Pressure and slippage during 48 hours of compression therapy: a study on healthy volunteers

OBJECTIVE: To evaluate slippage and resting/working pressures of seven different compression bandage systems over a 48-hour period.

METHODS: Both legs of 48 volunteers were wrapped with seven different compression bandages. A sensor device was used to obtain static/dynamic pressure measurements. Bandages were left in place for 48 hours and measurements were taken after 24 and 48 hours of wear time. Pressures were recorded at the B1-level in the supine position, during stance, and at the amplitude of exercise (maximum plantar/dorsal flexion of the ankle joint in the supine position with knee extended). Bandages were applied by nurses that were experienced in the use of the bandage systems.

RESULTS: Most bandages were well tolerated by the volunteers (84/96, 87.5%). Five (5.2%) bandages were removed by the volunteers on day 1 because of discomfort during the night. Seven (7.3%) bandages were removed after 24 hours because of serious slippage. The degree of slippage varied among the seven bandage systems tested, and ranged from a mean of 0.8 cm to 4.5 cm after 24 hours of wear and 1.1 cm to 6.6 cm after 48 hours of wear. Differences also existed in the pressure profiles of the various bandages while at rest, standing, during exercise, and during recovery.

DISCUSSION: Results mirror what is commonly observed in the clinic: that bandage slippage is common and that slippage varies by product and design. The more elastic systems showed less slippage, but exhibited lower pressure profiles. One exception to this was a unique 2-layer compression system, which exhibited the lowest slippage yet was highly effective in maintaining pressure profiles at rest as well as at the amplitude of exercise.

CONCLUSION: Slippage and pressure profiles vary among compression bandage systems. The system with the lowest slippage is also the most effective in maintaining clinically effective pressure profiles.