G Mosti1, H Partsch. 1. Clinica MD Barbantini, Via del Calcio n.2, 55100 Lucca, Italy. jmosti@tin.it
Abstract
OBJECTIVES: To measure the effect on the venous pumping function of a stocking providing a negative pressure gradient with higher pressures over the calf in comparison to a conventional graduated elastic compression stocking (GECS) in patients with advanced venous insufficiency. DESIGN: Experimental study. MATERIAL: 30 patients with severe superficial chronic venous insufficiency were enrolled. Two elastic stocking designs exerting a pressure at ankle between 15 and 25 mm Hg were compared; a conventional GECS and a stocking exerting a higher pressure over the calf than over the ankle producing a "progressive" increase in compression (PECS). METHOD: the venous calf pumping function was assessed by measuring the ejection fraction (EF) from the lower leg by a plethysmographic method during a standardised exercise. Interface pressure of the 2 compression devices was simultaneously recorded both at B1 = 12 cm above ankle, C = just above widest part of calf. RESULTS: The mean increase of EF produced by PECS was +75% (95 CI 48, 7-101,3) compared with +32% (95% CI 16, 8-48,6) with GECS (P < 0.001). There was a significant correlation between EF and the stocking pressure measured at calf level during standing and walking. CONCLUSION: Stockings exerting a higher pressure on the calf than on the ankle show a greater efficacy in increasing the venous ejection fraction from the leg.
RCT Entities:
OBJECTIVES: To measure the effect on the venous pumping function of a stocking providing a negative pressure gradient with higher pressures over the calf in comparison to a conventional graduated elastic compression stocking (GECS) in patients with advanced venous insufficiency. DESIGN: Experimental study. MATERIAL: 30 patients with severe superficial chronic venous insufficiency were enrolled. Two elastic stocking designs exerting a pressure at ankle between 15 and 25 mm Hg were compared; a conventional GECS and a stocking exerting a higher pressure over the calf than over the ankle producing a "progressive" increase in compression (PECS). METHOD: the venous calf pumping function was assessed by measuring the ejection fraction (EF) from the lower leg by a plethysmographic method during a standardised exercise. Interface pressure of the 2 compression devices was simultaneously recorded both at B1 = 12 cm above ankle, C = just above widest part of calf. RESULTS: The mean increase of EF produced by PECS was +75% (95 CI 48, 7-101,3) compared with +32% (95% CI 16, 8-48,6) with GECS (P < 0.001). There was a significant correlation between EF and the stocking pressure measured at calf level during standing and walking. CONCLUSION: Stockings exerting a higher pressure on the calf than on the ankle show a greater efficacy in increasing the venous ejection fraction from the leg.
Authors: Mieke Flour; Michael Clark; Hugo Partsch; Giovanni Mosti; Jean-Francois Uhl; Michel Chauveau; Francois Cros; Pierre Gelade; Dean Bender; Anneke Andriessen; Jan Schuren; André Cornu-Thenard; Ed Arkans; Dragan Milic; Jean-Patrick Benigni; Robert Damstra; Gyozo Szolnoky; Franz Schingale Journal: Int Wound J Date: 2012-06-21 Impact factor: 3.315