Stansal A, Tella E, Yannoutsos A, Keita I, Attal R, Gautier V, Sfeir D, Lazareth I, Priollet P, et al.
Journal de medecine vasculaire. Date of publication 2018 Jul 1;volume 43(4):225-230.
1. J Med Vasc. 2018 Jul;43(4):225-230. doi: 10.1016/j.jdmv.2018.05.006. Epub 2018
Jun 18.
Supervised short-stretch compression therapy in mixed leg ulcers.
Stansal A(1), Tella E(2), Yannoutsos A(2), Keita I(2), Attal R(2), Gautier V(2),
Sfeir D(2), Lazareth I(2), Priollet P(2).
Author information:
(1)Department of Vascular Medicine, Paris Saint-Joseph Hospital, 185, rue
Raymond-Losserand, 75674 Paris cedex 14, France. Electronic address:
astansal@hpsj.fr.
(2)Department of Vascular Medicine, Paris Saint-Joseph Hospital, 185, rue
Raymond-Losserand, 75674 Paris cedex 14, France.
OBJECTIVES: This study was conducted to determine hemodynamic and clinical
tolerance under short-stretch compression therapy in elderly patients suffering
from mixed-etiology leg ulcers.
DESIGN: Transversal observational study conducted in 25 hospitalized patients
with a moderate peripheral arterial occlusive disease defined as an
ankle-brachial pressure index>0.5, an ankle pressure of>70mmHg and a toe cuff
pressure (TP)>50mmHg.
MATERIAL AND METHODS: Short-stretch bandages were applied daily with pressures
from 20 to 30mmHg. Ankle-brachial pressure, great toe laser Doppler flowmetry
(LDF) and transcutaneous oxygen pressure (TcPO2) on dorsum of the foot were
measured at baseline and after its removal at 24hours. Great toe LDF was also
measured at 10minutes after bandage application. Compression pressure (CP) was
measured with a sub-bandage device at baseline, at 10minutes and before bandage
removal at 24hours. Clinical tolerance was evaluated taking into account the
patient's pain and skin tolerance.
RESULTS: Mean age of patients was 80±15 years. Median duration of ulcers was 18
months. Hypertension was highly prevalent. One third of patients had diabetes.
Toe pressure index and TcPO2 values did not significantly change under
compression therapy (P=0.51 and P=0.09, respectively) whereas CP decreased
significantly during 24hours. The loss of CP was significant 10minutes after
bandage application (P<0.001). Nearly all ulcers were painful prior to placement
of compression therapy and required level 1 analgesics. One patient required
level 2 analgesic for pain relief. No increase in pain and no ischemic skin
damage occurred under compression therapy.
CONCLUSIONS: In elderly patients with mixed leg ulcers and with an absolute
TP>50mmHg, short-stretch compression of up to 30mmHg does not adversely affect
arterial flow and appears clinically well tolerated. Such bandages with
appropriate levels of compression may aid ulcer healing by treating the venous
part of the disease.
Copyright © 2018 Elsevier Masson SAS. All rights reserved.
DOI: 10.1016/j.jdmv.2018.05.006
PMID: 29981730
