多层加压：应用于腿部的四种不同四层绷带系统的比较。

Dale J J, Ruckley C V, Gibson B, Brown D, Lee A J, Prescott R J

Lothian Health Board, Edinburgh, Scotland, UK.

Eur J Vasc Endovasc Surg. 2004 Jan;27(1):94-9. doi: 10.1016/j.ejvs.2003.10.014.

OBJECTIVE

To compare performance of four commercial four-layer bandage systems when applied to the leg.

METHODS

Four experienced bandagers applied each system: [Profore Regular (Smith and Nephew); Ultra-Four (Robinson); System 4 (Seton) and K Four (Parema)] to the same leg. Bandages were applied as single layers and as completed systems using standard techniques. For each application, 18 pressure measurements were taken using the Borgnis Medical Stocking Tester (MST) at three measuring points (ankle, gaiter and mid-calf) on medial and lateral aspects in three postures: (horizontal, standing and sitting).

RESULTS

In all 2304 observations were made, 576 for each bandager, 576 for each bandaging system, 768 for each measuring point, 1152 for each aspect and 768 for each posture. The increase in pressure produced by each additional layer was 65-75% of the pressure of the same bandage when used as a single layer. There were significant differences in the final pressures achieved by the bandagers (means: 45-54 mmHg, p<0.001) and between bandage systems (means: System 4: 46 mmHg, Profore: 47 mmHg, K Four: 52 mmHg, Ultra-Four: 54 mmHg; p=0.005). The relationships between the final pressures achieved at each of the three measuring points, the three postures and the two aspects were not consistent among the bandage systems (p<0.01).

CONCLUSIONS

When a bandage is applied as part of a multi-layered system it exerts approximately 70% of the pressure exerted when applied alone, thus challenging the commonly-held assumption that the final pressure achieved by a multi-layer bandaging system is the sum of the pressures exerted by each individual layer. Each of the four bandaging systems exerted different final pressures and gradients and different changes with posture change. These differences have important implications, which could influence the selection (or avoidance) of a particular bandage system according to a patient's condition and circumstances.

目的

比较四种商用四层绷带系统应用于腿部时的性能。

方法

四名经验丰富的包扎人员将每种系统（普洛福常规型（施乐辉）；超四型（罗宾逊）；4号系统（希顿）和K4型（帕雷马））应用于同一条腿。绷带以单层和完整系统的形式使用标准技术进行包扎。每次包扎时，使用博尔尼丝医用长袜测试仪（MST）在三个测量点（脚踝、小腿中部和小腿肚）的内侧和外侧，于三种姿势（水平、站立和坐姿）下进行18次压力测量。

结果

总共进行了2304次观察，每位包扎人员576次，每个绷带系统576次，每个测量点768次，每个侧面1152次，每种姿势768次。每增加一层所产生的压力增加量为同一绷带单层使用时压力的65%至75%。包扎人员最终施加的压力存在显著差异（平均值：45 - 54 mmHg，p<0.001），绷带系统之间也存在显著差异（平均值：4号系统：46 mmHg，普洛福：47 mmHg，K4型：52 mmHg，超四型：54 mmHg；p = 0.005）。在三个测量点、三种姿势和两个侧面所达到的最终压力之间的关系在各绷带系统中并不一致（p<0.01）。

结论

当绷带作为多层系统的一部分应用时，其施加的压力约为单独使用时的70%，这对普遍认为多层绷带系统最终达到的压力是各层单独施加压力之和的假设提出了挑战。四种绷带系统各自施加的最终压力、梯度以及随姿势变化的情况均有所不同。这些差异具有重要意义，可能会根据患者的病情和具体情况影响特定绷带系统的选择（或避免选择）。