Inelastic bandages maintain their hemodynamic effectiveness over time despite significant pressure loss

Background: It is widely believed that the loss of compression pressure of inelastic bandages is associated with a loss of efficacy in contrast to elastic material, which maintains its pressure and performance. This study compared the effect exerted by inelastic bandages vs elastic compression stockings on the venous pumping function in patients with severe superficial venous insufficiency immediately after application and 1 week later. Methods: Ejection fraction (EF) of the calf pump was measured in 18 patients presenting with bilateral reflux in the great saphenous vein (CEAP C-3-C-5) without any compression and immediately after application of an inelastic bandage on one leg and an elastic compression stocking on the other leg. Measurements were repeated 1 week later, before compression removal. EF was measured using a plethysmographic technique. The changes of interface pressure of the applied compression products were recorded simultaneously with EF measurements. Results: After application, bandages and stockings achieved a significant improvement of EF (P < .001) that was much more pronounced in the bandaged legs. The median resting pressure was 45 mm Hg (interquartile range, 41-48.5 mm Hg) under the stockings and 64.5 mm Hg (interquartile range, 51-80 mm Hg) under the bandages. After 1 week, EF was still significantly improved in the bandaged leg (P < .001), but not under the stockings. At this time, the pressure under the stockings was only slightly reduced (5.9% supine, 3.6% standing), but the mean pressure loss under the bandages was much higher (54.3% supine, 35.4% standing). Conclusion: The findings supporting inelastic compression are important in explaining the benefits of its use in chronic venous insufficiency. Inelastic bandages maintain their superior efficacy on the venous pumping function after a wearing time of 1 week, despite a significant loss of pressure. (J Vase Surg 2010;52:925-31.)