# Effect of Blood Circulation in the Upper Limb after Flossing Strategy
## 2 Materials and Methods
### Procedures  
Measurement of the blood flow to upper limbs was performed on a Precise 8008 device (Medicap GmbH, Ulrichstein, Germany)--a device for measuring transcutaneous oxygen (tcpO\({}_{2}\)).  
In the initial position of sitting with the support of the back of the chair, legs supported by the soles on the floor and the upper limbs hanging down, electrodes of Precise 8008 were glued to the body. Two electrodes were always applied to musculus biceps brachii both on the right upper limb (RUL) and the left upper limb (LUL). A position in the medial line on the ventral side of the arm in the middle of the distance between the acromion and the medial epicondyle of the humerus was chosen to place the electrode on musculus biceps brachii.  
After gluing the electrodes, recording of values on the Precise 8008 device was started. After the values on the device were stabilized, application of the compression therapy by flossing on the right upper limb was started. RUL of the proband was passively lifted and laid on the therapist's shoulder. The start of the flossing tape (Lime Green; Sancthand Flossband) was applied at the point of attachment of musculus deltoideus and wound on the shoulder area with its winding inwards and with an overlap of individual turns by half of the width of the flossing tape. The application was performed with the same force by a trained and identical person. After winding the tape, the upper limb was returned to position along the body, where it remained for two minutes (Figure 1). After this time, the tape was removed from the proband's arm and the arm was returned to basal position, and after registering the elevation of blood flow rate, measurement continued for another 15 min.  
The transcutaneous oximetry method was used in the analysis. \"Determination of transcutaneous oxygen tension (tcpO\({}_{2}\)) is the method for testing peripheral skin perfusion at the capillary level based on measurement of the partial pressure of oxygen diffusing through skin\" [23]. From the measured values it is possible to derive the absorption capacity of systems and the amount of dissolved oxygen in tissue, which informs us about the blood supply at the capillary level [23; 24]. Transcutaneous monitoring measures the partial pressure on the skin surface, from which it is possible to infer the partial pressure of oxygen in arterial bed (paO\({}_{2}\)). Thus, it is not a direct measurement of paO\({}_{2}\), while the arterial pressure of oxygen is usually higher than the pressure measured transcutaneously. TcpO\({}_{2}\) can be well used for long-term non-invasive monitoring of tissue perfusion [25].  
The device uses a sensor working on the principle of fluorescence and does not require calibration before each measurement. It is able to record values of 0-2000 mmHg \(\pm\) 10%. The device achieves valid results when used in a room with a temperature of 15-35 \({}^{\circ}\)C and relative air humidity of 10-95%. An advantage of this device is the adjustable sensor temperature to 40-44 \({}^{\circ}\)C. For the purpose of this experiment, the temperature was set at 44 \({}^{\circ}\)C [24].  
Using this method is safe. A contraindication to its use is only poor skin integrity and an allergy to the adhesive used material.