Mayrovitz Harvey N, Partsch Hugo, Vanscheidt Wolfgang
Harvey N. Mayrovitz, PhD, Physiology, College of Medical Sciences, Nova Southeastern University, Ft Lauderdale, Florida. Hugo Partsch, MD, Dermatology, Department of Dermatology, Medical University of Vienna, Vienna, Austria. Wolfgang Vanscheidt, MD, Dermatology, Facharzt für Dermatologie Phlebologie Allergologie, Freiburg, Germany.
J Wound Ostomy Continence Nurs. 2015 Sep-Oct;42(5):468-73. doi: 10.1097/WON.0000000000000157.
To characterize and compare interface pressure profiles of an adaptive compression therapy (ACT) device and a traditional 4-layer bandage (4LB) system.
A prospective, randomized, open-label, 1-arm, active controlled study.
The sample comprised 12 healthy volunteers.
Subjects wore both devices for 8 hours on 3 consecutive days. Treatments were randomized to left and right legs. One clinician performed all applications and was experienced in the clinical use of both devices. Pressures were measured in seated and standing positions at the lower, mid, and upper calf immediately post application and after 1, 4, and 8 hours.
Pressures achieved with the ACT were closer to targeted 40/30/20 mmHg graduated pressure values and were significantly less than the 4LB for corresponding sites/postures (P < .001). In the seated position, initial interface pressures (mean ± SD) for the ACT were 36.9 ± 4.9, 30.5 ± 4.5, and 21.0 ± 3.6 mmHg. Corresponding interface pressures for the 4LB were 52.5 ± 8.4, 57.5 ± 10.3, and 53.5 ± 12.9 mmHg. In the standing position, initial interface pressures for the ACT were 40.7 ± 4.8, 35.6 ± 4.5, and 21.1 ± 4.6 compared to 54.6 ± 12.5, 64.4 ± 10.9, and 53.7 ± 14.3 for the 4LB. At 1, 4, and 8 hours after application, the 4LB showed a significant progressive decline in interface pressure in both seated and standing positions (P < .001). Conversely, the ACT did not decrease over time and there was a slight but significant increase for lower and mid-calf sites in the seated position (P < .001).
The ACT device provided more consistent interface pressures than the 4LB and the pressures achieved were consistent with contemporary venous ulcer therapy standards.
描述并比较一种自适应加压治疗(ACT)设备和传统四层绷带(4LB)系统的界面压力分布情况。
一项前瞻性、随机、开放标签、单臂、活性对照研究。
样本包括12名健康志愿者。
受试者连续3天佩戴这两种设备各8小时。治疗随机分配至左腿和右腿。由一名临床医生进行所有应用操作,且该医生对这两种设备的临床使用都有经验。在佩戴后即刻以及1、4和8小时后,于小腿下部、中部和上部的坐位及站立位测量压力。
ACT所达到的压力更接近目标40/30/20 mmHg分级压力值,且在相应部位/姿势下显著低于4LB(P < .001)。在坐位时,ACT的初始界面压力(均值±标准差)分别为36.9±4.9、30.5±4.5和21.0±3.6 mmHg。4LB的相应界面压力分别为52.5±8.4、57.5±10.3和53.5±12.9 mmHg。在站立位时,ACT的初始界面压力分别为40.7±4.8、35.6±4.5和21.1±4.6,而4LB的分别为54.6±12.5、64.4±10.9和53.7±14.3。在应用后1、4和8小时,4LB在坐位和站立位的界面压力均显著逐渐下降(P < .001)。相反,ACT的压力并未随时间降低,且在坐位时小腿下部和中部部位有轻微但显著的增加(P < .001)。
ACT设备提供的界面压力比4LB更稳定,且所达到的压力符合当代静脉溃疡治疗标准。