Abstract
Compression therapy is used in the management and the treatment of various forms of venous insufficiency ranging from the relief of heavy and achy legs to the treatment of more severe forms such as acute venous ulceration. However, the pressure needed to achieve clinical benefit is a matter of debate. The purpose of this study was to examine the transmission of pressure within the soft tissues to improve current understanding of the mechanism of action of medical compression stockings (MCS). Three-dimensional patient-specific finite element models were developed for six subjects. The geometry was obtained from CT scans. Because experimental data on the mechanical properties of healthy adipose tissues and passive muscle are scarce in literature, an inverse method was setup to identify the constitutive properties of the said anatomical elements. This constitutes the original contribution of this work. The main outcome of this study is that the mean pressure applied by the MCS onto the skin is of the same order of magnitude as that applied by the compressed tissues onto the wall of the main deep veins, thereby suggesting that the mean pressure applied can be used as an indicator of the efficiency. Likewise, the maximal hydrostatic pressure in fat can be used to estimate the comfort.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Nehler, M.R., Moneta, G.L., Woodard, D.M., Defrang, R.D., Harker, C.T., Taylor Jr., L.M., Porter, J.M.: Perimalleolar subcutaneous tissue pressure effects of elastic compression stockings. J. Vasc. Surg. 18(5), 783–788 (1993)
Ibegbuna, V., Delis, K.T., Nicolaides, A.N., Aina, O.: Effect of elastic compression stockings on venous hemodynamics during walking. J. Vasc. Surg. 37(2), 420–425 (2003)
Mayberry, J.C., Moneta, G.L., De Frang, R.D., Porter, J.M.: The influence of elastic compression stockings on deep venous hemodynamics. J. Vasc. Surg. 13(1), 91–100 (1991)
Hamel-Desnos, C.M., Guias, B.J., Desnos, P.R., Mesgard, A.: Foam sclerotherapy of the saphenous veins: randomised controlled trial with or without compression. Eur. J. Vasc. Endovasc. Surg. 39(4), 500–507 (2010)
Kern, P., Ramelet, A.-A., Wütschert, R., Hayoz, D.: Compression after sclerotherapy for telangiectasias and reticular leg veins: a randomized controlled study. J. Vasc. Surg. 45(6), 1212–1216 (2007)
Wildin, C.J., Hui, A.C.W., Esler, C.N.A., Gregg, P.J.: In vivo pressure profiles of thigh]length graduated compression stockings. Br. J. Surg. 85(9), 1228–1231 (1998)
Gaied, I., Drapier, S., Lun, B.: Experimental assessment and analytical 2D predictions of the stocking pressures induced on a model leg by medical compressive stockings. J. Biomech. 39(16), 3017–3025 (2006)
Dai, X., Liu, R., Li, Y., Zhang, M., Kwok, Y.: Computational Textile, vol. 55, pp. 301–309. Springer, Berlin (2007)
Avril, S., Badel, P., Dubuis, L., Rohan, P.-Y., Debayle, J., Couzan, S., Pouget, J.-F.: Patient-specific modeling of leg compression in the treatment of venous deficiency. In: Gefen, A. (ed.) Patient-Specific Modeling in Tomorrow’s Medicine, vol. 09, pp. 217–238. Springer, Berlin (2011)
Dubuis, L., Avril, S., Debayle, J., Badel, P.: Identification of the material parameters of soft tissues in the compressed leg. Comput. Meth. Biomech. Biomed. Eng. 15(1), 3–11 (2012)
Liu, R., Kwok, Y.-L., Li, Y., Lao, T.-T., Zhang, X., Dai, X.: A three-dimensional biomechanical model for numerical simulation of dynamic pressure functional performances of graduated compression stocking (GCS). Fibers Polymer 7(4), 389–397 (2006)
Carter, T.J., Sermesant, M., Cash, D.M., Barratt, D.C., Tanner, C., Hawkes, D.J.: Application of soft tissue modelling to image-guided surgery. Med. Eng. Phys. 27(10), 893–909 (2005)
Kauer, M., Vuskovic, V., Dual, J., Szekely, G., Bajka, M.: Inverse finite element characterization of soft tissues. Med. Image Anal. 6(3), 275–287 (2002)
Avril, S., Bouten, L., Dubuis, L., Drapier, S., Pouget, J.-F.: Mixed experimental and numerical approach for characterizing the biomechanical response of the human leg under elastic compression. J. Biomech. Eng. 132(3), 31006–31014 (2010)
Goossens, R.H.M.: Fundamentals of pressure, shear and friction and their effects on the human body at supported postures. In: Gefen, A. (ed.) Bioengineering Research of Chronic Wounds, vol. 1, pp. 1–30. Springer, Berlin (2009)
Moreno, J.C., Brunetti, F.J., Pons, J.L., Baydal, J.M., Barbera, R.: Rationale for multiple compensation of muscle weakness walking with a wearable robotic orthosis. In: Robotics and Automation, 2005. ICRA 2005. Proceedings of the 2005 IEEE International Conference, pp. 1914–1919, 2005
Fischer, A.A.: Pressure tolerance over muscles and bones in normal subjects. Arch. Phys. Med. Rehabil. 67(6), 406–409 (1986)
Fischer, A.A.: Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. Pain 30(1), 115–126 (1987)
Ylinen, J., Takala, E.-P., Kautiainen, H., Nykänen, M., Häkkinen, A., Pohjolainen, T., Karppi, S.-L., Airaksinen, O.: Effect of long-term neck muscle training on pressure pain threshold: a randomized controlled trial. Eur. J. Pain 9(6), 673–681 (2005)
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this paper
Cite this paper
Dubuis, L., Rohan, C.PY., Avril, S., Badel, P., Debayle, J. (2013). Patient-Specific Computational Models: Tools for Improving the Efficiency of Medical Compression Stockings. In: Wittek, A., Miller, K., Nielsen, P. (eds) Computational Biomechanics for Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6351-1_4
Download citation
DOI: https://doi.org/10.1007/978-1-4614-6351-1_4
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-6350-4
Online ISBN: 978-1-4614-6351-1
eBook Packages: EngineeringEngineering (R0)