The conventional treatment for venous ulcers is with graduated compression bandages. They work by improving the calf-muscle pump and by augmenting venous tone, both which facilitate venous drainage. In an effort to standardise the degree of compression achieved, bandages have been developed with ink patterns on the surface. When stretched on a patient the patterns form a different shape depending on the amount of stretch. For example, rugby ball shapes transform into circles when the desired pressure is reached. The group from Bangkok, Thailand have used this principle to customise compression bandages using direct feedback from interface pressures and a rubber ink stamp in vivo once the target pressures have been achieved. In this way exact pressures can be attained taking into account the individual shape, size and contour of a patient’s leg.
NUTTAWUT SERMSATHANASAWADI Compression bandaging is a main treatment of venous ulcers. Its efficacy depends on the applied sub-bandage pressure, which is dependent on the skill of nurses or doctors applying the bandage. To improve quality of bandaging by reducing the variability in compression bandage sub-bandage pressures, we prepared elastic bandages into a customised version by marking them with circular ink stamps. This was stamped on the fabric when the stretch achieves sub-bandage pressures between 35 and 45 mmHg. When the bandage was not stretched, the markers became elliptical in shape. A visual marker (change from an elliptical to circular marker) helped to apply the bandage with the correct stretch.
Our published study demonstrated that the target pressure range is more often attained with the customised bandage with marker compared to the non-marked bandage. The customised bandage improved the efficacy of compression bandaging with optimal sub-bandage pressure. Furthermore, this technique provides a way of manipulating the sub-bandage pressures to the principle of the treating physician, i.e., graduated, reverse graduated, uniform, low pressure, high pressure, degree of overlap. The customised compression bandage may be a more scientific option for treating venous ulcers than factory made, one-size-fits-all products.
Customised pressure-guided elastic bandages. A) PicoPress®, B) Interface pressure air-sensors, C) Circular ink stampers with ink, D) Marked bandage awaiting re-application.
An applied customised pressure-guided elastic bandage on a patient. Note that the ellipses have become circles.