Compression (3) Knit Garments

INTRODUCTION

Compression garments are elastic knit two-way stretch sleeves, or stockings. These are worn under clothing during the day and are not intended to reduce swelling.

Instead they help to prevent additional swelling.

If this compression garment does not fit properly, or if it does not have the appropriate level of compression, it will:  

• Be uncomfortable.
• Block the flow of lymph.
• Cause damage to the tissues by forcing the lymph to flow back into the already swollen limb.

IMPORTANT: KNIT GARMENTS ARE NOT WORN WHILE SLEEPING

KNIT GARMENT GUIDELINES 
These garments are not worn while sleeping because, when the body is inactive or at rest, knit garments provide too much compression.
Also, if a knit garment moves out of place during sleep it could cause constriction that would damage the circulation.

• This type of garment can be worn during air travel. 
• These garments DO NOT provide protection against sunburn. Unless an outer layer of clothing is worn, a high SPF sunscreen  should be applied to the skin before donning the compression garment.

COMPRESSION SLEEVES

When the arm is affected by lymphedema, a compression sleeve that covers the entire arm from the wrist to the shoulder is usually required to be worn during the day.

Knit Compression Sleeve  (Courtesy of Juzo USA)

DO NOT WEAR A COMPRESSION SLEEVE THAT EXTENDS ONLY TO THE ELBOW. This is an important recommendation because the fold at the elbow blocks normal circulation.

• Sleeves are available in several styles designed to hold them in comfortably place. As shown here, some have a silicone band around the upper edge to keep the sleeve holds it securely in place.
• A sleeve that slides down the arm is a problem. A style that covers the shoulder and has a strap that goes across the chest, helps to solve this problem. This will hold the sleeve securely in place on the arm.

GAUNTLETS

A sleeve that stops at the wrist is convenient but does not provide compression for the hand. Yet, for patients particularly before their swelling is well controlled, compression on the hand is essential.

A gauntlet, also known as a or partial glove, is worn to provide hand compression. Also having a separate garment for the hand makes it easier to place and remove particularly for washing hands.

A glove with finger stubs. Courtesy of Juzo USA	A gauntlet for hand compression, (Courtesy of Juzo USA.)
Gloves are available with partial finger coverage that are known as finger stubs. These partially cover the fingers and leave the finger tips exposed.	Another style of compression for the hand is a partial glove that leaves with the fingers completely exposed. A thumb stub holds this garment in place.

COMPRESSION STOCKINGS 

Compression hose on the right leg. (Courtesy of Juzo USA.)

Compression stockings, which are also known as compression hose, are available in a wide range of styles, sizes, and compression strengths. 

When compression stockings worn to treat lymphedema of the leg they usually extends to the hip. When both legs are involved, a panty-hose style can be used.

If the patient has a problem, such as a heart codition, the compression may only extend to the knee.

• As shown in this photo, on the right leg the patient is wearing compression hose. Notice that the toes are exposed to avoid calluses.
• Shown on the left leg, which is not affected with lymphedema, the patient is wearing a regular Knee-Hi stocking.

FITTING COMPRESSION GARMENTS

A properly fitted compression garment (a) Has the proper compression level, (b) Stays comfortably in place, and (c) Fits smoothly without wrinkles or bulges that can damage the tissues.

• If the garment has the correct amount of compression, it enhances the patient's comfort and controls the swelling.
• If the garment has too little compression, it is ineffective.
• If the garment has too much compression, it can damage
  the tissues.
• To ensure a proper fit, the measurements for a compression garment should be taken by a trained fitter.
• The fit, and amount of wear of the garment, should be reevaluated very six months. This evaluation should be performed by a trained fitter.
• A garment that no longer fits properly, should be replaced immediately.

COMPRESSION LEVELS

Garments for lymphedema are recommended to have a compression levels of 20-30 mm/Hg or  30-40 mm/Hg (millimeters of mercury).

Garments with compression levels of less than 20 mm/Hg are not suitable for the management of lymphedema. Stockings of these compressions are commonly used only as support hose.

COMPRESSION FOR TRUNCAL CHEST LYMPHEDEMA

Bellisse Compressure Bra

The term, "Truncal Chest Lymphedema" describes swelling throughout the chest area. The Compressure Comfort Bra®, which is manufactured by the Bellisse Company, is a Class I medical item which, for insurance billing purposes, is listed as a Thoracic Compression Garment.

These garments have many features that are helpful in controlling truncal lymphedema and post-surgical swelling. 

The positive features of these garments include:

• A pocket to hold a prosthesis.
• Wide padded straps to prevent excess pressure on the shoulders.
• Special underarm gussets for added support and coverage into the tender armpit area.
• Adjustable closures in the front and back.

 REFERENCES

• Living Well with Lymphedema by A. Ehrlich, A, Harrewijn, and E. McMahon. Lymph Notes. 2005.
• Lymphedema Caregiver’s Guide by M.K. Kearse, PT, CLT-LANA, E. McMahon PhD, and A. Ehrlich, MA. Lymph Notes 2009.
• Lymphedema Management: The Comprehensive Guide for Practitioners, 2nd ed. by J. Zuther. Thieme, 2009.
• Compressure Comfort Bra.

© LymphNotes.com 2015. This information does not replace the advice of a qualified health care professional.

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Category: How Lymphedema is Treated Updated: 2015-01-26