ABSTRACT
- The Dutch guideline on 'Venous disease' comprises four parts: two revised guidelines ('Varicose veins' and 'Venous leg ulcer') and two new guidelines ('Deep venous disease' and 'Compression therapy').- These guidelines were drawn up by a working party made up of representatives from the Dutch Association of Surgeons, the Dutch Society of Vascular Surgery and the Dutch Society of Dermatology and Venereology.- We will discuss the most important parts of the guideline here.
Subject(s)
Dermatology , General Surgery , Practice Guidelines as Topic , Societies, Medical , Vascular Diseases/surgery , Vascular Surgical Procedures/standards , Venereology , Humans , Netherlands , Veins/surgeryABSTRACT
OBJECTIVES: There is no data available at present on the changes in the exerted pressure together with the dynamic stiffness index (DSI) of medical elastic compression stockings (MECS). The objective of this pilot study was to measure the pressure and calculate the DSI of 12 different brands of MECS before and after having been worn for eight hours. METHODS: In all, 12 different commercially available brands of MECS that were divided into two categories (class I round-knitted and class II flat-knitted MECS) were tested. The pressure was measured, and the DSI of the MECS was first calculated at the B1 level before wearing in the morning and again eight hours after they had been worn. All laboratory measurements were performed using a newly developed dynamic leg-segment model. RESULTS: The pressure at the B1 level dropped significantly in all 12 brands of MECS after having been worn for eight hours, whereas the DSI remained unchanged. CONCLUSION: The DSI of MECS reflects an important and particularly consistent therapeutic effect. As the pressure drops during the day, the pressure amplitude or pulsations remain the same. The pressure drop may be due to fatigue of the elastic material. The DSI would therefore form a valuable indicator for prescribing the most effective MECS for the patient.
Subject(s)
Models, Anatomic , Stockings, Compression , Venous Insufficiency/therapy , Elasticity , Humans , Materials Testing , Pilot Projects , PressureABSTRACT
OBJECTIVES: To calculate the dynamic stiffness index (DSI) of 18 different brands of medical elastic compression stockings (MECS). METHODS: In all, 18 different brands of MECS that were divided into five categories (class II round-knitted, class II flat-knitted, class III round-knitted, class III flat-knitted and class IV flat-knitted MECS) were tested. The static pressure and dynamic pressure pulsations at the B1 level were measured with a newly developed dynamic pressure-determining device. The DSI was calculated. RESULTS: The DSI of all 18 brands of MECS showed higher values compared with the static stiffness. A wide range of dynamic stiffness indices was observed not only between all brands of MECS, but also within the five categories. CONCLUSIONS: The DSI of MECS is independent of the compression class and the type of knit. The variation in the DSIs between MECS is not because of any measurement error and would indicate that different therapeutic effectiveness may be expected within one compression class. Therefore, a refinement in the current classification system for MECS with other characteristics such as the DSI is warranted.
