Compression Stockings for Treating Venous Leg Ulcers

Abstract

Background. In order to treat venous leg ulcers, it is recommended to use high pressure compression (30–40 mmHg at the ankle). Compression stockings which are not operator dependant could be the best option because of their pressure control. However 30–40 mmHg compression stockings are often hard to put on. Putting two lower pressure compression stockings over each other could be a good therapeutic alternative. Objectives. To compare the in vitro pressures given by the manufacturers of 2 antiulcer kits with the in vivo interface pressures measured in healthy subjects and to evaluate the stiffness and friction indices from those kits based on the interface pressure in order to assess their clinical properties. Material and Methods. Using a Kikuhime pressure device, interface pressure was measured in 12 healthy subjects at the reference point B1. One stiffness index (Static Stiffness Index (SSI)) and a friction index have been calculated. Results. Mediven Ulcer kit gets the recommended pressures whereas Jobst’s Ulcer Care kit does not for treating a venous leg ulcer. Jobst’s Ulcer Care transmits entirely the pressure in relation to a friction index close to 1. Conclusion. This antiulcer kit study underlines that in vivo and in vitro pressures can be different (Jobst’s Ulcer Care kit and Mediven Ulcer kit). In order not to lose pressure, it is important to take into account the friction index when superimposing two stockings.

In Vivo Measurement of the Friction Between Human Skin and Different Medical Compression Stockings

“…Although medical compression stockings (MCSs) have long been proven to be an efficient compression therapy for venous diseases [1][2][3], patients are not always willing to use them even if suffering from pain. According to an international questionnaire survey on the use of MCSs [4], the main reasons for abstaining to wear the stockings are difficulties in putting them on and discomfort feelings during long-time use.…”

Development of separated elastic stockings

“…However, elastic compression stockings are often hard to put on and take off, especially in the elderly and patients with orthopaedic problems, leading to poor compliance. 4,6–10,12 There are insufficient solutions to reduce the difficulty, although some measures are adopted and advice is given to the patients, such as education in techniques to put the elastic stockings on, the use of accessories such as foot slips, plastic accessories and non-slip mats, and techniques for applying double stockings, in which one stocking is applied over the other. 1,7,13,14 With such a background, we developed the separated elastic stockings, in which the elastic stockings were separated at the ankle region into two parts, leg and foot portions.…”

“…6 Of these factors, the practical acceptability of elastic stockings is an important limitation, especially in the elderly and patients with orthopaedic problems. 1,6–8,10 The most difficult region of the leg to put on and take off the elastic stockings is the heel. 7 It is difficult for the elastic stockings to pass the heel when they are bunched up.…”

Smart Compression Therapy Devices for Treatment of Venous Leg Ulcers: A Review

“…[20] Success of application (i.e., precise pressure level) relies on training of medical staff and manual skills; may suffer pressure loss in the first hours due to wear; [17] pressure may vary significantly depending on the patient movements. [40] Stocking [41] Hosiery-type garments, including knee-high socks, tights, and pantyhose.…”