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Background: Compression bandages appear to be simple medical devices. However, there is a lack of agreement over their classification and confusion over the use of important terms such as elastic, inelastic, and stiffness., Objectives: The objectives were to propose terms to describe both simple and complex compression bandage systems and to offer classification based on in vivo measurements of subbandage pressure and stiffness., Methods: A consensus meeting of experts including members from medical professions and from companies producing compression products discussed a proposal that was sent out beforehand and agreed on by the authors after correction., Results: Pressure, layers, components, and elastic properties (P-LA-C-E) are the important characteristics of compression bandages. Based on simple in vivo measurements, pressure ranges and elastic properties of different bandage systems can be described. Descriptions of composite bandages should also report the number of layers of bandage material applied to the leg and the components that have been used to create the final bandage system., Conclusion: Future descriptions of compression bandages should include the subbandage pressure range measured in the medial gaiter area, the number of layers, and a specification of the bandage components and of the elastic property (stiffness) of the final bandage.

Background: Venous leg ulcers are common in the adult population and cause a significant social economic burden. Despite their prevalence, venous leg ulcers are often managed inadequately., Objective: To provide an overview of venous ulceration, including a review of the current understanding of the pathophysiology of venous ulceration and the implications for management of venous ulceration., Methods: A review of the literature., Results: Modern methods of investigation have led to an improvement in our understanding of the pathophysiology of venous disease. In many patients, superficial and/or perforator venous disease is the only underlying hemodynamic abnormality. Although compression should serve as the cornerstone of treatment of venous ulceration, surgery and/or sclerotherapy can treat incompetent superficial and perforator veins. Important hemodynamic improvement is obtained, and the long-term prognosis of these patients is greatly improved., Conclusion: One must define the basic underlying abnormality of the venous system to form a rational, individualized management plan for the patient with venous ulceration.

Background: A previous study found hyaluronidase to be effective in the prevention of necrosis following intradermal sodium tetradecyl sulfate and 23.4% sodium chloride. There are no published dose-response studies of hyaluronidase used in this manner., Objective: To conduct a dose-response study using hyaluronidase in the prevention of necrosis following intradermal 23.4% sodium chloride., Methods: Study I evaluated control vs hyaluronidase groups (150, 300, 450 units; all in volume of 3 mL) in the prevention of necrosis following intradermal 0.25 mL 23.4% sodium chloride. Incidence and size of necrosis were compared between groups. In study II, hyaluronidase was administered in doses ranging from 18.75 to 900 units (all in volume of 3 mL) immediately following the intradermal instillation of 0.25 mL of 23.4% sodium chloride. A control group had no therapy. The incidence of necrosis was compared between groups. A dose-response curve was constructed. Both studies were randomized and blinded and used Sprague-Dawley rats., Results: A statistically significant protective effect was found in the treated vs the untreated groups in both studies. Maximal protection was achieved by 75 units of hyaluronidase and was not improved upon by higher doses., Conclusion: In the event of extravasation with 23.4% sodium chloride, in the model studied, one can expect maximal protection with a dose of 75 units of hyaluronidase.