lymphology measuring for custom-made flat-knit lower extremity effective October 1, 2017 Notes on taking Knee high measurements for All length measurements are contoured along the medial (inner) side of the leg custom-made flat-knit stockings Foot measurement points (Y, A, A1, Z) Circumference ( ) Y • Flat knit compression garments should c not be measured until the best possible Measurements taken over the heel decongestion effort has been achieved. and arch in dorsal flexion with tendons Circumference (c) and length (l) measurements taut. Take physical dimensions without are taken in a distal to proximal sequence tension. Take soft tissue projections (starting at the toes and working up the leg into account. towards the waist). Length (l) A • It is essential to mark measuring points on Distance from heel to base of little toe the leg so that the circumference and length (length of outer side of foot), including the measurements are taken at the same point. joint. • The amount of tension applied must be Length (l) A1 determined by a person experienced in Distance from heel to base of big toe bandaging techniques and depends on edema (medial length), including the joint. and tissue characteristics, sensitivity to pain, fibrosis, location of the edema, mobility, and Length (l) Z strength of the patient. Closed toe: distance from heel to end of longest toe. (Not needed for open toe • Generally flat-knitted garments are measured under tension with the exception garments, except open toe seamed toe caps. lZ needed for ALL seamed toe cap garments.) of cY. According to the measuring point we cA (for straight and oblique border) distinguish: Skin measurements = loose; Circumference (c) A Measuring to the first resistance = Apply tape measure around the measuring under tension without force; metacarpophalangeal joints Full Tension = absolutely compression (first joints of toe). of the tissue. Joint space Measuring point B: just above the malleolus (ankle bone) Measuring point B1: at the base of the calf Length (l) B Length (l) B1 From sole of foot to above (proximal to) From sole of foot to base of the calf. the ankle . Circumference (c) B Circumference (c) B1 Measure circumference, depending on Measure circumference, depending indication, tightly if necessary. on indication, tightly if necessary. Measuring point C: at the largest calf circumference Measuring point D: at the head of the fibula Length (l) D Length (l) C From the sole of the foot to the head From sole of foot to largest calf of the fibula (approx. two finger widths circumference . below kneecap) . Circumference (c) C Circumference (c) D Measure circumference, depending on Measure circumference, depending on indication, tightly if necessary. indication, tightly if necessary. Exception: AD stocking = Body dimension. Thigh high All length measurements are contoured along the medial (inner) side of the leg except (l)K2 which is contoured on the posterior (back) side of the leg. Measuring point E: at the middle of the kneecap Length (l) E Circumference (c) E From sole of foot to In general, measurements are not made tightly middle of kneecap. when the leg is bent (angle 30° - 45°), take l E circumference measurement one finger width proximal (above) to the back of the knee, and c E two finger widths proximal (above) to the knee cap. Do not place tape in the back of the knee or folds of skin. Measuring point F: at the middle of the thigh Measuring point G Length (l) F Length (l)G F c From sole of foot to AG stocking dimension: sole of the middle of thigh. foot to largest point (inner aspect) below the transverse buttock fold l F Circumference (c) F (including top band) . Depending on the indication, the circumference is generally measured fairly tight. Circumference (c) G Depending on the indication, the circumference is generally measured fairly tight at the c G widest part of upper thigh (not always the top of the thigh.) Measuring point K1: at the pubic bone Measuring point K2: at the gluteal fold Length (l) K1 Length (l) K2 From sole of foot to From sole of foot to lK1 the pubic bone . gluteal fold. c K Circumference (c) K Measure around l K2 both legs at the gluteal fold. Obligatory measurement for medi! Waist high All length measurements are contoured along the body except “H” and “T” which are straight lengths. Measuring point H: widest point of the pelvis Length (l) H Circumference (c) H From sole of foot to widest Circumference of pelvis at the point of pelvis. widest point, or buttocks, measure tightly depending on indication. Measuring point T: at the waist Length (l) T Circumference (c) T From the sole of the foot to Circumference of torso, the top border of the garment measured under (patient-specific). moderate tension. Measuring points for front (l) TK1 and back (l) TK2 top border of the garment Length (l) TK1 Length (l) TK2 Front length TK1: measure Back length TK2 measure l TK1 vertically next to body, at vertically near the body, at the level the level of the pubic bone of the transverse gluteal fold to the to the top border of the border of the garment. garment. Measuring a suspensory Length & width Measure the width and length length of the suspensory, as marked in Figures A and B - this width width measurement can be taken length over the underwear. Fig. A Fig. B Patient Last Name: Patient First Name: Absolute Medical. 1843 W Hubbard St #2A FFitter First Name:irst Name: Chicago, IL 60622 Fitter Last Name: Tel: 312 233 2207 Fax: 866 860 9358 To Order Online: [email protected] Date: Our website: absolutemedical.com LOWER EXTREMITY MEASURING & ORDER FORM: CUSTOM-MADE FLAT-KNIT LENGTHS (landmarks to floor) REQUIRED LENGTHS FOR THIGH & PANTY/WAIST FRONT BACK pubic bone l K2 lK1 lK2 (pubic bone to floor) (gluteal fold to floor) ____________cm ____________cm REQUIRED LENGTHS FOR THIGH & PANTY/WAIST WITH E-KNITTING MARK OPTION BACK D1 (popliteal crease to floor) D1 ____________cmD1 (contour) WEIGHT BEARING (must complete all) Left Foot Right Foot circ.A_______cm circ.A_______cm lA1_________cm lA1_________cm lA _________cm lA _________cm lA1 lZ _________cm Z _________cm H Rev l P0240 Absolute Medical. 1843 W Hubbard St #2A Patient Name: Date: Chicago, IL 60622 Tel: 312 233 2207 Fax: 866 860 9358 To Order Online: [email protected] Fitter Name: Our website: absolutemedical.com LOWER EXTREMITY MEASURING & ORDER FORM: CUSTOM-MADE FLAT-KNIT Fax order: 866 860 9358 email: [email protected] FOOT □ Open toe □ Closed toe: (CCLII) □ Tricot (half compression) *default □ Netting (no compression; 550 only) Knee high Thigh high Waist high MONDI SILVER 550 ONLY OPTIONS One leg Waist high* □ Y-C □ Gluteal shaper (tricot gusset only) Needed for all thigh high stockings □ Y-D □ Hallux ease (closed toe or □ Y-G seamless toe cap only) GUSSET: SUSPENSORY: ____ Tricot (standard) ____ Tricot with fly KNITTING OPTIONS □ Y knitting mark at ankle □ E knitting mark at knee ____ Netting ____ Netting SILICONE TOPBAND ____ Compressive ____ Compressive None ** Width ______ cm Length _____ cm ** SILICONE ANTI-SLIP Width Length POSITION PIECE SILICONE DOTS Lateral/along ** oblique border 15 X 5 cm 10 X 4.5 cm Width Length Anterior/vertically 8 X 5 cm 10 X 4.5 cm Location _________________________ Left Right Pair over “E” QTY Standard Colors Trend Colors* Posterior/rear 8 X 5 cm 10 X 4.5 cm Caramel Black Anthracite Magenta overLEVAPAD seam Aqua Mint-Green Y to D Y to G B to D B to G Cashmere* Sand Sole of the foot N/A Blue-Jeans Moss-Green 6 X 4.5 cm COLOR Cherry-Red Navy Coral SWAROVSKI CRYSTALS mediven 550 Fashion Elements* mediven 550 Pattern: BEAUTY Must pick 1 color & 1 pattern Design Elements Beauty Colors Patterns Stars LEVAMED SILICONE ANKLE PADS* BRILLIANCE Berry Animal Add 1 cm to cY measurement per pad. Brilliance DESIGN Ribs Brown Crosses Left: Inner Outer Permanent Removeable Romance Pyramids ROMANCE Gray Ornaments Right: Inner Outer Permanent Removeable *Not available in mediven sensoo. Trend colors and fashion elements require an extra 5 days for production. **mediven 550 only NOTES: Rev H Rev P0240.