Gardener AM, Fox RH, Lawrence C, Bunker TD, Ling RS, MacEachern AG.
Reduction of post-traumatic swelling and compartment pressure by impulse
compression of the foot.
J Bone Joint Surg Br 1990 Sep;72(5):810-5

Torbay Hospital, Devon, England.

Following the discovery of a powerful venous pump in the foot that is activated
by weight-bearing independently of muscular action, a pneumatic impulse device
was developed to actuate this pump artificially. In a multicentre international
trial the device was shown to reduce post-traumatic and postoperative swelling;
pain also was alleviated. Evidence is also presented that dangerously high
compartment pressures may be reduced to acceptable levels and fasciotomy avoided.
We present an explanation of the clinical effects of activation of the venous
footpump, based on recent improved understanding of the physiology of the
microcirculation. The hyperaemic response that follows the liberation of
endothelial-derived relaxing factor (EDRF) by sudden changes of pressure after
weight-bearing or impulse compression is particularly important.