Presenter ： Chung-Yi Chiu

Advisior ： Dr. Yi-chun Du

Date ： November 13th

Objective Evaluation of Skin Pressure Distribution of Graduated

Elastic Compression Stockings

Liu R, Kwok YL, Li Y, Lao TT, Zhang X, Dai XQ

By the American Society for Dermatologic, IncDermatol Surg, VOL. 31, NO. 6, pp615-624 2005

OutlineOutline

Introduction

Method

Results

Discussion

Conclusions

112/04/212

IntroductionIntroduction(1/5)(1/5)

Varicose veins : enlarged, swollen, and tortuous veins.

Factor : Venous valves

Symptom :Edema 、 Fester

112/04/213WEDMD http://www.webmd.com/default.htm

IntroductionIntroduction(2/5)(2/5)

112/04/214

muscleSuperfical

vein

perforatorvein

Proximal

Distal

muscle

Superficalvein

perforatorvein

Proximal

Distal

Varices

muscleSuperfical

vein

perforatorvein

Proximal

Distal

muscle

Superficalvein

perforatorvein

Proximal

Distal

NormalA.

B.Valves OpenLower Venous Pressure

IntroductionIntroduction(3/5)(3/5)

Edinburgh40% men32% women

American60% of all women and men

Finland7%-18% men25%-32% women

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IntroductionIntroduction(4/5)(4/5)

Graduated Elastic Compression stockngs (GCSs)

Compression therapy

Pressure gradient

Venous disorders

Relieve symptoms

112/04/216 Venacureevlt http://venacure-evlt.com/

IntroductionIntroduction(5/5)(5/5)

Graduated Elastic Compression stockngs

(GCSs)

Pressure level

Pressure distribution

Pressure gradient

112/04/217 Venacureevlt http://venacure-evlt.com/

Method(1/4)(1/4)

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Pressure Level

Stocking Code mmHg Function

LightA1B1

10-1412-16

Prevent varicose veinsrelieve 、 heaviness and fatigue

MildA2B2

18.4-21.218-25

For curing mild varicosities,initial varices during pregnancy

ModerateA3B3

25.1-32.120-30

For moderate varicose veins, edema

StrongA4B4

36.4-46.530-40

For curing serious varicose veins,severe edema, leg ulcer, lymphedema

Method(2/4)(2/4)

Pressure sensors

Thickness 0.127mm

Diameter 9.525mm

Area 71.1mm2

Sampling frequency 10Hz

112/04/219 Tekscan http://www.tekscan.com/

Method(3/4)(3/4)

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Loading LevelsLoad, g

(on71 mm2)Pressure

(Pa=1N/m2)Voltage

1 0 0 0.0016

2 5 688.78 0.0064

3 15 2,066.35 0.1868

4 25 3,443.91 0.3015

5 35 4,4821.48 0.4813

6 45 6,199.04 0.7153

7 55 7,576.61 0.8703

Method(4/4)(4/4)

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Result(1/6)(1/6)

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Six healthy females

Age 33.33 ± 6.37 year

Height 159.67 ±4.71 cm

Weight 52.58± 5.04kg

BMI 20.48± 1.90 kg/m2

Result(2/6)(2/6)

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Result(3/6)(3/6)

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Result(4/6)(4/6)

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Result(5/6)(5/6)

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1600

2639

3812

5525

4665

3332

2866

1866

Result(6/6)(6/6)

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Discussion (1/3)(1/3)

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Proper pressure distribution and magnitude are very important for the wearing comfort and medical function of compression stockings.

Discussion (2/3)(2/3)

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Pressure GradientsNot all tested compression stockings

have the claimed pressure gradients.The human leg is an irregular

geometric object.

Discussion (3/3)(3/3)

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Pressure Levels and General Skin Pressurepressure levels at the ankle region,

whereas the pressures around the ankle were lower than those specified by the manufacturers, implying that the tested compression stockings may not provide effective support to the ankle region.

Conclusions (1/4)(1/4)

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1. The general pattern of pressure gradients of all GCSs is that the highest pressure was exerted on the ankle region and decreased up to the thigh. The pressure at the anterior side of the leg was significantly higher than that at the medial and lateral sides.

The measured pressure values were lower than the pressure values specified by the manufacturers.

Conclusions (2/4)(2/4)

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2. Pressure gradients, pressure levels, testing locations,and body shape have significant influences on skin pressure.

Conclusions (3/4)(3/4)

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3. Variations in the anatomic structure and body shapes of individual human legs are the main reasons for no ideal pressure gradient distribution and pressure level performance.

Conclusions (4/4)(4/4)

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4. The difference between measured and specified pressure values in this study could be largely accounted for by the use of different pressure sensors and testing model with different leg shapes and interface conditions, as well as the differences in anatomic dimensions between Chinese and European subjects.

Thanks for your attention !Thanks for your attention !