The effects of gravity on the fluid-handling properties of wound dressings covered with compression bandages: results of a pilot laboratory investigation

The management of exudate from leg ulcers remains a major challenge for health care practitioners. Many different dressings are available for this purpose, often used in conjunction with graduated external compression provided by extensible bandages applied in different configurations to achieve the required physiological effect. Although a significant amount of data has been published on the fluid-handling properties of some of these primary dressings, this has mainly been derived from laboratory studies using standard tests conducted in the horizontal plane, often without the addition of a secondary compression dressing. A review of the literature failed to identify any publications which examined either the effects of compression bandages or gravity upon dressings tested in the vertical plane, simulating normal conditions of use. The present study was therefore undertaken to investigate the effect of both of these factors. While the application of multiple layers of bandages were found to have relatively little effect upon the loss of moisture vapor from a given dressing, compression and the effects of gravity were, in some instances, shown to significantly accelerate the rate of dressing failure, although important differences between products were noted in this regard. As a result of this work it is proposed that new test methods be devised which take account of both parameters to better inform potential users of the relative merits of various available dressing materials. .