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The Effects of a 4-Layer Compression Bandaging System on Skin Perfusion Pressure in Healthy Adults

Chimera, Nicole J. PhD; Brass, Corstiaan MD; Terryberry, Karl PhD; Matthews, Lynn DPT; Boggs, Ryan G. DPT; Denz, William DPT; Brogan, Michael PhD

Advances in Skin & Wound Care: July 2016 - Volume 29 - Issue 7 - p 308–315
doi: 10.1097/01.ASW.0000484086.79254.33

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.

DESIGN: This was a quasi-experimental time series.

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

PARTICIPANTS: 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/m2) and 10 in an older age bracket (55.90 [SD, 4.48] years, 28.84 [SD, 4.83] kg/m2).

INTERVENTIONS: Sixty minutes of Profore Multi-layer Compression was performed.

MAIN OUTCOME MEASURES: 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.

MAIN 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.

CONCLUSION: 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.

The authors have disclosed they have no financial relationships related to this article.

Acknowledgments: The authors disclose that some equipment for this study was purchased with support provided by the Daemen College Student Faculty Think Tank. Submitted November 5, 2014; accepted in revised form November 21, 2014.

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.