Compression-induced pulsatile blood flow changes in human legs.
Initial and sustained (7-h) impacts of foot-to-knee compression bandaging on leg arterial pulsatile blood flow were assessed by nuclear magnetic resonance flowmetry in eight healthy supine subjects. A widely used bandaging method (zinc impregnated gauze + Coban) and a slight variant (Coban only) were applied one week apart to one leg. Blood flow was measured on each day of bandage application before and after bandaging and after 7 h of normal activity. Initial mean sub-bandage pressures (lateral gaiter) were between 28.4 and 28.9 mmHg but were significantly reduced after 7 h to 16.3-19.4 mmHg. Overall below-knee pulsatile blood perfusion was initially significantly increased by both methods mainly due to increased proximal blood flow. Bandaging was also associated with a decrease in blood perfusion of the nonbandaged control leg mainly due to a decrease in distal blood flow. Neither of these effects were sustained after 7 h. The fact that neither sub-bandage pressure nor blood flow was sustained may indicate a causal linkage, a concept consistent with the finding of a linear relationship between afternoon blood flow and sub-bandage pressure reductions. The implications of the present findings for venous ulcer therapy are speculative and based on the concept that arterial pulsatile flow augmentation is a positive feature. If so, more frequent bandage changes to provide transient flow stimulation or use of bandages to better maintain sub-bandage pressure to sustain flow increases may be useful.
Mayrovitz
H N
HN
Miami Heart Research Institute, Miami Beach, Florida 33140, USA.
D000328:Adult; D001458:Bandages; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008875:Middle Aged; D011312:Pressure; D011673:Pulsatile Flow; D012039:Regional Blood Flow / Q000502:physiology; D014647:Varicose Ulcer / Q000503:physiopathology* / Q000628:therapy*