Contents
Preface ix
1. Introduction to compression therapy 1
1.1 Introduction 1
1.2 Cardiovascular system of human body 1
1.3 Chronic venous deficiency (CVD) 5
1.4 Compression therapy 12
2. Characterization of compression bandage 20
2.1 Introduction 20
2.2 Principles of bandaging 20
2.3 Terminology 21
2.4 Bandage construction 23
2.5 Classification 25
2.6 Compression efficiency of bandages 28
2.7 Smart compression bandages 30
3. Interface pressure 41
3.1 Introduction 41
3.2 Measurement of interface pressure 41
3.3 Factors affecting interface pressure 47
3.4 Prediction of interface pressure 49
4. Compression under static state 56
4.1 Introduction 56
4.2 Materials and experimental methods 57
4.3 Results and discussion 65
4.4 Conclusions 72
5. Compression under dynamic state 75
5.1 Introduction 75
5.2 Materials and experimental methods 76
5.3 Results and discussion 81
5.4 Conclusions 86
6. Assessment of dynamic stiffness index 90
6.1 Introduction 90
6.2 Materials and experimental methods 91
6.3 Results and discussion 94
6.4 Conclusions 99
7. Material and construction parameters 102
7.1 Introduction 102
7.2 Materials and experimental methods 103
7.3 Results and discussion 107
7.4 Conclusions 116
8. Dynamic assessment of sub-bandage pressure profile 119
8.1 Introduction 119
8.2 Materials and experimental methods 120
8.3 Results and discussion 126
8.3.3 Effect of bandage material 129
8.4 Conclusions 133
9. Modeling of Interface Pressure Profile Generated over Time 138
9.1 Introduction 138
9.2 Theory of mechanical models using spring and dashpot 139
9.3 Quasi-linear viscoelastic theory (QLV) 143
9.4 Prediction of interface pressure 145
9.5 Materials and experimental methods 146
9.6 Results and discussion 147
9.7 Conclusions 154
Appendix 157
Index 159
Preface
Chronic venous insufficiency is a venous disorder in the lower extremities associated with significant implications on patient’s life. Compression therapy is the most promising treatment given to the above cause. Treatment with compression bandage is highly recommended for advanced stages of chronic venous deficiencies. The compression performance of a bandage depends on the complex interaction of many factors – bandage characteristics, limb geometry, application technique and physical activity taken by the patient. Understanding the exact formulation and performance of the compression bandages under different conditions would be extremely helpful to obtain maximum clinical benefits from the compression treatment. There are many textbooks describing different aspects of compression management, i.e. underlying pathology, compression therapy, modes of compression, bandage characteristic, efficacy, cost, comparisons, etc. But, the subject still needs several aspects to be investigated further for improved understanding of the compression management and performance of different bandages.
Several studies have been performed by various experienced researchers and medical practitioners, and the exact knowledge of the compression performance by a bandage is widely spread. At present, there are not many books available on the sciences of compression bandage in one volume. The aim of this book is to introduce and assemble all the underlying knowledge related to compression bandage under one roof in order to partially fulfill the shortage of literature in this field. We are hopeful that this would fulfill the need of undergraduate and postgraduate students who are studying various aspects of textiles and clothing, medical science, and also the researchers who are working in the area of compression management. The above subject demands the understanding of the fundamental nature of compression therapy, i.e. compression or pressure that requires multi-disciplinary approaches involving various concepts of physics, biological science, biomaterials, fabric engineering, structural dynamics, material science, technical textiles and instrumentation to better deal the subject from different perspectives.
For simplification and meeting the desired requirements, the book introduces several multidisciplinary topics and describes the complex subject with very basic and simple discussions and gradually proceeds to the more sophisticated formulations for experienced scientific researchers and specialists only. References to original sources have also been given to follow the literature that will be useful for the readers.
We have tried to cover different aspects of compression bandage and kept the coherence among the various chapters described in the book. The first chapter introduces the different aspects of compression therapy: chronic venous diseases, assessments, clinical recommendations, physiopathology of compression management, different modes of compression, application guidelines, etc. The second chapter provides the information on the characterization of compression bandages: bandage structure and its composition, classification, comparison, cost, clinical efficiency, smart compression bandages, etc. In third chapter, the fundamental pursue of compression management i.e. sub-bandage pressure or compression is described. The fourth and the fifth chapters explain the detailed work on the compression management of the bandage under static and dynamic conditions respectively. In sixth chapter, the assessment of dynamic stiffness index of the compression bandage is detailed. The seventh chapter describes the influence of different materials and structure of the bandage on the longterm compression performance during the course of treatment. The eighth chapter describes the long-term compression behavior of the bandage under dynamic state. The last chapter deals with the prediction and modeling of the compression profile of the bandage over time.
The contents of the proposed book would be extremely useful for the academicians, R&D managers, bandage manufacturers, processing industries, doctors, health practitioners, researchers, nurses, users of the bandage for distinctive applications and all others related to the compression treatment. A few topics introduced in this book can be used for teaching of the undergraduate and postgraduate students and some advanced topic can be studied by the doctoral students and the experienced researchers. Each chapter of the book provides its clinical significance which would help in elucidating the clinical outcomes of a particular compression product and achieving maximum compression efficacy as novel wound care management. All the arguments and reasoning described would help in evaluating different compression products, standardization and characterization of compression bandage, innovating suitable compression product, designing and fabricating pressure measuring systems, recommending ideal compression product and developing suitable wrapping protocols for a compression management. We are hopeful that this book will prove to be very useful and informative to the readers.
We are indebted to Council of Scientific and Industrial Research (Human Resource Development Group) for giving necessary permission and providing financial support. We are thankful to our colleagues in the Department of Textile Technology, Indian Institute of Technology Delhi for their support. We are also thankful to their students for all the help during literature search, writing, editing and processing of the manuscript of this book. We would also like to express their appreciation to Woodhead Publishing India for editing and publishing of this book. There may be some shortcomings in the book, and we welcome the comments from readers and these constructive comments will be useful in bringing out the second edition of the book.
Bipin Kumar
Apurba Das
R. Alagirusamy