Patient-Specific Computational Models: Tools for Improving the Efficiency of Medical Compression Stockings

Abstract

Compression therapy is used in the management and the treatment of various forms of venous insufficiency ranging from the relief of heavy and achy legs to the treatment of more severe forms such as acute venous ulceration. However, the pressure needed to achieve clinical benefit is a matter of debate. The purpose of this study was to examine the transmission of pressure within the soft tissues to improve current understanding of the mechanism of action of Medical Compression Stockings (MCS). Three-dimensional patient-specific finite element models were developed for six subjects. The geometry was obtained from CT-scans. Because experimental data on the mechanical properties of healthy adipose tissues and passive muscle are scarce in literature, an inverse method was setup to identify the constitutive properties of the said anatomical elements. This constitutes the original contribution of this work. The main outcome of this study is that the mean pressure applied by the MCS onto the skin is of the same order of magnitude as that applied by the compressed tissues onto the wall of the main deep veins, thereby suggesting that the mean pressure applied can be used as an indicator of the efficiency. Likewise, the maximal hydrostatic pressure in fat can be used to estimate the comfort.

Lower leg compression and its biomechanical effects on the soft tissues of the leg

“…One more recent work addressed these aspects and proposed two patient-specific models obtained from MR and ultrasound images to study the effect of medical compression stockings on vein closure, both for superficial and deep veins (P.-Y. Rohan et al 2015;C. .-Y.…”

“…In particular, imaging the deformation induced by the compressive stocking or cuff is a way to obtain these data. In this manner, MR images with/without compression were used as input for inverse (or similar) approaches in (Avril et al 2010;Dubuis et al 2013;Narracott et al 2009). A similar approach (with/without compression) was implemented using US-echo imaging of superficial varicose veins to identify their tangent elastic moduli in standing and supine positions (C. .-Y.…”

A critical review on compression textiles for compression therapy: Textile-based compression interventions for chronic venous insufficiency

“…Pliance X system, 159 Talley Digital Skin Evaluator 160 and Flexiforce 98 ) are also most effective in determining interface pressure between intervention and skin, whereas in vivo assessment by clinical wear trials is accepted to be an important method and a common trend for determination of pressure performance in evidence based compression therapy. 152,161 In addition, recently 3D biomechanical mathematical models have been applied as numerical simulation method to investigate pressure performances exerted by compression interventions based on the finite element analysis (FEA), 162,163 by which not only the dynamic interface pressure performances can be quantitatively assessed, 105,107 but also the internal cross-sectional deformations and stress distributions within underlying tissue structures with time can be investigated and visualized. 106 The capability of computational simulation provides a valuable tool to help us further explore the compression systems and their corresponding biomechanical efficacy by compression textile on the human body.…”

Study on tensile properties of compression SOCKS ankle cut-strips at practical extension

“…blood vessels) to the pressure difference due to inflation and deflation of two halves of cylindrical vessels. 11,16,17 The equation can be expressed aswhere; P denotes pressure [Pa], T is the tension in the cylinder wall [N/mm] and D is the diameter of the cylinder [mm].…”