Measurement Guidelines for Lymphedema

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JOBST ® Elvarex ®: Functional Zones for perfect wearing comfort and targeted compression

Measurement Techniques for Lower and Upper Extremities Table of Contents

Measurement techniques for the lower extremities �� 3

Basic guidelines, general information ...... 4

Measurement technique for stockings ...... 5

Measurement point A ...... 6

Measurement point Y and P1 / P2 ...... 7

Measurement point B, B1, C and D ...... 8

Measurement point E, F and G ...... 9

Measurement point K = (K1), G = (K2) and H ...... 10

Measurement point T and abdomen ...... 11

Measurement techniques for the toe cap ...... 12

Measurement point A, A1, and toes 1-4 (5) ...... 13

Measurement techniques for the upper extremities ��14

Basic guidelines, general information ...... 5

Measurement point C, C1, D and E ...... 16

Measurement point F, G and G1 ...... 17

Measurement techniques for gloves ...... 18

Measurement point A, B, C and C1 ...... 19

Measurement point D, E, finger 1 and fingers 2-5 ...... 20

Measurement Materials ...... 21

Styles & Options for the lower extremities ...... 22

Styles & Options for the upper extremities ...... 23

Functional Zones ...... 24

2 Measurement Techniques - Lower Extremities

Basic guidelines, general information

This measurement guide was developed according to the guidelines of the Federal Academy of Orthopaedic Technology [Bundesfachschule für Orthopädie-Technik] (Germany).

Basic guidelines for measurement techniques for lymphatic treatment This measurement guideline is valid for all flat-knitted JOBST® product, such as Elvarex ®, Elvarex ® Soft and Elvarex ® Soft Seamless. This is to ensure that one measuring technique is used consistently. n Communication with the health care professional is absolutely necessary in preparation for the measurement. n Measure accurately to the millimeter in the area of the fingers / toes; skips in the needles are possible beyond these areas in 5 mm intervals. n Photo documentation is helpful in difficult cases. n Do not measure in skin folds. n In exceptional cases for purposes of contouring in the case of very soft, excess tissue and to facilitate measurement, the measurements can be taken either with the legs lightly bandaged or over the old stockings, tights, or a tube bandage!

3 General information: Lower extremities

Method for measuring length: n Measurements A-F (E) are taken in a supine position; measurements G-T are taken in a standing position. The total length of the foot and the inner and outer length should be checked in a standing position. n In the case of anatomically abnormally shaped extremities, the following can be used as a guideline: n Normal height for the B measurement: approx. 8-12 cm. n Additional measurement points: B1, C and D approx. 10 cm higher in each case. n The leg length measurements are measured vertically on the inner side of the extremities, the abdominal measurement is measured against the body, that is, following the curvatures of the body. In the case of very soft abdominal tissue, the abdominal lengths must be measured while tensioning or lifting the abdomen / buttocks. n If there is a significant reduction in circumference (measurement under tension), an extra length allowance should be made. This should be noted for documentation purposes on a separate measurement record.

Method for measuring circumference: n Measuring circumferences under tension should be done gently, but firmly to mimic the resistance of the edema, the limb should never be constricted. The patient’s sensitivity to pain should be taken into account.

n For follow-up documentation, it is advisable to take body measurements. This should be noted in a separate measurement record.

4 Order Form Customer-no.: Customer address: / Stamp: Elvarex ® Purchase date: Schema-no: Measurement techniqueBSN-JOBST for GmbH stockings · P.O. Box 10 10 52 · 46430 Emmerich am Rhein Lower Extremity Phone +49(0)28 22 / 6 07-333 · Fax +49(0)28 22 / 6 07-199 Patient: Signature: JOBST - a brand of Take measurements on edema-free extremities only. All measurements must be recorded in centi- menters. The purchaser is responsible for wrong measurements or misstatements on the order form. Local DC address needs to replace the PC Made-to-Measure compression garments will not be retuned. Jobst Emmerich address Quantity/Class CCL 1 CCL 2 CCL 3 CCL 3F CCL 4 CCL 4S Special Options Circumference Length Left  French cut/slip form/ Left Waist Right Outside higher Right (Pressure panty/Panty/Leg cT lT* to D or G) Pressure panty Elvarex ®  AT/Male Crotch length (Body Bandage) length length  Waist band for front back (for AT panty) pressure panty cH lK Pressure panty Bellavar (Body Bandage) (largest circ.)  Top Comfort Zone Leg extension for (B¹G, BG, CG, AG, AT Pressure cG cG lG Pressure panty Elvarex ® panty Elvarex ® (body bandage), (Body Bandage) Bermuda, Capri pants, stump stockings (ST)) cF cF lF Silicone dotted band: Basic styles  Top Stockings and panties  Inside  AD  AB cE cE lE  2,5 cm (AD only)  AD-F  AB¹  5,0 cm cD cD lD  AF  BD  3/4 circ. inside  AG  B¹G cC cC lC  AG-T (AG with chap style)  BG  Volant (AF; AG)  AG-HT (single leg with panty)  CG Color: cB¹ cB¹ lB¹  AT  CG-T (chap style)  Beige cB cB lB  CG-HT (single leg)  Black (class 1,2,3 only) cY cY Options  DF Zipper: (AD only) cA cA  Straight foot  Slant foot  Closed toe  Open toe from IB lA  Profile/Ankle pad  T-Heel/E-Version (Class 2-3 forte only) to (max.ID) * Please indicate all lZ length measurements  Knee Comfort Zone (Class 2 and 3)  Inside including “length front” and “length back”. Comments  Outside

Profile measuring points Foot length Length slant foot Point ①: is the horizontal circumference Profile measurement points With open toe ( A) Length medial from the inner to the outer malleolus. l ① Left leg 1 2 Point ②: is the „stirrup“ or vertical circumfer-

Right leg 1 2 With closed toe (lZ) Length lateral 70614-00010-00 ence from the inner to the outer malleolus. ②

Orderform_2011_Elvarex leg_GB_CMYK_RZ.indd 1 09.09.2011 14:55:135 Uhr Measurement point A

Measurement point Length (l ) Circumference (c)

All lengths should be taken medially. Open toe; straight edge: Distance from heel to webbing of the little toe (Fig. 1)

A Closed toe: Foot, full Distance from heel to longest toe Lay tape measure along the metatarsophalangeal joints. weight-bearing (Fig. 2) (Fig. 4)

Open toe; slant edge: Distance from heel to webbing of the little toe (= outer length) & distance from heel to webbing of the large toe (= inner length) (Fig. 3)

Fig. 1 Fig. 4

Fig. 2

Fig. 3

6 Measurement point Y and P1/P2

Measurement point Length (l ) Circumference (c)

Measurement over the heel and instep in dorsiflexion i. e. tendons flexed; body measurements should be taken without tension and take Y Only circumference necessary soft tissue projections into account. (Fig. 5)

Fig. 5

Measurement point Length (l ) Circumference (c)

Measurements should be taken from the middle of the lateral P1/P2 malleolus to the middle of the medial malleolus (P1) crossing over the Additional Achilles tendon. measurement for Only circumference necessary Measurements should be taken from the middle of the lateral Profile stockings malleolus to the middle of the medial malleolus (P2) crossing over the sole of the foot. (Fig. 6)

Fig. 6

7 Measurement point B, B1, C and D

Measurement point Length (l ) Circumference (c)

From the sole of the foot to above (proximal) Circumference measurement may be taken under tension, B the ankle (ankle, Fig. 7). Length should be if indicated (ie: edema) taken medially. (Fig. 7)

From the sole of the foot to the base of the Circumference measurement may be taken under tension, if indicated B1 calf (see also General Information) (Fig. 8). (ie: edema) Length should be taken medially. (Fig.8)

Fig. 7 Fig. 8

Measurement point Length (l ) Circumference (c)

From the sole of the foot to the widest part of Circumference measurement may be taken under tension, C the calf. Length should be taken medially. if indicated (ie: edema) (Fig. 9) (Fig. 9)

From the sole of the foot to the head of the fibula Circumference measurement may be taken under tension, (approximately two finger-widths below if indicated (ie: edema) D the patella, Fig. 10). Length should be taken Exception: Knee-high stocking = body measurement, if necessary with medially. addition (Fig. 10) Fig. 9 Fig. 10

8 Measurement point E, F and G

Measurement point Length (l ) Circumference (c)

Circumference measurement should be taken with the leg bent From the sole of the foot to the middle of (30°-45°). Do not measure under tension. In cases of larger circumfe- E the patella (Fig. 11). Length should be taken rences, these can be taken either one finger-width proximal to the back medially. of the knee , or two finger-widths proximal to the patella. Do not lay the measuring tape into the back of the knee or skin fold. (Fig. 12)

Fig. 11 Fig. 12

Measurement point Length (l ) Circumference (c)

From the sole of the foot to the middle of Circumference measurement may be taken under firm tension F the thigh (Fig. 13). Length should be taken if indicated (ie: edema) medially. (Fig. 13)

Thigh-high stocking measurement: Sole of Circumference measurement may be taken under appropriate tension the foot to below the transverse gluteal fold if indicated (ie: edema). Avoid constriction. This is the widest circumfe- G (including silicone band) rence, below the transverse gluteal fold. (Fig. 14) (Fig. 15)

Fig. 13 Fig. 14 Fig. 15

9 Measurement point K = (K1), G = (K2) and H

Measurement point Length (l ) Circumference (c)

From the sole of the foot to the crotch K = (K1) Only length measurement necessary (Fig. 16) (according to the manufacturer)

From the sole of the foot to the crotch G = (K2) Only length measurement necessary (Fig. 16) (according to the manufacturer)

Fig. 16 Fig. 17

Measurement point Length (l ) Circumference (c)

From the sole of the foot to the widest point of Measure circumference of the pelvis at its widest point, depending on H the pelvis (not needed by BSN-JOBST) the indication, generally under greater tension (Fig. 18) (Fig. 19)

Fig. 18 Fig. 19

10 Measurement point T and abdomen

Measurement point Length (l ) Circumference (c)

From the sole of the foot to the upper edge of Circumference of the torso (waist) is generally measured T the tights (patient-specific) without tension (Fig. 20) (Fig. 21)

Fig. 20 Fig. 21

Measurement point Length (l ) Circumference (c) Length in front T - K = (K1) (Fig. 22): Measure vertically, close to the body, from the waist to the crotch.

Length in back T - G = (K2) (Fig. 23): Measure vertically, close to the body, from the desired waist level of the panty to the Abdomen Only length measurement necessary transverse gluteal fold

Note: In the case of very soft abdominal tissue, the abdominal lengths must be measured while tensioning or lifting the abdomen / buttocks. In the case of larger circumferences, the abdomen should never be measured too short. Fig. 22 Fig. 23

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f 1 6 7 0 12 Measurement point A, A1 and toes 1-4 (5)

Measurement point Length (l ) Circumference (c) A (metatarsophalangeal joint of the little toe Lay tape measure distal to the metatarsophalangeal joints (Fig. 24) over the metatarso- (Fig. 25) phalangeal joint of the large toe) Lateral length: From the webbing of the little toe to the base of the instep (roughness of the 5th metatarsal) Lay tape measure distal to the metatarsophalangeal joints A1 Medial length: (Fig. 25) From the webbing of the large toe to the base of the instep. (Fig. 24)

Fig. 24 Fig. 25

Measurement point Length (l ) Circumference (c)

Toes 1-4 Shortest length from the webbing In general, measure X and Z to the nearest millimeter and without tension. X = proximal (X, to end of toenail (Z), (Fig. 26) The X measurement should not be less than the Z measurement; if measurement Exception: necessary, it should be made equal to the Z measurement Z = distal In the case of closed toes, measure to the end (Fig. 27) measurement of the toes Stockings should only be worn over this toe in Toe 5 exceptional cases see toes 1- 4 (if edematous) Fig. 26 Fig. 27

13 Measurement Techniques - Upper Extremities

Basic guidelines, general information Basic guidelines for measurement techniques for lymphatic treatment This measurement guideline is valid for all flat-knitted JOBST® product, such as Elvarex ®, Elvarex ® Soft and Elvarex ® Soft Seamless. This is to ensure that one measuring technique is used consistently. n Rest the arm on a pad. n Measure lengths on the flexor side of the arm when it is slightly bent and with the hand outstretched. n During length measurements depress the thumb slightly into the patient’s soft tissue at each measuring point. n Arm lengths can be checked, if necessary, with the arm hanging. n In general, use slant edges (A/C-G1). n Only use a silicone band if necessary in the case of a slant edge.

14 Orderform_2011_Elvarex arm_GB_CMYK_RZ.qxd:Layout 1 09.09.2011 17:08 Uhr Seite 1

Order Form Customer-no: Customer address: / Stamp: ® Purchase date: ® Elvarex® Medical Wear n Do not measure finger lengths too short; initiate brief finger treatment only in exceptional cases, but Sallowch eform treatmenta-no :up to at least the BSN-JOBST GmbH · P.O. Box 101052 · 46430 Emmerich am Rhein middle phalanx.Armsleeves/Gloves Patient: Signature: Phone +49(0)2822/607-333 · Fax +49(0)2822/607-199 n For a fingerless glove with a thumb base (work glove), the glove must extend up to the metacarpophalangeal joints. That is, the length JOBST – a brand of measurement (A-B) should be taken from the first flexor fold of the middle finger. n If the back of the hand is severely edematous, a one-piece product is recommended (A-G1) ; in any case, compression pads should be used Local DC address needs to replace the PC here in the area of the backA ofr them hand.sleeves Qty./Class Left Right Gloves Qty./Class Left Right Jobst Emmerich address n If the forearm is edematous, an elongated glove (A-E) should be used.Elvarex 1 Elvarex 1 n Compression pads for the back of the hand should extend over the jointsElv a(dor notex take2 into account when measuring circumference) unless Style Elvarex 2 the patient is pain sensitive. AC1 AE Styles Circ. Circ. Length H zxz–x Armsleeves without hand 3 lG1H Thumb 1 Strap length C-E 4 D-F 2 Finger 2 Z CG 5 Finger 3 G1 CG1 bias top end Finger 4 lGG1: 4 cm CH with shoulder cap cG Finger 5 Single piece, hand/arm cA X AG Arm with hand lCG 1 AG1 Arm with hand, lAB Z cF bias top end AH Arm with hand, cB shoulder cap X lCF cE Options Options lAC With shoulder strap Glove without finger, With bra loop without thumb cD lCE With bra loop with Velcro Glove without finger, with thumb Bra width (_____ cm) Glove with finger, Silicone dotted band, inside cC with thumb lCD Silicone dotted band; on top cC Bias end (AE only) Silicone dotted band 2,5 cm Length to be lAC1 Silicone dotted band 5 cm measured at palm side Zipper Relief Zone Silicone dotted band 3/4 circ. inside cC1 Back of the hand 1 Zipper inside Relief Zone only AC Palm side Please note: Position of C, D and E are identical for armsleeves Zipper outside lAD and gloves. The outside measurement of the bend of the elbow Elbow Comfort Zone (Class 2 only) Color will be taken into consideration by BSN-Jobst. G-G1 (bias top cD Beige end) is 3 cm as a standard if there is no other requirement. 15 Color lAE

0 Black (Class 1-2 only)

5 Take measurements on edema-free extremities only. All measure- Beige ments must be recorded in cm. The purchaser is responsible for cE Caramel (Class 1-2 only) wrong measurements or misstatments on the order form. Made- Black (Class 1-2 only) 1 6 9 2 7 0 to-Measure compression garments will not be returned. Caramel (Class 1-2 only) Measurement point C, C1, D and E

Measurement point Length (l ) Circumference (c) C Measure without tension; size allowance if necessary in the case of In general, distal smaller circumferences (approx. < 18 cm). (second) wrist crease Circumference only Important: If C measurement is too tight, edema formation at the back (distal styloid process) (Fig. 28) of the hand is possible depends on the degree (Fig. 28) of edema formation

C1 C1 is is in the first third Measure without tension (not needed by BSN-JOBST) between C and E, (Fig. 29) approximately 5-7 cm.

Fig. 28 Fig. 29

Measurement point Length (l ) Circumference (c)

D is in the middle third Measure on the flexor side (inner side) of the In general, measure under slight tension, depending on the indication between C and E, gre- slightly bent arm and degree of edema atest circumference Indicate length measurement of C-D (Fig. 30) in this area

E Mark measurement point in the bent elbow With elbow bent (approx. 45°), measure without tension and not in the Over the elbow and Determine length of C-E on the slightly flexor fold; measure somewhat more proximally, if necessary flexor fold flexed arm (Fig. 31)

Fig. 30 Fig. 31

16 Measurement point F, G and G1

Measurement point Length (l ) Circumference (c) F In general, measure under slight tension, depending on the degree Middle of the upper Determine length of C-F on the slightly flexed of edema arm length (middle arm (Fig. 32) between E and G) G In general, measure to the brachial axis perpendicularly without any Underarm; use Determine length of C-G on the inner side of tension, depending on the degree of edema measurement aids the slightly flexed arm (Fig. 33/35) (Fig. 34) Fig. 32 Fig. 33

Measurement point Length (l ) Circumference (c) G1 Slant edge: Lateral elevation/ The following applies to BSN-JOBST: slant, depending on Do not specify circumference Distance from G-G1; in the case of the circumference (Fig. 35) BSN-JOBST, this is calculated with a default approx. 3-7 cm above value of approx. 4 cm the G measurement Fig. 34 Fig. 35 Fig. 36

Fastening Options

1. If there is a grip edge: Slant edge (only in the case of lateral elevation) 3. Shoulder strap 2. Skin adhesive (be aware of skin compatibility) 4. Bra fastening

Measure strap length from the top of the shoulder (acromion) over the H Measure from G on the outer side to the top of torso and back to the start of the shoulder blade. (3. shoulder strap) the shoulder (acromion) (Fig. 36)

Measure from G to the outer side of the bra strap. Indicate width of bra strap (> 3 cm) The following applies to BSN-JOBST: H Measure from G1-H (outer side of bra strap). In- (Fig. 35) (4. Bra fastening) dicate width of bra strap (> 3 cm). Or: Measure from G to H (outer side of bra strap) minus the increase of approximately 4 cm.

17 Orderform_2011_Elvarex arm_GB_CMYK_RZ.qxd:Layout 1 09.09.2011 17:08 Uhr Seite 1

Order Form Customer-no: Customer address: / Stamp: ® Purchase date: ® Elvarex® Medical Wear Schema-no: Armsleeves/Gloves BSN-JOBST GmbH · P.O. Box 101052 · 46430 Emmerich am Rhein Patient: Signature: Phone +49(0)2822/607-333 · Fax +49(0)2822/6 07-199 Measurement techniques for glovesJOBST – a brand of

Local DC address needs to replace the PC Armsleeves Qty./Class Left Right Gloves Qty./Class Left Right Jobst Emmerich address Elvarex 1 Elvarex 1 Elvarex 2 Style Elvarex 2 AC1 AE Styles Circ. Circ. Length H zxz–x Armsleeves without hand 3 lG1H Thumb 1 Strap length C-E 4 D-F 2 Finger 2 Z CG 5 Finger 3 G1 CG1 bias top end Finger 4 lGG1: 4 cm CH with shoulder cap cG Finger 5 Single piece, hand/arm cA X AG Arm with hand lCG 1 AG1 Arm with hand, lAB Z cF bias top end AH Arm with hand, cB shoulder cap X lCF cE Options Options lAC With shoulder strap Glove without finger, With bra loop without thumb cD lCE With bra loop with Velcro Glove without finger, with thumb Bra width (_____ cm) Glove with finger, Silicone dotted band, inside cC with thumb lCD Silicone dotted band; on top cC Bias end (AE only) Silicone dotted band 2,5 cm Length to be lAC1 Silicone dotted band 5 cm measured at palm side Zipper Relief Zone Silicone dotted band 3/4 circ. inside cC1 Back of the hand 1 Zipper inside Relief Zone only AC Palm side Please note: Position of C, D and E are identical for armsleeves Zipper outside lAD and gloves. The outside measurement of the bend of the elbow Elbow Comfort Zone (Class 2 only) Color will be taken into consideration by BSN-Jobst. G-G1 (bias top cD Beige end) is 3 cm as a standard if there is no other requirement. Color lAE

0 Black (Class 1-2 only)

18 Measurement point A, B, C and C1

Measurement point Length (l ) Circumference (c) A Connecting line The starting point for additional length measu- between the movement Place tape measure along the metacarpophalangeal joints with the hand rements is the halfway point of the connecting crease of the meta rigidly supported lines carpophalangeal joints (Fig. 38) (Fig. 37) of the little finger and the index finger. B Line from the With the hand rigidly supported, measure straight over the metacarpus Measure A-B on the outstretched inner hand webbing of the thumb through the webbing of the thumb (Fig. 37) perpendicular to the (Fig. 38) axis of the hand Fig. 37 Fig. 38

Measurement point Length (l ) Circumference (c) C Measure without tension In general, distal Measure A-C on the outstretched Revise measurement in cases of small circumferences (approx <18cm). (second) wrist crease inner hand Important: If C measurement is too tight, edema formation in the back (distal styloid process) (Fig. 39) of the hand is possible; avoid increased pressure in the area of overlap depends on the degree with arm sleeve of edema formation

C1 Measure A-C1 on the outstretched inner hand To measure edge, measure without tension, otherwise measure as for is in at least the first (Fig. 40) arm sleeve third between C and E

Fig. 39 Fig. 40

19 Measurement point D, E, finger 1 and fingers 2 - 5

Measurement point Length (l ) Circumference (c)

D Measure A-D inside (palmar) on the out (elongated glove) Measure as for arm sleeve with tension based on degree of edema stretched wrist Generally up to E

E Measure A-E inside (palmar) on the out (elongated glove) Measure edge without tension stretched wrist to just below E

Measurement point Length (l ) Circumference (c)

Finger 1 (thumb) Shortest length from the webbing (X) to the In general, measure to the nearest millimeter and without tension. X = proximal nail bed (Z) Measure X around the first metacarpophalangeal joint of the thumb measurement Exception: In the case of closed fingers, Z measurement without tension Z = distal measure to the end of the fingers (Fig. 42) measurement (Fig. 41)

Fingers 2-5 Shortest length from the webbing (X) to the In general, measure X and Z to the nearest millimeter and X = proximal nail bed (Z) without tension. measurement Exception: In the case of closed fingers, The X measurement should not be less than the Z measurement; Z = distal measure to the end of the fingers if necessary, it should be made equal to the Z measurement measurement (Fig. 41) (Fig. 42)

Fig. 41 Fig. 42

20 Measurement Materials Have the following materials ready before taking measurements:

Tape Measures: Two tape measures of different widths are recommended for taking measurements, depending on which areas of the extremities are being measured:

A 0.5 cm wide tape measure or appropriate finger / toe tape measure is used to ensure measurements to the nearest millimeter in the hand and foot areas.

A coiled tape can measure the remaining circumference and length measurements (feet, legs, possibly abdomen, Tape shows centimeters on one side and inches on the other side hand and arm).

JOBST® Skin Pencil A skin pencil is recommended for marking the measurement points. Our JOBST® skin pencils are particularly skin-compatible and are easy to remove from the skin due to their fat solubility.

Measurement Chart The measurement chart is a measurement aid developed exclusively for arm sleeves and gloves. The chart allows finger lengths to be determined very easily and precisely. Moreover, the measurement aid is used for positioning measurement point G.

Measurement Board A measurement board is recommended for accurately measuring the lower extremities It is particularly convenient to take combined length and circumference measurements without marking the patient’s skin.

21 Elvarex ® in Lymphedema Therapy Styles and options lower extremities Most frequent styles:

AD AG AG-T AG-HT AT Knee High Thigh High Thigh High with waist Elvarex ® one leg panty Elvarex ® Panty (Thigh High attachment (chap style) (Single leg with body with body bandage) bandage and leg extension) Most frequent options:

Straight ending Slip form (French cut / Silicone dotted Silicone dotted 3 /4 silicone dotted outside higher) band; on top band; inside band; inside Width of the silicone dotted band: 2.5 cm or 5.0 cm

Further options:

Straight foot with Slant foot with open toe* Foot cap with toes open toe* * Open and closed toe are available Compression Classes (CCL) / Colors: Style CCL Beige Black Navy Cocoa Grey Cranberry Henna Graphite Denim Leg 1–4 super

Foot cap 1–3 N /A N /A N /A Addition to add colored seam at no addtional cost, e.g. cranberry garment with a black seam, denim garment with a blue seam. Excludes Henna, Graphite and Denim as seam color. The options displayed represent just an extract of the JOBST ® Elvarex® assortment. Each style can be combined individually. For further information on the JOBST ® Elvarex® assortment please refer to the current JOBST ® product information. 22 Styles and options upper extremities Most frequent styles:

AC1 AE CG1 CH AG1 Glove Glove to elbow Armsleeve with Armsleeve with shoulder One-piece armsleeve bias top end cap (e. g. with bra and glove attachment with Velcro®) Most frequent options for armsleeves:

Silicone dotted Silicone dotted 3/4 silicone dotted With shoulder cap and With shoulder cap band, on top band, inside band; inside bra attachment with Velcro® and strap

Glove/Gauntlet options:

Without fingers, with thumb* With fingers, with thumb* With zipper With pocket

* Individual length of the fingers and the thumb is variable

Compression Classes (CCL) / Colors:

Style CCL Beige Caramel Black Honey Cranberry Arm and Glove 1–2

Arm and Glove 2-Forte N /A

The options displayed represent just an extract of the JOBST ® Elvarex® assortment. Each style can be combined individually. For further information on the JOBST ® Elvarex® assortment please refer to the current JOBST ® product information.

23 JOBST ® Elvarex ®: Functional Zones for perfect wearing comfort and targeted compression

Functional Zone “Pressure Panty Elvarex ® „ (body-bandage)

Available as: • Body bandage: CCL 1 - 3 Forte • Corresponding leg stockings available in all CCL (1 - 4 Super)

Functional Zone Functional Zone “Bias top end” „ “Top Comfort Zone Available as: Available as: • All compression classes • B1G, BG, CG, AG, AT (CCL1 - 2 Forte) Pressure panty Elvarex ® (body bandage), Bermuda, Capri pants, stump stockings (ST) Functional Zone „ “Knee Comfort Zone Functional Zone Available as: „ • CCL 2 - 3 “Elbow Comfort Zone

Available as: • CCL 2 • Exception: not available Functional Zone „ for “single piece hand/arm” “T-Heel

Available as: • CCL 2 - 3 Forte

® JOBST ® For details of additional ELVAREX The Gold Standard in

Custom-made Lymphedema garments Quick Reference Brochure garment versions, please consult our special styles and options catalogue.

THERAPIES. HAND IN HAND. Functional Zone „ “Slant Foot

For more information, please contact Customer Service at 1-800-537-1063

VELCRO® is a Registered Trademark of Velcro BVBA. Please refer to the product label and / or package insert for full instructions on the safe use of these products.

original original BSN medical Inc., an Essity company original original 5825 Carnegie Blvd., Charlotte, NC 28209-4633 JOBST®, /JOBSTUSA @JOBST_USA an Essity brand Tel. (+1) 704 554 9933 Fax (+1) 800 835 4325 @JOBSTforUSA jobst-usa.com To order toll-free: Tel. (+1) 800 537 1063 60931 R1 ©2018 BSN medical Inc. REV 08/18