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[Compression stocking in treatment of ulcus cruris. An efficient alternative to bandages]
H M Häfner1, B Vollert, A Schlez
1Universitäts-Hautklinik, Tübingen.
Background And Objective:
The aim of the study was to measure the pressure exerted on the skin with application of the specially designed UlcerCare compression stocking for treatment of chronic venous leg ulcers and simultaneously to objectify the improvement in venous function.
Patients/Methods:
Twenty patients with chronic venous insufficiency according to the CEAP Classification C1-4 EP AS, A14, AP, PR were examined. Static exerted pressure was measured while standing and the dynamic equivalent was measured during 10 repetitions of tip-toe exercise. The patients were wearing the standard stocking JOBST Medical LegWear UlcerCare (Beiersdorf AG, Hamburg, Germany). As a control for the effectiveness of the therapy on venous hemodynamics, the lower leg volume, calculated using optoelectronically-measured lower leg circumference and venous reflux, determined by strain gauge plethysmographically-measured venous refill time, were used.
Results:
Use of the compression stocking system UlcerCare resulted in a decreased lower leg volume. This decrease was on average 5.3%, corresponding to 106 +/- 78 ml (p < 0.001). The calf and forefoot venous function parameters also improved. The venous refill time improved from 27.2 +/- 15.2 s to 45.0 +/- 27.4 s at the forefoot (p < 0.003) and from 10.5 +/- 4.5 s to 19.4 +/- 10.9 s at the calf (p < 0.002). The exerted pressure at the ankle while standing was 46.2 +/- 24.2 mmHg (resting pressure) and 48.5 +/- 27.2 mmHg during repetitive tip-toe exercises (mean exercise pressure). At the calf, the exerted pressure while standing was 40.7 +/- 26.9 mmHg (resting pressure) and during the repetitive tip-toe exercises it was 42.1 +/- 29.5 mmHg (mean exercise pressure).
Conclusions:
The exerted pressure of the UlcerCare compression stocking is equivalent to that of a class 3 medical compression stocking. This newly developed stocking diminishes venous reflux and reduces leg edema. These objectified effects suggest that the UlcerCare stocking is effective as compression therapy for venous ulcers.