Effects of Different Compression Pressure Levels on Peripheral Circulation After Surgery

Elastic compression therapy is a standard component of postoperative care aimed at improving venous return, reducing lower extremity edema, and supporting peripheral circulation. Despite its widespread use, compression is commonly applied using fixed pressure levels without systematic consideration of individual circulatory responses. This may result in suboptimal effectiveness or discomfort in some patients.

This study is designed as a prospective, single-center pilot interventional study to investigate the effects of different compression pressure levels on lower extremity peripheral circulation in adult postoperative patients. The study will be conducted in surgical wards of Ağrı Training and Research Hospital. Adult patients who have undergone elective surgery and are hemodynamically stable will be enrolled during the early postoperative period.

Each participant will receive three sequential compression pressure levels applied to the calf region using a pressure-controlled compression device. The predefined pressure levels are low (30 mmHg), moderate (45 mmHg), and high (60 mmHg). Compression will be applied in a supine position following a standardized rest period. Each pressure level will be maintained for a fixed duration, with adequate rest intervals between applications to allow circulation to return to baseline.

Peripheral circulation will be assessed at baseline and after each compression level using non-invasive measurement techniques. The primary outcome measures include peripheral perfusion index and venous filling time assessed by photoplethysmography. Secondary outcome measures include lower extremity edema, skin surface temperature, and patient-reported comfort assessed using a visual analog scale. Safety and tolerability will be monitored throughout the study, and compression will be discontinued immediately if any discomfort or adverse effects occur.

As a pilot study, the planned sample size is limited and no formal power calculation has been performed. The primary objective is to generate preliminary data on circulatory responses to different compression pressures and to evaluate the feasibility of the study protocol. The results are intended to inform the design of future larger-scale clinical trials and contribute to evidence-based, individualized postoperative compression practices.

The study will be conducted in accordance with the Declaration of Helsinki. Ethics committee approval was obtained prior to study initiation, and written informed consent will be obtained from all participants before enrollment.

Inclusion criteria

• Adults aged 18 to 65 years
• Undergoing elective surgery
• In the early postoperative period at the time of assessment
• Hemodynamically stable
• Intact skin on the lower extremities at the planned compression sites
• Able to understand the study procedures
• Willing and able to provide written informed consent

Exclusion criteria

• Peripheral arterial disease or clinically significant arterial insufficiency
• Current or previous diagnosis of deep vein thrombosis or venous thromboembolism
• Known peripheral neuropathy or sensory impairment affecting the lower extremities
• Open wounds, active infection, or dermatological conditions on the lower extremities
• Severe edema requiring therapeutic intervention beyond standard postoperative care
• Inability to tolerate compression therapy due to pain or discomfort
• Pregnancy
• Participation in another interventional clinical study during the same hospitalization period