leg ulcer healing, and to relate this to calf pump function and muscle bulk. Methods: This was a prospective cohort study undertaken in a leg ulcer clinic. Ankle motility, calf-ankle circumference ratio and calf pump power (derived from digital photoplethysmography) were assessed as to their effect on ulcer healing rate. Thirty consecutive patients undergoing multi-layer compression bandaging for open chronic venous ulcers were included. Results: Ankle motility was an independent risk factor for ulcer healing ( p = 0.001, hazard ratio 1.08, 95% CI 1.03–1.13). Ankle motility correlated with calf-ankle circumference ratio ( r = 0.48, p<0.01). No relationship was found between photoplethysmography-derived calf pump power, ankle motility or ulcer healing rate. Conclusions Ulcers in legs with poor ankle motility are slower to heal and this may be related to reduced calf muscle bulk. Ankle exercises or physiotherapy could be considered in such patients.
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Ning, Junjie, John Fish, Felix Trinh, Jihad Abbas, Andrew Seiwert, and Fedor Lurie. "Comparison of three pressure monitors used to measure interface pressure under compression bandages." Phlebology: The Journal of Venous Disease 35, no. 4 (July 11, 2019): 262–67. http://dx.doi.org/10.1177/0268355519862178.
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Background Measuring the interface pressure produced by compression therapy devices is essential for research and clinical practice. New user-friendly measuring devices, such as Smart Sleeve Pressure Monitor (SSPM) and Juzo Pressure Monitor (JPM) allow longitudinal pressure measurement. However, their accuracy and agreement with well-established usage of the PicoPress (PP) are unknown. The aim of this study is to investigate measurement accuracy of PP, SSPM, and JPM. Methods The three devices were tested in 10 healthy volunteers by applying incrementally increasing pressure from 20 mm Hg to 50 mm Hg using a calibrated sphygmomanometer cuff. The linearity of the response and measurement accuracy were compared among the three devices. In a separate experiment, the three devices were compared by simultaneously recording the interface pressure under bandages immediately after bandaging and after 4 h of wearing the bandage. Results PP had the best performance with the reference of sphygmomanometer, while JPM had better linearity and accuracy than SSPM. The mean difference in the interface pressure under bandages was +13.36 mm Hg between SSPM and PP, and +0.50 mm Hg between JPM and PP. The 95% limits of agreement were −13.92 and +40.64 mm Hg, and −19.83 and +20.84 mm Hg, respectively. Conclusions JPM showed better agreement with both sphygmomanometer and PP compared to SSPM. JPM is a reasonable alternative for monitoring interface pressure continuously.
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Pollard, Anita, and Gerard Cronin. "Compression bandaging for soft tissue injury of the ankle: a literature review." Emergency Nurse 13, no. 6 (October 2005): 20–25. http://dx.doi.org/10.7748/en2005.10.13.6.20.c1218.
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Wang, Yumei, Huichao Fu, and Ying Lin. "Alginate/Gelatin Sponges Composited with ZnO Sponge Effective Extensibility and Compressibility as a Wound Dressing for the Care of Fracture Surgery." Journal of Biomaterials and Tissue Engineering 11, no. 10 (October 1, 2021): 1873–80. http://dx.doi.org/10.1166/jbt.2021.2767.
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We designed and synthesized highly porous alginate and gelatin hydrogels with zinc oxide nanoparticles (AGZNPs) as dressings using sol–gel methods. The presence of functional groups and the surface characteristics of the as-synthesised dressings were analyzed via Fourier transforminfrared (FT-IR) spectroscopy, while their morphology was studied via scanning electron microscopy (SEM). Additionally, the mechanical, inflammatory, and antibacterial properties and biocompatibility of the AGZNPs were evaluated to determine the efficiency of these bandages for wound healing applications. The AGZNPs demonstrated enhanced inflammatory and antibacterial properties. The biocompatibility of the nanocomposites was investigated in noncancerous NIH3T3 human fibroblasts. Furthermore, in-vivo examinations showed that the composition of the synthesized AGZNPs enhanced wound healing and promoted rapid cell construction and growth. Therefore, the AGZNP strategy promotes the future application of these nanoformulation hydrogels for wound bandaging in fracture surgeries.