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Title: Optimisation of intermittent compression for the improvement of vascular inflow and outflow proximal to a wound site
Author: O'Doherty, Bethan
ISNI:       0000 0004 2751 7050
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2008
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Ulceration of the lower limb is a chronic, debilitating condition affecting an increasing percentage of the adult and elderly populations. Conservative treatment options are limited, and generally result in surgery or amputation. The purpose of this research was to investigate the feasibility of using intermittent pneumatic compression for the treatment and management of chronic non-healing leg ulcers. The aim was to develop a system capable of improving the healing of leg ulcers of varying causes through improving distal blood flow whilst also being comfortable and easy to use, to encourage patient compliance. Using Doppler ultrasound, it was demonstrated that intermittent pneumatic compression was capable of producing a distal blood flow response in the limb of a healthy volunteer. Further investigations examined the effect on this distal response of altering the cuff design, pressure and cycle duration in order to determine the optimal compression regime for enhancing the distal circulation the ultimate objective being to use intermittent pneumatic compression to improve the healing of chronic leg ulcers by improving distal blood flow. The optimal sequence involved a 3-chamber thigh cuff, using a pressure of 60mmHg and a short sequential cycle which was operated within a 2 minute on and off sequence. The optimal system was investigated for distal blood flow effects in a group of 20 healthy volunteers, and 14 patients with leg ulcers of differing aetiologies. A distal hyperaemic response was achieved during the 2 minutes without compression, consequent upon changes included in the venous circulation during the 2 minutes of compression. A greater response was detected in the patient group as compared with the healthy volunteer group. A 3 month case study of the clinical effects of the new system resulted in the complete healing of the patients long standing non-healing leg ulcer. Further case studies are required to determine the significance of this finding.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available