title: Controlled, comparative study of relation between volume changes and interface pressure under short-stretch bandages in leg lymphedema patients.
abstract: BACKGROUND
  Pressure loss under short-stretch bandages (SSBs) is a well-known phenomenon and is thought to be related to bandage relaxation and poor quality of application.
  
  
  OBJECTIVE
  The aim was to demonstrate that therapeutically intended volume reduction of the compressed leg is the most important cause for the loss of bandage pressure.
  
  
  METHODS
  This was an experimental, controlled comparative study.
  
  
  METHODS
  In 20 patients suffering from lymphedema of the lower extremities and in 9 healthy persons, lower leg volume was measured by water displacement. After application of a pressure measurement device (Kikuhime) at the B1 region, SSBs were applied on one leg according to a standard protocol. Volume and pressure measurements were performed at 0, 2, and 24 hours in supine as well as standing positions.
  
  
  RESULTS
  A significant reduction of leg volume is already achieved 2 hours after bandage application, both in lymphedema patients and in normal controls. A further volume decrease of the lymphedematous legs is observed in the following 24 hours after application of a new bandage (-290 mL). The volume reduction is associated with a significant loss of bandage pressure from initial values over 60 mmHg by 37 and 48% in controls and lymphedema patients, respectively.
  
  
  CONCLUSIONS
  Inelastic, multilayer, multicomponent compression bandages lead to an immediate reduction of leg volume, both in lymphedematous and in normal legs. This therapeutically intended volume reduction seems to be the main reason for the fast decrease of the subbandage pressure. This study was supported by Lohmann & Rauscher, Ltd. Germany.
authors.affiliation: Department of Dermatology, Phlebology and Lymphology, Hospital Nij Smellinghe, Drachten, The Netherlands. r.damstra@nijsmellinghe.nl
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Damstra
authors.forename: Els R
authors.initials: ER
authors.lastname: Brouwer
authors.forename: Hugo
authors.initials: H
authors.lastname: Partsch
mesh_terms: D000328:Adult; D000368:Aged; D019245:Compressive Strength; D005260:Female; D006801:Humans; D007866:Leg; D008209:Lymphedema / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011312:Pressure; D053828:Stockings, Compression; D013997:Time Factors; D014160:Transducers, Pressure; D016896:Treatment Outcome