Types of compression bandages
1. Elasticity: Wide range of highly elastic to inelastic bandages. Higher the elasticity, stronger the compression.
2. Stretch type: single-stretch or double-stretch.
3. Adhesion: adhesive, cohesive or non-adhesive characteristics.
The intensity of elastic compression is measured in Compression Pressure (mmHg). Two types of pressures are important. Resting pressure refers to pressure applied to lower tissues during muscle relaxation and varies depending on the number of layers and tightness of bandaging. Working pressure refers to pressure from muscle contraction during physical activity such as walking or running.
Inelastic bandages provide stronger compression during muscle volume change such as in physical activity. Therefore, it is used in deep vein thrombosis.
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Table 2. Comparison of elastic bandage and inelastic bandage.
High-elastic (stretch) bandage: low working pressure and high resting pressure
Low-elastic (stretch) to inelastic bandage: high working pressure and low resting pressure
a. Low stretch elastic bandage
- Stretch between 30% and 70% of the original length
- Provides satisfactory support with high pressure during physical movement
- Excellent when combined with physical exercise for the treatment of deep vein system and the suprafascial part of edema with good therapeutic results
- Comfortable to wear for the long-term use
b. Medium stretch elastic bandage
- Stretch between 70% and 140% of its original length
- Provides good working pressure and also good resting pressure
- Widely used on daily exercise compression on the superficial vein system, including perforating vein system, and also on the deep vein system and lymphatic system
c. High stretch elastic bandage
- Stretch by more than 140% of its original length
- Provides similar pressure either on resting condition or during the physical exercise; the pressure does not vary significantly due to its elasticity which accommodates volume expansion during muscle contraction by exercise
- Excellent only to compress the superficial vein system but not very successful to deliver adequate pressure on deep vein and lymphatic system
4. Inelastic bandages with zinc ointment such as Unna Boot are used in leg ulcer. The inelastic bandage acts as an inflexible cast and compression is directly delivered to the deep compartment. Products such as Unna Boot, Unna-flex, and Gelocast are available.
Table 3. Counter pressure exerted by various COMPRESSION class.
Class mmHg Indication
I 18.4~21.2 Leg fatigue, mild symptom, mild varices
II 25.1~32.1 More symptoms, edema, after minor ulceration, following sclerotherapy. Moderate varices
III 36.4~46.5 Chronic postthrombotic venous insufficiency, marked edema, lipodermosclerosis, after severe ulcers
IV Over 59 Very severe ds. Unresponsive to lower compression, lymphedema
-To be continued-
