A high-resolution tape sensor improves the accuracy of applied pressure profiles during lower-leg bandaging – results from a study using a fibre-optic sensing tape

Luke A Parkinson, Malou van Zanten, Neil Piller & John W Arkwright. Medical helplines.com Inc and John Wiley & Sons Ltd. 2017

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A high-resolution tape sensor improves the accuracy of applied pressure profiles during lower-leg bandaging – results from a study using a fibre-optic sensing tape

Luke A Parkinson, Malou van Zanten, Neil Piller & John W Arkwright. Medical helplines.com Inc and John W

Compression bandaging is a mainstay practice in the treatment of conditions such as chronic wounds and lymphoedema. However, the ability of practitioners to measure bandage application to a desired pressure profile is difficult because of sensor limitations. We have used a novel fibre-optic-based, high-resolution sub-bandage pressure monitor to measure adherence to a target pressure gradient during compression bandaging. Participants of various experience (n=46) were asked to bandage a lower-leg manikin to a gradient of 40 (ankle) to 20 mmHg (proximal calf) in both a blinded trial and subsequently with sensor feedback. Mean pressures across all sensors for both the blind and sensor-guided trials approximated a target mean of 30 mmHg. However, the mean gradient achieved in the blinded trial showed an inverse pressure gradient to the target with a high-pressure region at the mid-calf (44±19 mmHg). Correlation to the targetgradientimprovedfromR2=0⋅62duringtheblindtrialto0⋅93usingsensorfeedback, with a gradient that closely approximated the target. This demonstrates the use of high-resolution sub-bandage pressure sensing in improving the ability of practitioners to achieve a target pressure gradient in compression bandaging for clinical use and training.iley & Sons Ltd. 2017

Main findings

  • A novel high-resolution, fibre-optic sub-bandage pressure sensor with 30 individual sensors in a compression bandaging trial using a manikin leg and correlated results to a target gradient, demonstrating that high-resolution monitoring improves practitioners’ ability to achieve a target compression gradient and reduces variability.
  • The objectives of this study were to examine the variability in compression achieved during bandaging of the lower-leg and to demonstrate the benefits of real-time feedback on the final compression gradient.
  • On average, the pressure gradient achieved by practitioners in blinded trials was inverse with respect to the target and showed a high-pressure region at the mid-calf, whereas the gradient achieved in sensor-guided trials closely followed the target. The correlation to the target gradient from R2 =0⋅62 (blind) to 0⋅93 (guided) with a decrease in variance amongst participants from 46% to 4⋅6% by using feedback from the sensor.
  • The primary result of this study was the clear increase in bandaging accuracy that was achieved by using the feedback from the pressure sensor strip.
  • It must be remembered a manikin was used. The manikin leg also prevents patient feedback, and a common comment from participants was that the firmness of the simulated leg prevented standard pressure-checking techniques, such as manual palpation, making it difficult to monitor progress as usual during the blinded trials.
  • We have shown that a high-resolution pressure sensing strip is a very good feedback tool to quantify the pressure being applied to a manikin leg and, more importantly, has shown that the high spatial resolution available permits a true pressure gradient to be observed dynamically.