2018 IEEE 4th Middle East Conference on Biomedical Engineering (MECBME)
Assessment of the accuracy of Laplace’s law in
predicting interface pressure generated by
compressive garment used for medical applications
H. Barhoumi, S. Ben Abdessalem
Textile Materials and Processes Research Unit, Tunisia
National Engineering School of Monastir
Monastir, Tunisia
Abstract— Compression therapy is the foundation of
phlebological therapy. Its efficacy is highly dependent on the level
of pressure applied on the leg. In most related researches,
Laplace's law has been used as a predictor equation of interface
pressure. The aim of this study is to evaluate the accuracy of
Laplace’s law using two types of knitted compressive garments.
The experimental pressure values are obtained using a developed
experimental device based on a force-pressure sensor. The
obtained results indicate that there is a significant difference
between the measured interface pressure values and the
predicted ones. Thus, the accuracy of Laplace's law was proven
to be insufficient to predict interface pressure.
Keywords— Interface pressure; Laplace’s law; Compression
therapy; Elastane yarn; Knitted garment.
I. INTRODUCTION
The concept of compression therapy lies on a simple
mechanical principle: the application of an elastic garment
around the leg. By compressing the limb with a compressive
garment, a pressure strongest at the ankle and decreasing
going up the leg, is created. This pressure, generated in the
inner surface between the compression garment and the skin,
is called interface pressure. In medical applications, using
compression garment system is recommended during the
therapy phase. It is suitable in healing venous leg ulcers and
lymphatic disorders. In addition, the interface pressure helps
venous return, prevents venous and efficiently relieves aching
and heavy legs by aiding the body in moving blood up the leg
against the pull of gravity [1]. Moreover, this use was well
documented in the literature as method which offers good
improvement of recovery, reduction of fatigue and better
muscle’s oxygenation [2].
As reported by Partsch, the prescribed value of interface
pressure required for different medical conditions is as
follows:
Light pressure: in the range of (10---14 mmHg),
Moderate pressure: in the range of (18.4---21.2 mmHg),
Firm pressure: in the range of (25.1---32.1 mmHg),
Strong pressure: in the range of (36.4---46.5 mmHg) [3].
978-1-5386-1462-4/18/$31.00 ©2018 IEEE
S.Marzougui
Textile Engineering Laboratory, Tunisia
ISET Ksar-Hellal
Monastir, Tunisia
In compression therapy, knitted compressive garment is the
most used fabric. It is essentially made with elastic fabrics.
Knitted fabrics are chosen for this application because they are
more elastic and extensible than woven fabric. Additionally,
they have a good recuperation [4]. They are constructed in a
tubular form in a size smaller than human leg.
In order to predict the required interface pressure value,
several researchers have attempted to use Laplace’s law
expressed by the following equation:

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It is a relationship between the interface pressure P (mmHg),
the tension T (N/m) of the knitted garment and the radius R
(m) of the human leg. Among these investigations, Laplace’s
law was applied with different types of garments. The
accuracy of this equation has been established in some works,
but for others it was not proven [5], [6]. As a result, the aim of
this work is to evaluate the accuracy of Laplace’s law
generated by two types of knitted compressive structures
(Plain, Pique) designated for medical applications.
I. MATERIALS AND METHODS
A. Development of Experimental Device
In order to measure the interface pressure, an experimental
device was developed. The most important component in this
®
device is a force-pressure sensor: FlexiForce sensor A201
(Mescan, France) presented in Fig. 1. It is a piezoresistive
2
sensor having 14 mm width, 200 mm length and a 71.1mm
sensing area.
Fig. 1. FlexiForce® Sensor Model A201
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 2018 IEEE 4th Middle East Conference on Biomedical Engineering (MECBME)

The sensor is composed of two layers of film substrate TABLE I. CHARACTERISTICS OF TESTED SAMPLES
(polyester/polyamide). On each layer, a conductive material
(silver) is applied, followed by a layer of pressure-sensitive Sample Code
ink. The electrical resistance of the sensor fluctuates with Characteristics
applied force. The FlexiForce® sensor acts as a force-sensing F1 F2 F3 F4
resistor linked to a developed electrical circuit that converts Polyamide 6-6 yarn count
77 77 77 77
the resistance of the sensor into a voltage read by a digital (dtex)

multimeter. When the force is unloaded, its resistance is very Elastane yarn count (dtex) 17 44 17 44
high. When a force is applied to the sensor, this resistance Fabric weight (g/m2) 199 232 227 278
decreases. The sensor's active area is composed by conductive
Knitted structure Plain Plain Plain Pique
strips connecting them to electronic circuit. FlexiForce®
sensor is considered as the best sensor used for this type of Fabric thickness (mm) 0.8 0.87 0.95 1.01
applications which needs high sensitivity when compared
with piezoelectric, capacitive and hydrostatic sensors [7].

The calibration of the sensor was performed by using
different masses levels: 5, 15, 20, 30, 40 and 50 g. These
masses were applied on the active area of the pressure sensor
generating an electrical voltage. Then, loads were converted
into pressure. Fig. 2 shows the linear relationship between
pressure (mmHg) and voltage (V) values obtained by the
2
developed circuit. The coefficient R is high and equal to 0.98
which means that there is a good correlation between the
variables.
60
50
Interface pressure (mmHg)
C. Mannequin Leg Model and Choice of Measuremant Area
The compressibility of the human body is a complex factor
and varies widely between peoples. For this reason, several
researchers have prescribed their experiment on measuring
interface pressure on rigid body [8]. In this study,
experimental measurements were carried out on a rigid ‘‘size
S’’ mannequin leg.
According to the standard (CEN/TC 205 WG2) [9], the
most important measurement point is in the ankle region (B
2 level). In fact, the importance of this position is demonstrated
R =0.98 by [10]. They proved that passive dorsiflexion of the ankle (B
level) significantly increases pressure in the others
compartments of the leg. The sensor has to be placed in the

adequate position. Then it was fixed using an adhesive tape as

40 shown in Fig. 3.

30

20
B level

10

0
0 2 4 6 8 10
Tension (V)

Fig. 2. Relationship between pressure and voltage values

B. Development of Compressive Garments
Four samples of seamless compressive knitted garments were
produced on a “Santoni SM8 TOP2” machine. Two kinds of
knitted structure (Plain and Pique), with various
manufacturing parameters were studied in this work. Their
characteristics are presented in TABLE I.
Fig.3. The FlexiForce® sensor fixed at B level.
The sample is carefully worn on the leg in order to cover
the active area of the sensor as shown in Fig. 4. To reduce the
measurement dispersion, five measurements are realized
around this region for each sample.

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 2018 IEEE 4th Middle East Conference on Biomedical Engineering (MECBME)

Active surface of the sensor positioned at B level

FlexiForce® sensor

Multimeter

The developed circuit

Fig. 4. Developed pressure measurement device

.
D. Theoritical Measurement of Interface Pressure. In order to evaluate the accuracy of Laplace’s law, the
percentage error values between approximate or predict
interface pressure using Laplace’s law (Pp) and exact or
The theoretical values of interface pressure were
experimental interface pressure values (Pexp) is needed.
calculated using (1). Tension fabric values are obtained
The percentage error (% Error) was calculated using (2).
through the tensile-strain curve as shown in Fig. 5.
The obtained results are shown in the TABLE II.

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500
Ψ””‘” ൌ ቤ ቤ ൈ ͳͲͲ ሺʹሻ
‡š’
F1
F2
400 F3
F4
TABLE II. PERCENTAGE ERROR BETWEEN EXPERIMENTAL AND
Fabric tension (N/m)

300
PREDICTED INTERFACE PRESSURE VALUES

Pexp Pp %Error (%)

200 Sample R (mm) T (N/m)
(mmHg) (mmHg)

F1 81.05 11.52 19.3 67.53

100
F2 86.88 17.69 25.38 43.47
31.5
0 F3 106.58 20.87 27.14 30.04
0 10 20 30 40 50 60 70
strain (%)
F4 130.35 23.04 34.53 49.87

Fig. 5. Tensile behavior of tested samples

As shown in TABLE II, the percentage errors between

experimental and predicted interface pressure values are
Tensile tests were carried out according to the conditions
highs (30.04% and 67.53%). This fact explains that the
of the standard ISO 13934 (2014) which consists of
values obtained by (1) are overestimated. This discrepancy
applying a traction effort at a constant rate equal to 100
between Pp and Pexp can be explained by the fact that
mm/min to a rectangular fabric sample (20×5 cm2) [11]. The
Laplace’s law considered only the fabric tension and the
tensile value is obtained in correspondence with the strain
radius of the area on which the interface pressure is applied.
generated when worn.
We can note that the use of tensile force T and leg radius R
remains insufficient to predict real compression. In fact,
II. RESULT AND DISCUSSION defining the profile of a limb by its radius is of little or no
practical value, as this parameter is virtually impossible to
A. The Assessment of the Accuracy of Laplace’s Law determine in a normal clinical setting. In literature,
researchers studied the dependence of the variation of
interface pressure on manufacturing parameters [12]–[14].

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 2018 IEEE 4th Middle East Conference on Biomedical Engineering (MECBME)

Thus, in order to improve the validity of Laplace’s law these
factors should be integrated in the equation. These funding
is of great interest for medical compressive garment
manufacturers who have to model fabric architecture
according to required mechanical pressure on body.
Consequently, it is imperative that more investigations have
to be performed to know the source of discordance between
experimental and predicted interface pressure values using
Laplace’s law.
of knitted compression fabric on interface pressure’, Indian J. Fabr.
Text. Res, in press.
[14] J. Umar, T. Hussain, and M. Maqsood, ‘Modeling the mechanical
and compression properties of polyamide/elastane knitted fabrics
used in compression sportswear’, J. Text. Inst., vol. 107, pp. 1240–
1252, 2016.

III. CONCLUSION
In medical applications, the interface pressure is very
important for venous treatments. Laplace’s Law is the most
common model used to predict the pressure value between
the garment and the human limb. Consequently, it is very
essential to evaluate its accuracy. In this work, we noted a
considerable discrepancy between predicted values and
experimental results. In the light of these results, the future
study will investigate the possibility to modify this law in
order to overcome this discordance.

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