Film compression bandage

Summary

Purpose: Textile compression stockings or bandages are limited in comfort; they do not allow uninterrupted wearing. A novel elastic film bandage was evaluated regarding practicability, patient comfort and effect on vein regression. Main endpoint was the frequency of symptomatic inflammatory reactions.

Methods: In a comparative pilot study, a compression film bandage (CFB, investigational) comprising an elastic, self-adhesive breathable polymer film of d <20 µm was continuously worn for 14 d after foam sclero-therapy. Inclusion: 62 patients (26–68 y.) frequently doing sports and taking daily showers, 90 legs with superficial varicosities, 5–12 mm ø (MW: 7.3 mm), randomized to A) CFB + medical compression stocking (MCS), B) MCS alone, C) CFB alone. Follow-up examinations including ultrasound and photography were performed after 2, 4 and 8 weeks.

Results: Continuous wearing time of 14 days was completed in 57/60 cases with CFB (95.0 %, A+C), while 3/60 (5.0 %) finished wearing after 8–10 d. There were no adverse skin reactions except minor irritations at the upper edge (n = 2). Vein diameters were reduced within 14 days by 29–54 % (mean: 43.5 %) in group A, 16–44% (mean: 39.1 %) in group B, and 24–50 % (mean: 37.3 %) in group C. Symptomatic inflammation, indu-ration or discolouration was observed within 28 days in 5/60 cases (8.3 %) when using CFB (A, C) versus 19/30 (63.3%) related to stocking compression (B). Comfort was rated by the patients 6.6 (A), 4.3 (B) and 9.2 (C) on a 10 degree scale. This difference was statistically highly significant (p <0.01).

Conclusions: The film bandage is an effective and safe compression modality. For superficial varicosities the adhesive bond to the skin seems to be relevant additional to the elastic properties. The device significantly improves vein regression of foam-treated superficial varicosities when combined with compression stockings or even as stand-alone modality. Continuous wearing for two weeks is well tolerated. The bandage may also offer an alternative for patients not tolerating textile compression media, or during summer.

Keywords

Film bandage - compression - sports - varicose vein - foam sclerotherapy

• References

• 1 Breu FX, Guggenbichler S. European Consensus Meeting on Foam Sclerotherapy, April, 4–6, 2003, Tegernsee, Germany. Dermatol Surg 2004; 30: 709-717.
• 2 Blättler W, Kreis N, Lun B, Winiger J, Amsler F. Leg symptoms of healthy people and their treatment with compression hosiery. Phlebology 2008; 23 (Suppl. 05) 214-221. doi: 10.1258/phleb.2008.008014.
• 3 Blättler W, Zimmet SE. Compression therapy in venous disease. Phlebology 2008; 23 (Suppl. 05) 203-205. doi: 10.1258/phleb.2008.081004
• 4 Catarinella FS, Nieman FHM, Wittens CHA. An overview of the most commonly used venous quality of life and clinical outcome measurements. J Vascular Surgery 2015; 3 (Suppl. 03) 333-340. DOI: http://dx.doi.org/10.1016/j.jvsv.2014.09.003
• 5 Fegan WG. Continuous compression technique of injecting varicose veins. Lancet 1963; 2 7299 109.
• 6 Flour M, Clark M, Partsch H, Mosti G, Uhl J-F. et al. Dogmas and controversies in compression therapy. Report of an International Compression Club (ICC) meeting, Brussels, May 2011, International Wound Journal, 2012 Blackwell Publishing Ltd and Medicalhelplines.com Inc doi: 10.1111/j.1742–481X.2012.01009.x
• 7 Gillies DI, O’Riordan E, Carr D, O’Brien I, Frost J, Gunning R. Central venous catheter dressings: a systematic review. J Adv Nurs 2003; 44 6 623-632.
• 8 Guex JJ, Allaert FA, Gillet JL. Immediate and mid-term complications of sclerotherapy: Report of a prospective multicenter registry of 12,173 sclerotherapy sessions. Dermatol Surg 2005; 31: 123-128.
• 9 Hamel-Desnos CM, Guias BJ, Desnos PR, Mesgard A. Foam sclerotherapy of the saphenous veins: randomised controlled trial with or without compression. Eur J Vasc Endovasc Surg 2010; 39 (Suppl. 04) 500-507. doi: 10.1016/j.ejvs.2009.11.027. Epub 2010 Jan 25.
• 10 Holmström B, Svensson C. ’Tegaderm’ dressings prevent recolonization of chlorhexidine-treated skin. J Hosp Infect 1987; 10 (Suppl. 03) 287-291.
• 11 Mosti G. Post-treatment compression: duration and techniques. Phlebology 2013; Mar; 28 (Suppl. 01) 21-24. doi: 10.1177/0268355513475955
• 12 Mosti G, Partsch H. Is low compression pressure able to improve venous pumping function in patients with venous insufficiency?. Phlebology 2010; 25 (Suppl. 03) 145-150. doi: 10.1258/phleb.2009.009023.
• 13 Nootheti PK, Cadag KM, Magpantay A, Goldman MP. Efficacy of graduated compression stockings for an additional 3 weeks after sclerotherapy treatment of reticular and telangiectatic leg veins. Dermatol Surg 2009; 35: 53.
• 14 Noppeney T, Nüllen H. Kompressionstherapie nach invasiven Maßnahmen in der Phlebologie. Phlebologie 2011; 40: 15-19.
• 15 O’Hare JL, Stephens J, Parkin D, Earnshaw JJ. Randomized clinical trial of different bandage regimens after foam sclerotherapy for varicose veins. Br J Surg 2010; 97: 650.
• 16 Pannier F, Hoffman B, Stang A, Jöckel K-H, Rabe E. Prevalence and acceptance of therapy with medical compression stockings in the adult population – results from the Bonn Vein Study. Phlebologie 2007; 36: 245-249.
• 17 Partsch H. Evidence based compression therapy. VASA 2007; 34: 1-39.
• 18 Partsch H. The static stiffness index: a simple method to assess the elastic property of compression material in vivo. Dermatol Surg 2005; 31 (Suppl. 06) 625-630.
• 19 Partsch H, Mosti G, Uhl JF. Unexpected venous diameter reduction by compression stocking of deep, but not of superficial veins. Veins and Lymphatics 2012; 1: e3
• 20 Rabe E, Gerlach H, Breu FX, Guggenbichler S, Stücker M, Pannier F. Leitlinie: Sklerosierungsbehandlung der Varikose. Phlebologie 2008; 37: 27-34.
• 21 Ragg JC. Eccentric compression of large varicose veins after foam sclerotherapy using a novel silicone gel pad. Phlebologie 2014; 43: 250-256. doi: http://dx.doi.org/10.12687/phleb2224–5–2014
• 22 Ragg JC. Hygiene unter phlebologischen Folienverbänden im Vergleich zu Kompressionsstrümpfen. Phlebologie 2014; 43: A29.
• 23 Ragg JC. Optimierte Verteilung von Mikroschaum durch ultraschallkontrollierte Muskelaktivierung. Phlebologie. 2015 (5); Abstract
• 24 Reich-Schupke S, Stücker M. Schaumsklerosierungstherapie. Phlebologie 2013; 42: 31-36.
• 25 Scurr JH, Coleridge-Smith P, Cutting P. Varicose veins: optimum compression following sclerotherapy. Ann R Coll Surg Engl 1985; 67 (Suppl. 02) 109-111.
• 26 Townsend E. Compression sclerotherapy of varicose veins. J R Coll Gen Pract 1970; 20 (Suppl. 98) 137-145.
• 27 Vasquez MA, Rabe E. et al. Revision of the venous clinical severity score: Venous outcomes consensus statement: Special communication of the American Venous Forum Ad Hoc Outcomes Working Group. J Vascular Surgery 2010; 52 (Suppl. 05) 1387-1396.
• 28 Weindorf M, Körber A, Klode J, Dissemond J. Non-interventional study to investigate the efficacy and safety of Tegaderm™ Matrix in the treatment of patients with therapy-refractory chronic wounds. J Dtsch Dermatol Ges 2012; 10 (Suppl. 06) 412-420. doi: 10.1111/j.1610–0387.2011.07828.x. Epub 2011 Oct 17.
• 29 Weiss RA, Sadick NS, Goldman MP, Weiss MA. Post-sclerotherapy compression: controlled comparative study of duration of compression and its effects on clinical outcome. Dermatol Surg 1999; 25: 105-108.