Edema Fluid in Limbs with Inflammation and Ulcers Under Elastic Material Compression-methods of Evaluation

Background: Contemporary methods for visualization of inflammatory and edema fluid accumulation regions in lower limbs enable targeting compression therapy to these specific sites.In compression procedures the externally applied force is disseminated according to the surface area and is resisted in epidermis by keratinocytes, basal membrane, blood capillaries and lymph in the subepidermal plexus and in dermis by elastic and collagen fibers, fibroblasts and adipocytes, blood vessels, and interstitial fluid between cells and fibers. Moreover, the tissue structure differs at various limb levels.

Aim: To measure the hydromechanics parameters in and under the compressed skin and visualize edema fluid mobilization.

Methods and material: Skin dielectric constant (water concentration, %), tissue bioimpedance (Ldex index), stiffness measured with durometer (1.25 mm depth, newtons), and deep tissue tonometry (10.0 mm depth, kg/sq.cm), tissue fluid pressure (wick-in-needle method, mmHg), tissue fluid mobilization force test (volume) , near infra-red indocyanine green (ICG, fluorescence level) and isotopic lymphographies (fluid location and flow, radioactivity level), in-tissue angio contrast medium distribution (tissue channels), thermography, ultrasonography and MRI imaging (mobile fluid to solid tissue ratio, tissue structure) were applied in 50 patients with obstructive lymphedema of limbs.

Results: Representative data and images of all tests will be shown.

Conclusions: To evaluate the effectiveness of therapeutic compression of inflammation and edema of limbs integrated data obtained by all available electric conductivity, hydromechanics, thermography  and visualization methods are necessary.