Compression Legwear
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MEDICAL COMPRESSION LEGWEAR MEDICAL LEGWEAR OVERVIEW What do Medical Stockings do?: Compression Values - mmHg: • Medical stockings feature graduated compression – being strongest at the ankle, • Compression is measured in mmHg (millimetres of mercury) at the ankle – with pressure progressively reducing up the leg. the higher the mmHg, the stronger the compression. • This improves blood flow in the legs, assisting in the prevention and management • These compression levels are usually expressed as ranges (‘x’ - ‘y’ mmHg) of venous disease. as shown in the table below. • Medical stockings are also widely used in the treatment of lymphoedema, where fluid build-up in the lower limbs may occur. Differences in mmHg between brands: Medical Stockings - Preventative vs Therapeutic: • Depending on their country of origin, the mmHg for medical stockings may be • Preventative medical stockings - those with mmHg less than Class 1 - are often expressed differently, which can be most confusing if trying to compare brands. prescribed for general leg relief, mild varicose veins, or as a safeguard against • The better-known brands of medical stockings from Europe use one system of DVT and swollen ankles during long-distance travel for those with no specific mmHg measurement, which we refer to as ‘European’. This includes GloriaMed (for vascular problems. They can also be used during pregnancy. Of the stockings in this which Cosmac is the Australian distributor), Venosan, Medi, Sigvaris and Venotrain. catalogue, most of the IBICI range and Trusheer for women fall into this category, as Others (mainly the USA) use another system, which we refer to as ‘International’. does the Jobst 15-20 mmHg range. This includes Jobst and Truform. • Therapeutic medical stockings - Class 1, 2 and 3 - are for more serious or pre- • However, for the stronger medical stockings, what all these brands have in common existing conditions, and will be prescribed accordingly by the health provider. is a system of classification by Compression Class - 1, 2, 3 (in ascending order of Cosmac Healthcare will not supply stockings of Class 2 or above without such a > LEGWEAR compression), where the compression class of one is generally equivalent to that of prescription, or unless the wearer has been previously prescribed and been wearing the other, even though the stated mmHg may differ..... see chart below. such stockings. • Cosmac Healthcare prefers to use Compression Classes 1, 2 and 3 in describing • Medical stockings are often confused with the white anti-embolism stockings these stockings. However, if referring to the mmHg, we prefer to use the supplied to patients while in hospital. International mmHg ranges, as they are easier to remember (20-30, 30-40, 40-50). While such stockings are indeed compression stockings with gradient compression, For this reason, although GloriaMed products come under the European system, they feature an inspection opening at the toe or under the foot, and are designed in Australia we use the International system to describe them. Interestingly, some specifically for patients who are in bed. They are not designed for every-day use by European stocking manufacturers do the same for their USA distribution. those with vascular insufficiency or lymphoedema. COMPRESSION Preventative Therapeutic CLASS 1 CLASS 2 CLASS 3 15-20mmHg Int ...20-30 mmHg Int ...30-40 mmHg Int ...40-50 mmHg Eur ...18-21 mmHg Eur ...23-32 mmHg Eur ...34-46 mmHg • Tired, aching legs • Mild/moderate varicose veins • Mild chronic venous insufficiency • Pronounced varicosities with oedema • Mild varicose veins • Varicosities tending towards • Moderate/severe varicosities • Pronounced chronic venous insufficiency • Mild varicose veins during pregnancy mild oedema during pregnancy • After deep thrombophlebitis • Mild fluid retention • Varicose veins during and • Prevention of thrombosis (ambulatory) • Valvular insufficiency of the deep veins • Post sclerotherapy after pregnancy • Phlebitis with mild oedema • Varicose ulcers • Travel - for those with otherwise • Prevention of thrombosis • After deep vein thrombosis healthy legs. (ambulatory) • Post sclerotherapy Contraindications: Arteriopathy, hyperdermatitis in acute state, wet dermatosis, cutaneous infections, unreduced oedema, acute thrombophlebitis. Styles Available: • Several styles are available.....knee highs are the most commonly used, as most • If you have sensitive skin, or live in a hot, humid climate, stockings with high cotton circulation problems originate in the lower leg. content (100% cotton against the skin) may be appropriate (eg. GloriaMed 162 • However, there may be specific medical conditions or surgical procedures where other and 262). styles are more appropriate and prescribed by the health provider. • For strong Class 3 compression stockings, the optimum elasticity and prompt return of • Many therapeutic stockings offer the choice of ‘closed-toe’ (full-foot, like a sock), or natural rubber is more suitable than synthetic stretch materials (GloriaMed 361). ‘open-toe’ (toes exposed). Usually this is a personal preference, although for those with swelling of the foot/toes, a closed-toe style may be more appropriate. The open-toe style may be more suited to those with large foot size in relation to their leg measurements. Knee High Thigh High Waist High Plain Top Grip Top Single Leg with Belt (CHAPS) Panty Hose Maternity AD AG AGH AGG AT ATM 2 Call: 1300 723 092 visiT: www.cosmac.com.au GENERAL ENQUIRIES: email [email protected] fax 02 9033 7473 DVA ENQUIRIES: email [email protected] fax 02 9033 7410 MEDICAL COMPRESSION LEGWEAR Measuring & Sizing: Circumference Measurements (cm) Length (cm) Take the measurements per the diagram, and t then check these against the sizing chart of your Waist High: Thigh & Waist High: preferred brand to determine size. ‘t’- around the waist ‘A-g’ from floor to 5cm below the groin. Some important points: g left right Thigh & Waist High: • Measurements should be taken first thing in ‘g’- around the top of the leg, Knee High: the morning. 5cm below the groin. ‘A-d’ from floor to 2cm below the knee • If one measurement indicates a larger size than another, select the larger size. All Stockings: • If there is more than one size difference d ‘d’ - around the leg, 2cm between measurements, contact Cosmac. c below the knee Patient’s Height (cm): • Some 15-20mmHg preventative stockings have length A-g ‘c’ - around the widest part a height/weight grid for sizing. While this of the lower leg (calf). Patient’s Weight (kg): provides a useful guide, measurements should length A-d b ‘b’ - around the narrowest (if maternity, pre-pregnant weight) still be taken. point of the ankle, just above COMPRESSION A the ankle bone. Most Important: • Knee high stockings should not be pulled up too far. They should finish about 3-4cm. • For those with a V-shaped leg, and a fleshy knee area, knee high stockings are often below the crease behind the knee, and the top band of the stocking should be flat difficult to fit, as they will always tend to roll. In such cases, a thigh length stocking may against the leg. be more suitable. • On no account should they be allowed to ‘roll’ at the top, or doubled over if the wearer • Stockings should be put on first thing in the morning. Oedema often reduces when the thinks they are too long. It is better for the wearer to ease them down the leg, so that leg is elevated (as during sleeping at night). Hence it is important to put on stockings > LEGWEAR the top of the stocking is in the correct position below the knee, and then smooth out when getting out of bed. A stocking will not remove swelling once it is there - the any wrinkles down the stocking. stocking must be put on before it begins. • If thigh length stockings are required, it should be noted that those with a ‘grip top’ • If flying, put on stockings the morning of flight... don’t wait until you get to the airport. silicone band are usually more suited to those with a fairly ‘normal’ size leg. If the leg is • Do not wear medical stockings to bed (unless specifically instructed to do so by the too big at the thigh, they will have a tendency to roll. physician). ORDER FORM Need Help with Sizing? If you need help with sizing, fill-in the measurements above, and in the chart below, complete the patient/prescriber details, tick the style/compression level required, photocopy this page, and either fax or email it to Cosmac as detailed at the bottom of this page. Patient/Prescriber Details Patient Name: M / F If Veteran, insert DVA File No. (circle one) Prescriber/ Supplier Name: Phone Contact: Compression Levels and Style Requirement Knee High Thigh High Waist High Plain Top Grip Top Single Leg with Pantyhose Maternity Belt (CHAPS) 15-20 N/A (preventative) 20-30 Class 1 Left Right (European 18-21) 30-40 Class 2 Left Right (European 23-32) 40-50 Class 3 Left Right (European 34-46) open TOE closed N/A N/A Preferred Brand*/Type: Preferred Colour: beige / black / other (if avail) *Ibici (15-20), GloriaMed (Class 1, 2 & 3), and Truform (Class 1 & 2) are Cosmac’s preferred quality brands. The availability of open or closed toe, and colour choice, varies between brands. Fax/Email Veteran Orders: Non-Veteran Orders: Fax: 02-9033 7410 or email [email protected] Fax: 02-9033 7473 or email [email protected] • This order form must be accompanied by a fully completed DVA RAP Direct Order Form. • Please include with your order: (Cosmac is subcontracted to Aidacare and Paraquad ). ° purchase quantity • Veteran entitlement is 3 pairs (or 6 single stockings) every 6 months. ° billing/payment details • Check DVA RAP- AU13 for stocking applicators & accessories. ° delivery address. GENERAL ENQUIRIES: email [email protected] fax 02 9033 7473 Call: 1300 723 092 visiT: www.cosmac.com.au 3 DVA ENQUIRIES: email [email protected] fax 02 9033 7410 MEDICAL COMPRESSION LEGWEAR IBICI MEDICAL LEGWEAR DVA RAP code AR22 Designed and manufactured in Italy, IBICI's 'Segreta' for women, 'Repomen' for men, and unisex ‘Skywalk’ knee highs, are ideal for mild vascular conditions, or as a preventative measure.