Prospective Randomized Controlled Trial to Analyze the Effects of Intermittent Pneumatic Compression on Edema Following Autologous Femoropopliteal Bypass Surgery

Background Patients who undergo autologous femoropopliteal bypass surgery develop postoperative edema in the revascularized leg. The effects of intermittent pneumatic compression (IPC) to treat and to prevent postreconstructive edema were examined in this study. Methods In a prospective randomized t...

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Veröffentlicht in:World journal of surgery Jg. 35; H. 2; S. 446 - 454
Hauptverfasser: te Slaa, Alexander, Dolmans, Dennis E. J. G. J., Ho, Gwan H., Mulder, Paul G. H., van der Waal, Jan C. H., de Groot, Hans G. W., van der Laan, Lijckle
Format: Journal Article
Sprache:Englisch
Veröffentlicht: New York Springer-Verlag 01.02.2011
Springer‐Verlag
Springer
John Wiley & Sons, Inc
Schlagworte:
Abdominal Surgery
Adult
Aged
Aged, 80 and over
Anastomosis, Surgical - adverse effects
Biological and medical sciences
Cardiac Surgery
Compression Stocking
Distal Anastomosis
Edema - therapy
Female
Femoral Artery - surgery
General aspects
General Surgery
Humans
Intermittent Pneumatic Compression
Intermittent Pneumatic Compression Devices
Leukocyte Count
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Peripheral Arterial Disease
Peripheral Arterial Disease - surgery
Popliteal Artery - surgery
Prospective Studies
Surgery
Thoracic Surgery
Vascular Surgery
Vascular Surgical Procedures - adverse effects
Leukocyte Count
Intermittent Pneumatic Compression
Distal Anastomosis
Compression Stocking
Peripheral Arterial Disease
Postoperative
Edema
Compression
Surgical anastomosis
Autologous system
Randomized controlled trial
Medicine
Prospective
Randomization
Treatment
Intermittent
Surgery
Clinical trial
ISSN:0364-2313, 1432-2323, 1432-2323
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Zusammenfassung:Background Patients who undergo autologous femoropopliteal bypass surgery develop postoperative edema in the revascularized leg. The effects of intermittent pneumatic compression (IPC) to treat and to prevent postreconstructive edema were examined in this study. Methods In a prospective randomized trial, patients were assigned to one of two groups. All patients suffered from peripheral arterial disease, and all were subjected to autologous femoropopliteal bypass reconstruction. Patients in group 1 used a compression stocking (CS) above the knee exerting 18 mmHg (class I) on the leg postoperatively for 1 week (day and night). Patients in group 2 used IPC on the foot postoperatively at night for 1 week. The lower leg circumference was measured preoperatively and at five postoperative time points. A multivariate analysis was done using a mixed model analysis of variance. Results A total of 57 patients were analyzed (CS 28; IPC 29). Indications for operation were severe claudication (CS 13; IPC 13), rest pain (10/5), or tissue loss (7/11). Revascularization was performed with either a supragenicular (CS 13; IPC10) or an infragenicular (CS 15; IPC 19) autologous bypass. Leg circumference increased on day 1 (CS/IPC): 0.4%/2.7%, day 4 (2.1%/6.1%), day 7 (2.5%/7.9%), day 14 (4.7%/7.3%), and day 90 (1.0%/3.3%) from baseline (preoperative situation). On days 1, 4, and 7 there was a significant difference in leg circumference between the two treatment groups. Conclusions Edema following femoropopliteal bypass surgery occurs in all patients. For the prevention and treatment of that edema the use of a class I CS proved superior to treatment with IPC. The use of CS remains the recommended practice following femoropopliteal bypass surgery.
Bibliographie:Trial registered in 2006 through “TWOR, Rotterdam, the Netherlands” under number 06.071.
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ISSN:0364-2313
1432-2323
1432-2323
DOI:10.1007/s00268-010-0858-9