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Effect of Time and Posture on Pressure Profiles Obtained by Three Different Types of Compression

There is controversy concerning the merits and safety of elastic versus inelastic compression in the treatment of venous leg ulceration. Thirty legs were randomized to elastic, minimal stretch and non-elastic (Circaid®) bandages. Pressure profiles (repeated thrice) were measured with the Borgnis MST device on bandage application and at 4 h, in both the standing and lying positions. All bandages produced significant graduated compression in the leg (P < 0.001), in the standing position, with no significant difference in gradient between the bandages (P = 0.5). However, 4 h after application the bandages collectively exerted less pressure than on application, though gradients were maintained. Elastic bandages, at 4 h, recorded a mean 94% of the initial level compared to 70% for minimal stretch and 63% for non-elastic (P < 0.001) in the standing position. In the lying position the decrease at 4 h was 72% for elastic, 59% for minimal stretch and 44% for non-elastic compression (P < 0.001). Elastic bandages provided the most sustained compression, but with the smallest margin of safety (least reduction of pressure on lying).