PubMed · 48084
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A K Marsden. 1975-04-12. Letter: A large field dressing.. https://doi.org/10.1016/s0140-6736(75)93037-8
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To determine whether elastic compression alters the venous hemodynamics in the postphlebitic limb, we measured venous pressure patterns in 11 postphlebitic limbs with and without elastic compression stockings. Following cannulation of a dorsal vein of the foot, the patients underwent measurements of basal resting pressure, maximum percent decrease in venous pressure with exercise (delta VPex), peak systolic venous pressure during exercise (SVPmax), the amplitude of the pressure swing, and venous return time. Elastic compression did not alter basal resting pressure, delta VPex, or venous return time. By contrast, SVPmax decreased from 139 +/- 0.3 mm Hg to 11 +/- 8 mm Hg with elastic compression. If venous ulcers are related to the high pressure developed in the superficial veins during calf muscle systole, then elastic compression may be beneficial by decreasing systolic venous pressure and its subsequent deleterious consequences.
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In the treatment of varicose veins and their complications most European phlebologists use today, unlike the past, surgery, sclerotherapy and compression without any preconceived preference, guided solely by the indications of choice of each method. Within this framework, it is generally admitted that surgery is by far the best treatment for incompetent saphenous terminations, main saphenous trunks and insufficient bulky perforating veins. Sclerotherapy, on the other hand, is given the task of eliminating the varicose tributaries of the removed saphenous conduits, as well for treating reticular non-saphenous varices, dermal varicosities and recurrent varicose veins after correct operations. As far compression treatment, it requires today respect for "posology" that is expressed in terms of mmHg of pressures to be exerted at different levels of the extremity; depending on venous and skin changes, semi-stiff sticky bandages or various types of elastic stockings will be chosen. Often two or more of the methods listed are used during the same treatment or in successive stages.