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Biomedical Engineering Education

The Effects of Compression Wrapping Techniques and Primary Wound Dressings on Leg Skin Interface Pressure

(F-223) The Effects of Compression Wrapping Techniques and Primary Wound Dressings on Leg Skin Interface Pressure

Friday, October 13, 2023

3:30 PM – 4:30 PM PDT

Location: Exhibit Hall - Row F - Poster # 223

Presenting Author(s)

AQ

Aidan Quinn

Undergraduate Student Researcher
Clemson University Bioengineering
Chesterfield, New Jersey, United States
GB

Grace Boone

Undergraduate Student Researcher
Clemson University Bioengineering, United States

Co-Author(s)

JC

James Cox

Graduate Research Investigator
Clemson University Bioengineering, United States

Primary Investigator(s)

John D. DesJardins (he/him/his)

Hambright Leadership Professor
Clemson University, United States

Co-Author(s)

NW

Naomi Wolhar

R&D Professional I, MHD Wound and Burn Bus Development
Milliken and Co., United States
SE

Suzanne Ehmann

Co-Author
Nova Southeastern University, United States

Introduction:: Fluid accumulation in the lower extremities characterized by swelling is known as chronic edema. Compression is an established therapeutic tool utilized for the management of several chronic edema presentations including lymphedema, venous reflux, and venous leg ulcers.1 The purpose of this study was to evaluate the pressure distribution in the B1 (ankle) and C (calf) regions of the leg during use of compressive textile wrappings. The pressure provided by the compressive layer improves blood flow and lymphatic drainage ultimately reducing the symptoms of edema.2 Proper wound care techniques and appropriate selection and application of primary wound dressings are crucial for optimizing pressure distribution and promoting wound healing.

Materials and Methods:: To evaluate IP and IP distributions of compressive applications chosen for this study, a two week long clinical trial was conducted at Rhodes Engineering Research Center on Clemson University’s campus with forty (40) healthy student volunteers. The textile combinations evaluated in this clinical trial included: a Fuzzy Wale Compression (FWC) stockinette, a traditional two-layer cohesive bandage, and a combination of the two. The Tekscan I-Scan pressure mapping system was used to measure pressure distribution underneath the textile combinations during and following the application. For each participant, a series of pressure measurements were taken including an initial reading, a reading right after the application of the compressive wrapping in supine position, a reading in standing position after completing toe raises, and a reading after walking on the treadmill for ten (10) minutes. This procedure was completed for each compression application chosen which led to a total of three (3) sessions per patient.

Results, Conclusions, and Discussions:: For Fuzzy Whale Compression (FWC) applications, a uniform pressure distribution was produced along the entire length of the limb. The FWC had the lowest average IPs at each position, with pressures ranging from 10.82-15.25 mmHg in the B1 region and 10.86-14.86 mmHg in the C region. Coflex average IPs were significantly greater at each position, with pressures ranging from 25.53-35.93 mmHg in the B1 region and 18.21-30.53 mmHg in the C region. Applications including both Coflex and Edemawear had the highest average IPs at each position, with pressures ranging from 27.46-43.66 mmHg in the B1 region and 23.91-41.76 mmHg in the C region. For each compressive application evaluated in this study, IP was greatest at the ankle and gradually decreased towards the calf. Variation in data could have been influenced by several mechanisms. IP pressure readings could have been affected by patient anatomy, different leg diameters, limb lengths, etc. Small variations in sensor positioning or calibration techniques could also have introduced measurement errors, resulting in observed differences. Lastly, differences in application techniques could have resulted in variation.
In the testing of these three different compressive textiles, each combination demonstrated adequate levels of therapeutic pressure and appropriate IP distributions to reduce fluid retention in the leg, potentially mitigating the symptoms of chronic edema. These compressive textiles are better understood with an accurate IP distribution along patients’ legs. Another important factor to consider is the presence of open wounds in compressive applications. Primary wound dressings should be used in combination with the compressive wrappings to maintain an optimal environment for healing while also exerting pressure on the wound and surrounding tissues.

Acknowledgements (Optional): :

References (Optional): :

Bjork R, Ehman S. S.T.R.I.D.E. Profession Guide to Compression Garment Selection for the Lower Extremity. J Wound Care. June 1 2019;28(Sup6a):1-44. doi:10.12968/jowc.2019.28.Sup6a.

Britto EJ, Nezwek TA, Popwicz P, et al. Wound Dressings. [Updated 2023 May 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470199/

Sibbald RG, Elliot JA, Coutts P, Persaud-Jaimangal R. Evaluation of Longitudinal and Tubular Compression Treatment for Lower Limb Edema. Adv Skin Wound Care. 2020 Dec;333(12);643-649. doi: 10.1097/01.ASW.0000720264.41419.38. PMID: 33208662; PMCID: PMC8082994.