Is compression bandaging accurate? The routine use of interface pressure measurements in compression bandaging of venous leg ulcers

摘要

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. nnMethods: 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. nnResults: 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. nnConclusion: 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.