Photoplethysmographic evaluation of external compressive therapy for chronic venous ulceration

The photoplethysmograph (PPG) was utilized to evaluate the role of external compression in the treatment of chronic venous insufficiency with ulceration (CVIU). Thirty patients with long standing CVIU were evaluated using a PPG probe placed just above the medial malleolus. Venous recovery time (VRT) was calculated after 5 active dorsiflexions. Patients were then retested after an Unna boot had been applied and again, after this had been supplemented by a tight elastoplast wrap. VRT in 10 normal control subjects was >12 seconds (12-30 seconds, mean 19+/-5 seconds). VRT was <12 seconds in all tested patients (0-11 seconds, mean 5+/-2 seconds). When an Unna boot was applied, VRT increased to 7+/-2 seconds in 20 patients. An Unna boot and elastoplast wrap increased VRT to 10+/-3 in 25 patients (p<0.01).