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                                                             Veins and Lymphatics 2017; volume 6:6636

A new compression pressure
measuring device
Yung-Wei Chi
Vascular Center, University of
California, Davis, CA, USA

Introduction
The sine qua non of compression thera-

py is interface pressure yet it is rarely meas-
ured in the routine care of patients. In 2006,
the first International Compression Club
consensus on an ideal sensor to measure
interface pressure was published.1 In 2008,
the International Union of Phlebology
(IUP) published a consensus document stat-
ing the lack of interface pressure measure-
ment was a knowledge gap in compression
therapy.2 The 2014 Society for Vascular
Surgery and American Venous Forum
(SVS-AVF) clinical guideline on venous
ulcer care reiterated the lack of pressure
measurement as a deficiency in the evi-
dence to compression therapy.3 Moreover,
in the 2015 IUP response to the SVS-AVF
guideline, targeted pressure ranges were
recommended for specific disease state.4
Yet interface pressure is seldom measured
in routine ulcer care leaving most if not all
compression therapy, arbitrary. After a
decade from the initial call to action,

manometer based devices such as
PicoPress® (Microlab, Padua, Italy) and
Kikuhime® (Meditrade, Soro, Denmark)
are commercially available. Unfortunately,
neither was widely adopted or used. The
fact is the lack of this rudimentary informa-
tion has raised concern from many health-
care and scientific entities including the
Agency for Heathcare Research and Quality
(AHRQ), the think-tank for U.S. healthcare
policy. In the Jun 2016 AHRQ draft on
Technology Assessment Report on
Treatment Strategies for Patients with
Lower Extremity Chronic Venous Disease,
it clearly indicated two deficiencies related
to compression therapy i) optimal pressure
dosing and ii) duration of compression ther-
apy. All existing and future interface pres-
sure measuring devices will need to satisfy
these two paucities.

Materials and Methods
From a technological stand-point, the

mechanical properties of manometer,
piezoresistive and capacitive based sensing
characteristics are vastly different with pros
and cons to each. In our work, a novel patent-
ed microfluidic capacitive (iontronic) sensor
was developed, and was compared to the
mechanical performance of PicoPress®5
according to pressure cuff based cylinder
model described previously by Partsch et al.6

Results
After 10,000 cycle runs, the iontronic

sensor demonstrated stability in both
mechanical response and repeatability. In
sensing characterization, both the iontronic
sensor and PicoPress® showed complete
overlap of pressure graphs against the stan-
dard pressure cuff model, P>0.05 (Figure
1).5 In other words, the 2 sensors had the
same sensing performance or efficacy. 

Conclusions
Manometer based interface pressure

measuring devices are available but future
device innovation should focus on accuracy,
versatility, user-friendliness, wireless com-
munication and data collection including
compliance tracking to ensure seamless
adoption by healthcare providers and
patients. 

References
1. Partsch H, Clark M, Bassez S, et al.

Measurement of lower leg compression
in vivo: recommendations for the per-
formance of measurements of interface
pressure and stiffness: consensus state-
ment. Dermatol Surg 2006;32:224-32;
discussion 33.

2. Partsch H, Flour M, Smith PC;
International Compression C.
Indications for compression therapy in
venous and lymphatic disease consen-
sus based on experimental data and sci-
entific evidence. Under the auspices of
the IUP. Int Angiol 2008;27:193-219.

3. O’Donnell TF Jr, Passman MA,
Marston WA, et al. Management of
venous leg ulcers: clinical practice
guidelines of the Society for Vascular
Surgery (R) and the American Venous
Forum. J Vasc Surg 2014;60:3S-59S.

4. Mosti G, De Maeseneer M, Cavezzi A,

                                                                          [Veins and Lymphatics 2017; 6:6636]                                                        [page 31]

Correspondence: Yung-Wei Chi, Vascular
Center, University of California, Davis, CA,
USA.
E-mail: ywchi@ucdavis.edu

This work is licensed under a Creative
Commons Attribution 4.0 License (by-nc 4.0).

©Copyright Y.W. Chi, 2017
Licensee PAGEPress, Italy
Veins and Lymphatics 2017; 6:6636
doi:10.4081/vl.2017.6636

Figure 1. Iontronic sensor versus Picopress® performance characterization.

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                             Conference presentation

et al. Society for Vascular Surgery and
American Venous Forum Guidelines on
the management of venous leg ulcers:
the point of view of the International
Union of Phlebology. Int Angiol

2015;34:202-18.
5. Li R, Nie B, Zhai C, et al. Telemedical

wearable sensing platform for manage-
ment of chronic venous disorder. Ann
Biomed Eng 2016;44:2282-91.

6. Partsch H, Mosti G. Comparison of

three portable instruments to measure

compression pressure. Int Angiol

2010;29:426-30.

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