Importance of adequate pressure in compression therapy : Basis for successful treatment

• Published in: Hautarzt Vol. 70; no. 9; pp. 707 - 714
• Main Authors: Partsch, Hugo, Stücker, Markus, Vanscheidt, Wolfgang, Läuchli, Severin, Eder, Stephan, Protz, Kerstin, Dissemond, Joachim
• Format: Journal Article
• Language: German
• Published: Germany 01.09.2019
• Subjects: Compression stockings; Edema; Hemodynamics; Bandages; Posture
• ISSN: 1432-1173
• DOI: 10.1007/s00105-019-4413-9

The pressure exerted by a compression device on a part of the body corresponds to the dosage of the compression therapy. Therefore, the pressure course under compression materials should be investigated in different clinical situations. Pressure measurements were carried out under different compression materials in lying, standing and walking positions within the framework of training, self-experimentation and in patients with venous leg ulcers. The results showed that the pressure varied considerably depending on the material used, the firmness of application, the local configuration (body position) and the time interval between applications. A loss of pressure occurred under each compression therapy, especially under inelastic short-stretch material, mainly due to movement and edema reduction. This pressure loss is decisive for the timing of dressing changes and a reason for the good tolerance of high-pressure levels in mobile patients. Low pressures are particularly suitable for edema reduction. Hemodynamic effects require higher pressures (60-80 mmHg). For this purpose, inelastic materials are preferred which enable lower pressures when lying down (40-60 mmHg). As compression bandages are too loosely applied by many users, pressure indicators on bandages or adaptive bandages with templates are helpful to apply the material with the correct pressure. As a consequence of these findings it is postulated that, at least in studies comparing different compression media, pressure measurements should be carried out in the future, whereby the measuring point and body position should be documented.