Compression Garments

Overview

Compression garments must only be purchased from a qualified Orthotist in order to guarantee a safe, comfortable and effective fit that will be efficient to treat the cause of the swelling.

Compression garment work by means of a medical graded compression scale to provide more pressure from the distal part of the affected limb to less pressure over the proximal part of the affected limb. This graded compression is very effective in treating any type of oedema (swelling) if it is measured and provided by a qualified Orthotist.

A compression garment’s mechanism of action

A compression garment’s mechanism of action is to provide a high working pressure by means of a external force that provided pressure on the exterior walls of the valves in the circulatory system.  The garment provides external pressure from the outside inwards, and the body provides a counter pressure by means of muscle contracture when you are active. These 2 pressures work in “harmony” to facilitate the movement of fluid by the valves in the veins and reduce back flow or fluid to build up in that part of the limb.  By forcing this fluid forward the body can naturally absorb this high protein oedema  and  flush it out of the area where it can drain and be excreted by the body naturally my means of urine.

Compression Grading

Class 1

Class 1 compression is provided for mild stage 0-1 oedema and can be used day and night. This compression is generally fit pre op to reduce the risk of Deep Venous Thrombosis after surgery. This type of compression is usually a round knit style only. Indications include knee and hip replacement surgery, C-sections and spinal surgery.  This compression comes in Below knee, Above knee, Thigh with waist attachment or Pantyhose. This type of compression can be used after Sclero therapy or if an elderly patient with minimal mobility has mild swelling. This compression is only used for short term treatment and need to be replaced at least every 6-8 weeks.

Class 2

Class 2 is provided for stage 1-2 oedema with mild to moderate swelling. This compression is available in round knit as well as flat knit style knitting and is prescribed after an evaluation and proper diagnosis for effective treatment has been performed.

Class 3

Class 3 compression is provided for stage 1-2 oedema with moderate to severe swelling. This class compression is generally only fitted to treat oedema of the lower extremity. This compression is available in options to include below knee, above knee and pantyhose This class compression is still available in a off the shelf item.

Indications include:

  • Chronic venous insufficiency stage 1- 3 with the tendency for severe oedema, after recurrent, severe ulcerations and severe leg ulcers
  • Deep venous thrombosis where there is a tendency for moderate to severe oedema
  • Inflammitory venous disease with a tendency for severe oedema
  • Primary and secondary lymphoedema stages 2 and 3
  • Phlebolymphoedema as a mixed form of lymphoedema and a secondary cause to oedema
  • Severe oedema of the foot and toes
  • Lipoedema stage 2 and 3

Class 4

Class 4 compression is provided for severe oedema and may be measured and manufactured as a custom product to provide effective and long term treatment. This compression is available in options to include below knee, above knee and pantyhose

Indications include: 

  • Primary and secondary lymphoedema stages 2 and 3
  • Lipoedema stage 2 and 3
  • Elephantiasis
  • Severe phlebological conditions

Advantages of compression garment are that they can be worn daily to effectively treat and control the swelling that occur in the affected limb.

Compression garment are soft, easy to put on and take off with the proper training and assistive devices , improve clima -comfort and will fit seamlessly in with your style whether it be corporate to more extravagant.

A wide range of styles, colours and selections are available and I will guide you through this process to find the right one for your need.

Lower extremity

This type of compression is also available in below knee, above knee, thigh with waist attachment or pantyhose.

Indications include: 

  • Mild varicose veins treatment
  • Chronic venous insufficiency stage 1- 3
  • Superficial thrombophlebitis
  • Ulcer care with mild to moderate oedema
  • Lipoedema stage 1
  • Post traumatic burn and keloid treatment
  • Primary and secondary lymphoedema stages 1 and 2

Upper extremity

This class compression is also the standard pressure to affectively treat diagnosed upper extremity lymphedema after MLD treatment has been performed by a trained therapist.

For severe oedema in the arm a custom/ made to measure ccl3 compression may be considered if proper diagnosis and risk factors have been obtained.

This compression for the arm can be fit to provide comfort and functional treatment for any type of activity level.

  • A one piece armsleeve and hand sleeve with open fingers or gauntlet

 

  • 2 piece with separate armsleeve, glove or gauntlet.

Contraindications for compression

  • Severe PAD disease
  • Untreated congestive heart failure 
  • Septic phlebitis
  • Moist dermatitis
  • Intolerance of compression stoking material 
  • Sensitivity disorders that are advanced such as diabetes mellitus

Specialised compression devices and night devices

Velcro devices  

Other items for above extremity compression include juxta fit and farrow wrap.
These product are not the same as a night device and are made from a neoprene tipe material. Velco bands fastener in the opposite direction to apply either a ccl2 or ccl3 compression to the arm.

 

 

This product can be used in cases where no assistance is available to don a compression sleeve but a more aggressive treatment is needed.

This product can also be used during the reduction phase of treatment if the patient is unable to travel for mld treatment.

It is very important to educate your patient in the correct donning an doffing procedure for all compression garment. Various product are available to assist your patient to apply and remove the stocking by their own means.

Night devices

Night devices are available in a off the shelf item and can be applied to any patient that wears a class 2 flatknit or mtm garment.

These products are user friendly and easy to apply and are applied by the use of velcro staps that can be easily don of doffed. This product works without elastic compression within the garment and has a mobiderm or comprifoam like texture. Friction from the skin onto the inner aspect of the product increases blood circulation and drainage.

In some cases it can also be used if the paient is unable to apply a compression sleeve by him/her self or in geriatric patients where even a small amount of compression is better than no compression at all.