PULSEPRESS - mjsgrp.com · LEG ULCERS In a world of increasing life expectancy the problems associated with the elderly are becom-ing ever more prominent in society. Leg ulcers are

PULSEPRESSDYNAMIC COMPRESSION systems

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TREATMENTS

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How does IPC work?

Leg Ulcers

Lymphedema

Sports Injuries

DVT

Wound Healing

Stroke

General IPC

Oxygen Perfusion

http://www.pulsepress.com

http://www.mjsgrp.com/pdf/pulsepress/pumps.pdf

http://www.mjsgrp.com/pdf/pulsepress/pump_specs.pdf

http://www.mjsgrp.com/pdf/pulsepress/garments.pdf

http://www.mjsgrp.com/pdf/pulsepress/garment_specs.pdf

http://www.mjsgrp.com/pdf/pulsepress/Clinicalfiles_general_ipc.pdf

http://www.mjsgrp.com/pdf/pulsepress/Clinicalfiles_oxygen_clinical.pdf


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WHAT IS IPC?

What is IPC? Basics Two parts to the system. Pump Units - They comprise of an air pump which has a pressure regulated output and timed cycle time. (In essence they are powerful bedpumps). Garments - They are inflatable splints which encompass the limbs of the body. System - The pump unit inflates the garment which compresses the limb. After a set time the garment is then deflated to relieve pressure. This cycle continues for a required time of therapy (30-120mins).In essence the therapy acts as an intense massage.







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WHAT IS IPC?

What is IPC used for? There are basically 2 main benefits of using IPC. Aid circulation

Reduce inflammation Reducing Inflammation The technical term for inflammation ona limb is oedema. This can be caused by a multitude of reasons. Sports Injuries:-Normally occurring after an individual has fallen, miss-stepped e.t.c and includes sprains, muscle tears, pulled tendons, cramps and so on. The natual reaction of the body after an injury of this type is swelling up around the damaged area. This causes pain with the desired effect that you stop using the dam-aged area in order that the healing process is allowed to occur.In reality there is also a negative impact which is that the circulation of fresh oxygen-ated blood is also restricted which slows down the healing process.







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WHAT IS IPC?

Aid Circulation This reduction in circulation of oxygenated bloody has a significant effect on the healing rate. It is the oxygenated blood into a damaged area which promotes rapid regeneration of the injured tissue structure and also removes any toxins which are accumulating/building up. How does IPC work? This is a two stage process. The regular low pressure compression on the limb helps squeeze the oedema(retained water) into the blood stream via the capillary network. Once the inflammation has been removed then the second stage kicks in.The compression of the muscles, where most blood flows, pushes the blood through the venous system back towards the heart. There are ‘one-way’ valves in the venous return system which ensure blood only travels back to the heart in one direction. When the inflation cycle ends and garment is de-pressurized the blood naturally fills up the areas of low pressure within the muscles with fresh oxygenated blood.And so the cycle continues to pump the blood around the injured limb and increase the healing rate significantly. - Leg Ulcers (venous/arterial/diabetic)- Heel Ulcers- Lymphadema- Stroke rehab- Post operative trauma- Wound Healing- Sports training- Sports injuries







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WHAT IS IPC?

Types of IPC

There are 3 main types of IPC on the market, namely, Single, Sequential and Peri-staltic

Single Chamber (Uniform) Compression

This is the most cost effective option. The garment is made up of a single inflating chamber.

A single hose feed air from the pump unit and inflates the entire garment in one go.In general this method is only now used for the very small specialized garments.

Foot & Ankle Hand & Wrist Limb Sleeves Stumps







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WHAT IS IPC?

Gradient Sequential Compression

The garment is divided into segments along its length. There are generally between 3 and 12 chambers. The inflation cycle will always operate in a distal (further from the heart) to proximal (closest to the heart). To explain, that would mean in a 3-chamber device the foot section would inflate, followed by the calf, and the finally the thigh.The gradient system reduces the pressure progressively in each successive cham-ber. This is currently the preferred method and that used by all Pulse Press systems.

Gradient Sequential Inflation Cycle

Stage 1 Foot = 50mmHg Calf = 0mmHg Thigh = 0mmHg



Deflate Foot = 0mmHg Calf = 0mmHg Thigh = 0mmHg







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WHAT IS IPC?

Peristaltic Compression

This is used with multi – chamber systems and is like a wave pushing the fluid up the limb.Studies have shown that this treatment is not particularly effective and is not very popular. Some units use a reverse peristaltic system which it sells as a manual lymph drainage mode. This starts from the top and then progressively moves down moves down the limb. In general, it has not been well received and is a marketing tool.

Peristaltic Inflation Cycle











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WHAT IS IPC?

TREATMENT INFORMATION

Now you have an overview of what IPC is in general, it is time to move onto specific points of how the Pulse press system operate and the advantages of them in offer-ing a class beating therapy.

What makes for a good therapy

As previously explained the system is broken into two parts, the pump and the gar-ment. Both require big features in order to deliver a good treatment.

Pump unit

The speed with which the garment is inflated up to pressure is paramount in delivering a good therapy. The key here is the use of a powerful compressor.All Pulse Press pump units use the patented Cyclone compressor. this is a purpose built unit specially for IPC use and it gives a high free flow of air to ini-tially fill up the garment and then very good pressurized air flow to ensure that the garment is brought up to pressure in as short a time as is possible.

The majority of our competitors use off the shelf compressors which have been designed to be all things to all men, and thus are not as effective. See graph below.







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WHAT IS IPC?

TREATMENT INFORMATION

GRAPH SHOWING PUMP PERFORMANCE

What does the graph show?

1) Due to the high performance compressor the system inflates the gar-ment to pressure quicker. The pressure rise time is what gives an effective therapy as it acts more like a pump on the blood.2) As the systems have adjustable time cycles for setting the inflate & de-flate times an optimal setting can be achieved by deflating the garment prior to the other system even reaching pressure.3) The feed time cycle of the competitor pump unit means that the number of compression cycles you receive per therapy session is far less.

For many conditions (removal of edema), this is directly proportionate to the effectiveness of the treatments. in real terms the patient would have to wear the garment for three times as long to get the same number of compressions.







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WHAT IS IPC?

Garment Design

Design features:- triangular foot section prevents toes being pinched and compress-es the sole of the foot. Internal gussets:- gives a totally flat inner surface (not sausages) automatically ad-justed to size of patient limbs. This allows simple installation and use. It means that the single garment stays with the patient throughout treatment without need for ex-panders or new smaller garments.

Some competitors use individual cells in an outer shell with many zips. Need to fit each time you use and sometimes refit halfway through therapy. Also not effective if one part, e.g. knee, is disproportionably swollen as only that area receives effective treatment.

Another common offering is garments with a soft, stretchy inner material. on the face of it this appears very comfortable but is actually only there to prevent the toe-pinch-ing from occurring. The downside is that with a stretchy inner material it is possible to get shearing action on the skin which is not a good thing especially with leg ulcer patients.

For comfort we do offer an absorbent cotton-based, sterile liner. this helps to absorb sweat. It must be remembered that in essence all systems are the equivalent of a plastic bag and during treatment the limb under treat (along with the patient) sweat a lot, and can be very unpleasant. the other advantage of the liners is that they are a consumable, and hence a good source of revenue.

Finally, and probably the biggest sales point of the whole system is that the gar-ments are machine washable. There is a wash bung on all garments and they can be put into a standard washing machine. All of our competitors’ have to be hand-washed.







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WHAT IS IPC?

What Settings to use?

Pressure Settings

Current medical thinking is that you stay between 40-60mmHg. Each profes-sional will have their own ideas and (your Insurance provider) with most likely prevent you from giving exact figures.

Normally start a treatment at 40mmHg and if after a week there is no change, gradually increase up to 60mmHg in 5mmHg increments.

Increasing pressures over 60mmHg will have a significant effect of reducing the swelling more but the flip-side is that it further damages the soft tissue structure and thus the limb will swell up quicker after therapy. Some consult-ants use higher pressures for 1-2 weeks for severe lymphedema to help soften the fibrous tissue and then reduce them later.

Time Cycles

ALL of the Pulse press units offer adjustable time cycles which allow individual settings for specific conditions. In general the following applies for time setting:

Primary Motive Inflate DeflateIncrease circulation – leg ulcers, heelulcerssports injuries.

Short Short

Reduce lymphedema Medium ShortWound Healing Short ShortArterial insufficiency Short LongStroke rehabilitation Very short Very shortDeep Vein Thrombosis Short Long







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Click here to see Clinical Reports

LEG ULCERS

In a world of increasing life expectancy the problems associated with the elderly are becom-ing ever more prominent in society. Leg ulcers are such a case. In the Western world over 20% of the population over 80 years old have leg ulcers. In the UK alone over 1% of the annual health-care budget is now spent on curing leg ulcers. Dynamic Compression can be used in conjunction with Static compression stockings to greatly increase the healing rate of leg ulcers. Also regular use of a Dynamic Compression system can help in the prevention of leg ulcers.

Venous Ulcers

The most common type of leg ulcer, accounting for 70% of leg ulcers. The cause of venous ulcers in normally due to venous insufficiency. Early signs are swollen lower legs, Lymphedema ( Click here to link to Lymphedema ). This leads to a reduction in oxygenation as the skin surface. Any damage to the surface normally leads to a venous ulcer, as the lack of oxygen rich blood leading to a very slow healing rate. The application of Dynamic Compression Therapy firstly reduces the swelling in the lower leg. This helps to re-oxygenation the skin and thus increases the rate of heal-ing.

Diabetic Ulcers

These ulcers are very common amongst the diabetic population. Normally found on the feet it is essential to heal these ulcers as quickly as possible to prevent the extreme action of amputation. Again due the varicous insufficiency the use of Dynamic Compression Therapy helps promote circulation and thus increase the healing process.






http://www.mjsgrp.com/pdf/pulsepress/Clinicalfiles_legulcers.pdf


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Click here to see Clinical ReportsLYMPHEDEMA

Although Lymphedema has afflicted the population for centuries, little was understood about the disease. Only recently have clinicians begun to seriously focus on its treatment. Lymphedema is an accumulation of lymphatic fluid that causes swelling in the arms and legs. Ede-ma occurs when venous and/or lymphatic vessels are impaired. When the impairment is so great that the lymph fluid exceeds the lymphatic transport capacity, an abnormal amount of protein fluid collects in the tissues of the extremity. Untreated, this stagnant, protein-rich fluid not only causes tissue channels to increase in size and number, but also reduces oxygen through the transport system, interferes with wound healing and provides a culture medium for bacteria that can result in various infections.

Lymphedema can occur from idiopathic or unknown causes. This is called Primary Lymphedema. Lymphedema can be present at birth, either idiopathically or associated with arterial-venous ab-normalities, hemangioma, or lymphangioma. Breast or abdominal surgery can result in Secondary Lymphedema. Surgical removal of a tumor and the adjacent lymph nodes and vessels can block lymph fluid from flowing naturally through its system. Other surgeries that require lymph node removal are those performed for skin cancer (melanoma), gynecological cancers, bladder or colon cancer and prostate or testicular cancer.

http://www.mjsgrp.com/pdf/pulsepress/Clinicalfiles_lymphedema.pdf







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Radiation therapy used in the treatments of various cancers, can damage otherwise healthy lymph nodes by causing scar tissue to form and thus, interrupt the normal pathway of the lymphatic fluid.Lymphedema can occur secondary to an infection that interrupts normal lymphatic pathway func-tion. A severe traumatic injury may also trigger the onset of lymphedema. According to the World Health Organization, lymphedema affects 250 million people worldwide. Others estimate that one in every twenty-five will suffer from some form of lymphedema during their lifetime. It is estimated that approximately 15% of all women with breast cancer will develop lymphedema over the course of their lifetime and that lymphedema resulting from the treatment of prostate cancer is on the rise.Lymphedema is a chronic condition and often begins with a swelling in the hands or feet. Early diagnosis and treatment improves both the prognosis and the condition. Left untreated, the limbs become more edematous and the skin hardens, losing its elasticity (fibrosis). Moreover, untreated lymphedema leads to infection and sometimes, irreversible complications. Compression must be applied to the limb to reduce the swelling. Surgical compression stock-ings or sleeves can apply compression. Manual Lymph Drainage (MLD) is performed by specially trained therapists, utilizing a gentle massaging technique in conjunction with a pumping motion. Some treatment centers use a special bandaging technique. Increasingly, compression pumps are being used to treat lymphedema. Since lymphatic pressure is greater distally than proximally, the preferred method of compression therapy would be to mimic the lymphatic system. This is accomplished by means of a pump that applies gradient pressure to the segmented appliance.

This system mimics the lymphatic system wherein it applies gradual, gradient pressure distally to proximally, moving the accumulated fluid from the affected extremities back into the body where it can be naturally eliminated. It simulates a gentle massaging action. Pressure and the subsequent effectiveness can be gradually increased as the patient becomes more tolerant. These devices are low cost, lightweight, quiet, comfortable and easy to use for home therapy. Because of its comfort and ease of use, compliance is very high. It is the cost-effective way to treat lymphedema and venous insufficiency.







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Click here to see Clinical ReportsSPORTS INJURIES

Dynamic Compression Therapy helps by playing a key role in the treatment of sport injuries being used by sports physiotherapists across the globe. Anything from a sprained ankle to tennis elbow can be helped by early use of Dynamic Compression therapy. Generally when a sports person gets injured it results in a loss of mobility in the injured limb.

Sprained Ankle

If we look at the common example of a sprained ankle. And this is very common. In the UK alone there are an estimated 2 million sprained ankles a year. Average heal time is 1-2 weeks. The liga-ments in the ankle have been over stretched or possibly torn. There is no magic pill for this situa-tion, you have to wait for the body to heal itself. So that you do not continue to add to the damage already caused the body swells up the area around the ankle which in turn makes it painful if you try to walk. However the very protection method also slows down the healing process. The inflam-mation around the ankle cuts down on the ability to get freshly oxygenated blood to the damaged tissue. Also losing the ability to walk further restricts the blood flow to the area.

So what can we do to help? If we remove the inflammation from the area then this will help to al-low oxygenated blood to the tissue. Also if we increase the blood flow in the lower leg then this will also increase the rate of healing.

http://www.mjsgrp.com/pdf/pulsepress/Clinicalfiles_sportsinjuries.pdf







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Dynamic Compression is perfect for this process. If a half leg garment is used then this helps with both areas. Firstly by compressing the inflamed area intermittently it reduces the swelling. First goal achieved. Now that the damaged tissue is able to receive an unimpeded blood supply. As a half legging is being used the large calf muscle is also being compressed. There is a large pool of blood in this muscle and with the help of the bodies venous return system as the muscle is com-pressed the blood is returned to the heart and then as it is decompressed a fresh supply of blood replaces it as the pressure garment is decompressed. So now we also have an increased blood supply. Second goal has been achieved. The longer the therapy can be applied to the injured area the more effective the treatment will be. Generally the patient will be up and around by the second day of treatment. A vast improve-ment over natural healing alone. Another important fact is early treatment. The sooner an injury is treated the quicker the recovery time will be.

Other Injuries: The same process as explained for the sprained ankle can generally be applied across the board. The process is just helping the body to help itself. The important facts are:-

Early treatment. Remove inflammation Continued Treatment Increased blood flow







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D.V.T. (Deep Vein Thrombosis)

The area of DVT has been bought to the public notice recently with the increased incidence of airline passengers suffering from the condition. In reality there is a far greater chance of suffering from DVT after a major surgical operation. To help prevent the occurrence of DVT it is common to use a drug called heparin to thin the blood. Of course there are consequences of using this drug, the patient is more likely to haemorrhage after the surgery. There is an alternative, Dynamic Compression. These specially designed pumps and pressure garments help to keep circulation of blood in the lower legs and thus prevent a DVT occurring. The system is used during and after surgery until the patient is up onto there feet once again.The garments tend to be made from a breathable material as they are used for up to a week con-tinuously and are generally single patient use.

http://www.mjsgrp.com/pdf/pulsepress/Clinicalfiles_dvt.pdf







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WOUND HEALING

Dynamic Compression Therapy has been clinically proven over many years to significantly im-prove healing rates associated with many kinds of medical ailments. The application of a Dynamic Compression System has a very similar end result as using intense physiotherapy, whilst having other beneficial side effects. In the area of wound healing it is commonly reported that the use of pain killers is substantially reduced, also the circulation of a patient is promoted and if used post surgery reduces the chance of a D.V.T occurring.

AMPUTEES

A special range of garments has been developed for this dedicated area of wound healing. The benefits of using such a garment is:-

formation of a smooth stump, reduced pain, reduced infection rates increased healing rate.

POST OPERATIVE

Due to the property of increased healing rates Dynamic Compression Therapy is ideal for using after certain operations, mainly on the lower limbs. Benefits are listed below:-

reduction of scar tissue build up, reduced pain, reduced infection rates increased healing rateeliminates swellingreduced chance of D.V.T






http://www.mjsgrp.com/pdf/pulsepress/Clinicalfiles_woundhealing.pdf


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STROKE REHABILITAION

This highly specialised area has been researched by Margaret Johnstone for many years now. Her book ‘Restoration of Normal Movement after Stroke’ published by Churchill Livingstone is particu-larly good at explaining the role of Dynamic Compression is the treatment.

In brief the use of Dynamic Compression is used on patients who have proprioceptive loss to aid in their sensory development. Special pressure splints are used in conjunction with clinical grade pump units and the pressure and time cycles are extremely important. For more detailed information please contact us directly.

http://www.mjsgrp.com/pdf/pulsepress/Clinicalfiles_stroke.pdf






PULSEPRESS - mjsgrp.com · LEG ULCERS In a world of increasing life expectancy the problems associated with the elderly are becom-ing ever more prominent in society. Leg ulcers are

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