Quantifying graduation of layered below-the-knee compression garment combinations using a model-based assessment

Area of Science:

• Biomedical Engineering
• Vascular Medicine
• Rehabilitation Science

Background:

• Lymphedema and vascular conditions often require compression garments.
• Layered compression garments are prescribed to improve treatment compliance.
• Limited evidence exists on interface pressures generated by layered compression garments.

Purpose of the Study:

• To explore interface pressures produced by layering below-the-knee compression garments.
• To quantify pressure graduation in layered garment combinations.
• To determine the effect of layer order on interface pressure.

Main Methods:

• Mechanical testing using PicoPress to measure interface pressure.
• Evaluated 30 combinations of low and high class compression garments.
• Measured pressure at four specific sites on a model limb.

Main Results:

• Consistent graduation observed from the ankle to below the knee (sites B1 to D).
• Reversed graduation noted at the ankle (sites B to B1), possibly due to model limb shape.
• No significant difference in interface pressure based on layer order (high vs. low class).
• Actual pressures strongly correlated with the sum of individual garment pressures.

Conclusions:

• Double layering of compression garments maintained guideline adherence for pressure graduation.
• Layered garment pressures were generally cumulative.
• Garment wearers can layer garments in any order without affecting interface pressure outcomes.