Compression Stockings for Treating Venous Leg Ulcers

Background. In order to treat venous leg ulcers, it is recommended to use high pressure compression (30–40？mmHg at the ankle). Compression stockings which are not operator dependant could be the best option because of their pressure control. However 30–40？mmHg compression stockings are often hard to put on. Putting two lower pressure compression stockings over each other could be a good therapeutic alternative. Objectives. To compare the in vitro pressures given by the manufacturers of 2 antiulcer kits with the in vivo interface pressures measured in healthy subjects and to evaluate the stiffness and friction indices from those kits based on the interface pressure in order to assess their clinical properties. Material and Methods. Using a Kikuhime pressure device, interface pressure was measured in 12 healthy subjects at the reference point B1. One stiffness index (Static Stiffness Index (SSI)) and a friction index have been calculated. Results. Mediven Ulcer kit gets the recommended pressures whereas Jobst’s Ulcer Care kit does not for treating a venous leg ulcer. Jobst’s Ulcer Care transmits entirely the pressure in relation to a friction index close to 1. Conclusion. This antiulcer kit study underlines that in vivo and in vitro pressures can be different (Jobst’s Ulcer Care kit and Mediven Ulcer kit). In order not to lose pressure, it is important to take into account the friction index when superimposing two stockings. 1. Background Compression increases ulcer healing rates compared with no compression [1, 2]. Thus to improve the healing process (recommendation grade 1B) it is recommended to treat venous or mixed venous (0.6 > ABI < 0.9) with high pressure. A pressure between 30 and 40？mmHg should be obtained at the ankle (professional agreement). Multicomponent systems are more effective than single-component systems. Multicomponent systems containing an elastic bandage appear more effective than those composed mainly of inelastic constituents. Two-layer stockings appear more effective than the short-stretch bandage [3]. In fact, there are no clear differences in the effectiveness of different types of high compression. Putting on the bandages requires a great experience and the respect of the bandage stretching rules. A pressure level from 30 to 40？mmHg may not be easy to achieve. The main criticism that can be made against the use of a multilayer bandage or short stretch is linked to bandage slippage. Slippage is a cause of adverse effects: pain, aggravation of ulcer ulceration, and necrosis [4]. The use of compression stockings seems to be the