Compression (3) Knit Garments

Introduction

Compression garments are elastic knit two-way stretch sleeves or stockings that are worn under clothing during the day. These garments do not reduce swelling. Instead they help prevent additional swelling.

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

• Be uncomfortable.
• Cause damage by blocking the flow of lymph.
• Force the flow of lymph back into the swollen limb.

Guidelines

• These garments are not worn while sleeping because they provide too much compression when the body is inactive while at rest.
• Also, if the garment moves out of place during sleep it can cause constriction that damages the circulation.
• Wearing this type of garment during air travel is recommended by the NLN Position Paper on Air Travel. 1]
• These garments do not provide protection against sunburn. Unless an outer layer of clothing is worn, a high SPF sunscreen should be applied under the compression garment.

Compression Sleeves

Knit Compression Sleeve  (Courtesy of Juzo USA)

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. Wearing a compression sleeve that extends only to the elbow is not recommended.

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 securely in place.

If keeping the sleeve from sliding down is a problem, the solution may be a style that covers the shoulder and has a strap that goes across the chest. This style holds the sleeve securely up on the arm.

Gauntlets

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

A gauntlet 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 (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 Stocking (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, 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, the right leg has compression hose with the toes exposed to avoid pressure points or the formation of calluses. 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 has the proper compression level, stays comfortably in place, and fits smoothly without wrinkles or bulges that can damage the tissues.

• If the garment has too little compression, it is ineffective. If it has too much compression, it can damage the tissues.
• Compression garments with the correct amount of pressure enhance the comfort and the control of swelling.
• Compression garments measurements should be taken by a trained fitter.
• Every six months, the fit and wear of the garment should be re-evaluated.
• Garments that no longer function properly should be replaced immediately.

Compression Levels

• Garments with compression levels below 20 mm/hg (millimeters of mercury) are not suitable for the management of lymphedema. Stockings of these compressions are commonly used as support hose.
• Garments with compression levels of 20-30 mm Hg and 30-40 mm Hg are commonly recommend for lymphedema patients.

Compression for Truncal Lymphedema

Compressure Comfort BraŽ (Courtesy of Bellisse)

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.  hese 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

[1] NLN Air Travel Position Paper issued 2009.

[2] Living Well with Lymphedema by A. Ehrlich, A, Vinjé-Harrewijn, and E. McMahon. Lymph Notes. 2005.

[3] Lymphedema Caregiver’s Guide by M.K. Kearse, PT, CLT-LANA, E. McMahon PhD, and A. Ehrlich, MA. Lymph Notes 2009.

[4] Lymphedema Management: The Comprehensive Guide for Practitioners, 2nd ed. by J. Zuther. Thieme, 2009.

[5] Compressure Comfort Bra.

© LymphNotes.com 2010. This information does not replace the advice of a qualified health care professional.

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Category: How Lymphedema is Treated Updated: 2010-04-06