EFFECTS OF COMPRESSION BANDAGING ON LEG PULSATILE BLOOD-FLOW

Leg external compression bandaging is the mainstay of venous ulcer tre atment, yet little is known about the impact of therapeutic compressio n levels on arterial haemodynamics. In this study, the effect of foot- to-knee, four-layer compression bandaging on below-knee arterial pulsa tile blood flow was assessed by nuclear magnetic resonance flowmetry. In 14 healthy supine subjects, bilateral flow measurements at five bel ow-knee sites without compression, and after compressing one leg to an average malleolar sub-bandage pressure of 40.7+/-4.0 mmHg, revealed a potentially important new phenomenon. The forefoot-to-knee compressio n bandaging caused a highly significant (P<0.001) increase in the band aged leg pulsatile blood now owing to increases in both peak Bow and p ulse width. It is hypothesized that arteriolar vasodilatation, induced either myogenically by reduced transmural pressure or by vasodilatory substance release triggered by increased venous shear stress, produce the observed compression-related phenomenon. Whatever the mechanism(s ), the finding of a compression-associated pulsatile flow increase sug gests a previously undiscovered arterial linkage, which may play a rol e in the well-documented beneficial effects of compression bandaging i n venous ulcer treatment. A possible impact of the arterial flow-pulse increase is speculated to effect venous ulcer outcome via a decrease in leucocyte effects in the distal microvasculature, as a consequence of the more vigorous haemodynamic state.