The Effects of a 4-Layer Compression Bandaging System on Skin Perfusion Pressure in Healthy Adults.
OBJECTIVE
Current practice precludes compression in patients with wounds and reduced arterial flow; however, this treatment may reduce edema and vascular resistance, thus improving distal circulation. The objective of this study was to determine the effects of compression on skin perfusion pressure (SPP), edema, and ankle range of motion.


METHODS
This was a quasi-experimental time series.


METHODS
The study was conducted at The Center for Skin Integrity in Cheektowaga, New York.


METHODS
The study participants were 20 healthy adults, 10 in a younger age bracket (22.10 [SD, 2.77] years, 23.14 [SD, 5.03] kg/m) and 10 in an older age bracket (55.90 [SD, 4.48] years, 28.84 [SD, 4.83] kg/m).


METHODS
Sixty minutes of Profore Multi-layer Compression was performed.


METHODS
Precompression and postcompression measurements: SPP, Ankle Brachial Index, calf circumference (15 cm proximal to lateral malleolus), and static and dynamic ankle dorsiflexion range of motion (DF ROM) compared between young and older adults.


RESULTS
There was a significant main effect for time for SPP (P = .049) and static (P = .02) and dynamic (P = .03) DF ROM. Skin perfusion pressure significantly increased at 40, 50, and 60 minutes of compression compared with precompression. Static and dynamic DF ROM significantly increased from precompression to postcompression. Although not statistically significant, calf circumference decreased by 6 cm in the older-adult group postcompression.


CONCLUSIONS
A 4-layer compression dressing system improved SPP; this may be secondary to the decongestion of a proximal confined space. The 4-layer compression dressing also improves DF ROM postcompression and may reduce lower-extremity edema. Seeing these results in healthy participants suggests the need for future research in a patient population to determine if compression can be used to offload arterial structures and thus promote wound healing in patients.
Nicole J. Chimera, PhD, is Chairperson and Program Director, Athletic Training Department, Daemen College, Amherst, New York. Corstiaan Brass, MD, is Clinical Associate Professor, The State University of New York at Buffalo, and board-certified Physician, Internal Medicine and Infectious Disease, The Center for Skin Integrity, Cheektowaga, New York. Karl Terryberry, PhD, is Associate Professor, Physician Assistant Department, Daemen College, Amherst, New York. Lynn Matthews, DPT, is Assistant Professor, Athletic Training Department, Daemen College, Amherst, New York. Ryan G. Boggs, DPT, is a Physical Therapist, Advanced Care Physical Therapy, Niagara Falls, New York. William Denz, DPT, is a Physical Therapist, Delta Healthcare, Dallas, Texas. Michael Brogan, PhD, is Vice President, Academic Affairs, and Dean of the College, Daemen College, Amherst, New York.
Nicole J
NJ
Chimera
Corstiaan
C
Brass
Karl
K
Terryberry
Lynn
L
Matthews
Ryan G
RG
Boggs
William
W
Denz
Michael
M
Brogan
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000843:Ankle Joint / Q000502:physiology; D004487:Edema / Q000628:therapy; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D035002:Lower Extremity / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011312:Pressure; D016059:Range of Motion, Articular / Q000502:physiology*; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology; D018570:Risk Assessment; D012737:Sex Factors; D012867:Skin / Q000098:blood supply*; D055815:Young Adult