(CS-159) Five Bedside Signs Suggesting Textile Compression Delivers Effective Wound Tissue Micro Deformation, Enhancing Local Protein Synthesis and Increasing Perfusion During Venous Leg Ulcer Therapy

We’ve reported dramatic outcomes using an inexpensive warp knitted compression stockinet* to control edema since 2009 (Sibbald) (Ehmann 2020). Anecdotal bedside diagnostic findings that suggest fuzzy wale stockinet compression 1.) increases arterial perfusion of skin and subcutaneous fat, and 2.) delivers physiologically effective micro deformation to wound granulation tissue.

Cell membrane mechano transduction signals arise in tissue experiencing micro deformation and upregulate local gene expression, increasing protein synthesis required to heal (Orgill) (Saxena). Healing outcomes with fuzzy wale stockinet appear similar to what is seen with open cell foam Negative Pressure Wound Therapy, NPWT. Ehmann has coined the term Positive Pressure Wound Therapy, PPWT** when fuzzy wale stockinet is intimate with wound surface tissue. (Ehmann 2022)

Methods:

Photos document anecdotal findings at bedside that suggest enhanced perfusion and dramatic wound bed progress. (Schultz 2003) (Ostler 2019)

Results:

Wound photos document anecdotal rapid:
1) Resolution of epiboly
2) Clearing peri-wound stasis dermatitis in refractory VLUs (Ostler 2019)
3) Neo epithelialization
4) Healing without scar
5) Healing full thickness ankle wound with no pedal Doppler signals. (Winkler 2023) 

Discussion:

Fuzzy wale compression stockinet creates furrows in granulation tissue and appears to be considerably more effective than flat compression textiles to speed wound bed preparation. Temple of Asclepius priest healers, c. 350 BCE, swaddled limbs with rough-spun linen which created furrows in subcutaneous fat with effective tissue micro deformation such as we are reporting. Wound  granulation compression research holds promise for VLU treatment.*