The different types of bandages

Long-stretch or elastic bandages

Long-stretch bandages (LSBs) are, by definition, bandages for which the extensibility is high: greater than 100% to 120% (depending on the bibliographic articles and the country). They contain elastic fibres and may be dry or cohesive.

The elastic behaviour provides constant pressure, which is almost the same at rest and at work, therefore leading to a low static stiffness index (SSI), with little or no massage effect.
This type of action is particularly recommended for immobile or not very mobile patients, incapable of sufficiently activating their calf-muscle pump.

Elastic systems may need to be taken off at night since the pressure that they exert is difficult to tolerate when sleeping. The need for re-application every day can sometimes be a significant obstacle in terms of a patient’s compliance with treatment.

In addition, elastic bandages, particularly when they do not comprise a visual compression guide, can be relatively difficult to apply without prior training since they need to be applied at a 50% stretch which requires regular practice and bandage knowledge.

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Short-stretch or low-elasticity bandages

These bandages are defined as having low elasticity (or non-elastic) if they have an extensibility of less than 100% to 120% (depending on the bibliographic articles and the country).

Short-stretch bandages deliver a low resting pressure and a high working pressure (high SSI), producing a significant massage effect on the calf-muscle when the patient is active. This massage effect reactivates the efficacy of the muscle pump by propelling the venous blood flow from the superficial network to the deep network. Short-stretch systems are therefore very effective in the treatment of severe stages of chronic venous disease (CVD), especially in the treatment of venous leg ulcers and severe oedema, since they significantly improve venous return and lymphatic drainage.

They are effective in patients with sufficient mobility and are particularly recommended in the event of severe oedema.
They can usually be kept on day and night, due to their low resting pressures.

However, there are some reports in literature of a significant reduction in interface pressure after the first few hours following application. This can quite quickly leading to  these bandages slipping and the need to regularly re-apply the bandage in order to maintain the required sub-bandage pressure. This is particularly true at the very start of compression therapy when the venous oedema is in the resorption phase and leg volume reduction is at its greatest.

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Multicomponent multilayer bandage systems (MLBs)

The first multicomponent multilayer system was developed by specialists at Charing Cross Hospital in London in 1988, based on studies conducted by Stemmer. He demonstrated that high compression of the lower limb, in the region of 40 mmHg, was required for the treatment of venous leg ulcers in patients suffering from severe chronic venous disease.

A multilayer bandage system consists of a combination of different bandages of variable elasticity to provide a compression system combining the benefits of both short-stretch and long-stretch bandages. At work, it behaves like a short-stretch bandage, producing a marked massage effect. At rest, it provides constant intermediate pressure, which can be tolerated at night, making it possible to keep the system on for up to 7 days, without loss of pressure or slipping.

Traditionally, multicomponent multilayer systems consisted of 4 bandages. (Read more...)

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