title: Compression bandaging effects on lower extremity peripheral and sub-bandage skin blood perfusion.
abstract: Laser-Doppler blood perfusion was simultaneously measured on both great toes and the lateral upper-calf before and during fore-foot-to-knee compression bandaging of one test-leg in ten vascularly healthy female volunteers. Two bandaging methods were sequentially used separated by a 30 minutes interval. Bandage A consisted of a layer of zinc impregnated gauze and an elastic wrap; bandage B had the elastic wrap only. Sub-bandage pressures of the test-leg were measured at distal and proximal lateral below-knee standardized sites. The study purpose was to determine the effects of moderate compression pressure achieved for bandages A under and distal to bandaged regions. Initial (mean +/- sem_ sub-bandage pressure achieved for bandages A and B were similar, being respectively 32.9 +/- 2.8 and 28.4 +/- 3.9 mm Hg. Both bandages types were associated with significant reductions in test-leg toe blood perfusion amounting to 44.2 +/- 13.1 percent and 27.5 +/- 10.5 percent for bandages A and B respectively. Contrastingly, test-leg sub-bandage blood perfusion did not differ from its pre-bandage baseline mean level for either bandage type. These findings show that a widely used bandaging method and a slight variant each significantly reduces distal (toe) blood perfusion without reducing sub-bandage skin perfusion. Absence of sub-bandage perfusion decreases may be related to a partially compensating reflex vasodilatory response, but such effects if present are inadequate to prevent reductions in distal perfusion. These results reinforce the need for due care and risk-benefit consideration with respect to therapeutic compression levels.
authors.affiliation: Miami Heart Research Institute, Miami Beach, Fl 33140, USA.
authors.forename: H N
authors.initials: HN
authors.lastname: Mayrovitz
authors.forename: M
authors.initials: M
authors.lastname: Delgado
authors.forename: J
authors.initials: J
authors.lastname: Smith
mesh_terms: D000328:Adult; D001458:Bandages / Q000592:standards*; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D007866:Leg / Q000098:blood supply; D008875:Middle Aged; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply* / Q000000981:diagnostic imaging; D012883:Skin Ulcer / Q000628:therapy*; D014463:Ultrasonography; D014945:Wound Healing