E. Daamen’s scientific contributions

Elastic compression stockings are valuable tools in the treatment of many phlebological diseases. As to day no data are available about how long these elastic compression stockings continue to exert enough compression for a proper clinical function. In this study we measured the pressure at the B level of compression class II and III elastic stockings directly after the patients started to use them, after 1 month, and after 3 months. In total 99 below knee stocking were measured with a TNO-tester, which has officially been accepted by the CEN for measurement of elastic compression stockings. Class II flat knitted stockings showed a mean pressure of 29.3 (SD 4.9) mmHg at the start of the study, declining to 27.6 (SD 5.2) mmHg, and 26.5 (SD 4.4) mmHg, at 1 and 3 months respectively. The round knitted class II had comparable results. In class III flat knitted stockings we measured 47.5 mmHg (SD 8.1) at the start, and 44.2 (SD 7.1) mmHg, and 41.3 (SD 6.7) mmHg, at 1 and 3 months respectively. Extrapolation of the results after 1 and 3 months demonstrate that the mean pressure of class II stocking is less than 25 mmHg after 4 to 5 months. Class III stockings were less than 35 mmHg close to 6 months, if evaluated in the same way. Individual regression analysis show that after 6 months 66% of the pressure class II stockings have a pressure of less than 25 mmHg and 45% of the pressure class III less than 35 mmHg. When considering a 10% safety margin the figures are respectively 84% and 63%. From the results of this study it can be concluded that, especially for the most frequently used compression class II stockings, three new stockings each year are necessary to ensure an effective function of the stocking during the time they are being used by the patient. For compression class III flat knitted stockings two pairs can be considered as sufficient.

This study was set up to evaluate the interface pressure underneath short stretch (approximately 70% elasticity) and elastic (approximately 170% elasticity) bandages at different places and at several intervals during 7 days. Furthermore measurements were taken during active walking on a treadmill at a certain speed. A total of 39 legs from 35 subjects (33 known with venous insufficiency and two healthy probands) were investigated in time. 15 legs of 11 healthy subjects were studied during active walking. Interface pressure recordings were made with the aid of an Oxford Pressure Measurement MK II (CPM) machine. The cells were placed at twelve different areas of the leg and recordings were made in supine position. The pressure underneath the short stretch bandage showed a rapid decreases in pressure in supine position (80.5 mmHg to 43.6 mmHg after 3 hours and 26.3 after 7 days). In the elastic bandages the pressures stayed high in all positions. At the Achilles tendon, dorsal foot and pretibial area extreme high pressure were found up to 150 mmHg continuing to stay high in the elastic bandages. During walking the maximal and minimal pressure were statistically different (p < 0.05) in favor of the short stretch bandage. It can be concluded from the study that short stretch bandages are not only safer and more economical in the treatment of patients with venous complaints, but are also more effective because of their better walking pressures.