Educational Resources

Finding the right compression for lipedema is a struggle. There are many brands and types, and while practitioners may prescribe higher compression levels, the truth is, that if patients can tolerate any type of compression and will wear it, this is better than wearing no compression at all.

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There are four classes of medical compression–the higher the compression class, the higher the pressure. This is also known as resting pressure. Compression is measured in either kilopascals, abbreviated kPa, or millimeters of mercury, abbreviated mmHg. Class I has pressures in the range of 18–21 mmHg and is considered light compression. Class II has pressures in the range of 23–32 mmHg and is considered moderate compression and is standard. Class III has pressures in the range of 34–46 mmHg and is considered firm compression, and class IV pressures exceed 49 mmHg, are considered extra firm, and are custom made. Your physician will designate the class of compression on your prescription. Class II and greater require a prescription.


Compression around the ankle area is decisive for the classification of medical compression stockings into the four compression classes. This is because the pressure is highest here. This value determines the compression class. For the compression stocking to be medically effective, the pressure must decrease continuously from bottom to top, i.e. from the ankle to the thigh.

Nurses should only use graduated compression socks instead of anti-embolism stockings or TED hose which are only used for bedridden patients. Graduated compression socks can vary in compression strength and length with the most common length being the thigh and knee length. Since they can be a pain to put on and most people suffer the most in their lower legs, knee length is the most popular type of compression sock.

Thrombo-Embolic Deterrent (TED) hose is designed for non-ambulatory patients. The compression exerted is fairly gentle in comparison to compression stockings. TED hose is designed to assist the patient’s blood flow so that blood does pool and clot in the legs. Their compression level is approximately 8 to 18 mmHg, and this type of hose may be prescribed for periods as short as three weeks.

There are four main strengths of compression socks. The strength rating of compression socks is always issued in a range of graduated compression and is conveyed in millimeters of mercury (or mmHg) such as 23-32mm Hg socks or there is 32 mmHg around your ankles and 23 mmHg around the top of your sock.

Compression classes for compression stockings. (n.d.). Medi. https://www.medi.de/en/faq/compression-garments/compression-classes
Kaplan, M. (2019, August 12). What is TED hose and how is it different from compression stockings? Save Rite Medical. https://www.saveritemedical.com/blogs/news/what-is-ted-hose-and-how-is-it-different-from-compression-stockings

Types of Compression

Circular Knit Versus Flat Knit

Circular knit compression works to contain the skin by being slightly smaller than the limb for which they are fitted. Those sold over the counter are typically made of nylon, have four-way stretch (meaning they stretch both in length and in width), and range in compression strength from 8-15 mmHg. They are thin, which can make them more comfortable, and they have gradient compression, meaning they will be tighter at the foot and ankle than at the knee or thigh. The downside of the thinner material is that the garment may bunch behind the knee or ankle, causing discomfort.

Custom-made garments are usually a thicker circular knit made of nylon or a nylon-cotton blend, or a flat knit, and have a higher compression strength range from 20-30 mmHg or 30-40 mmHg. The flat knit also has a seam and is often preferred for larger or abnormally shaped limbs. Many patients find that a thicker flat knit compression garment is less painful then its circular knit cousin. The downside is that the flat knit stretch is only 2 way, making it both more difficult to fit, and less forgiving. It is also more expensive.

Elvarex – Jobst
Juzo
Medi
Sigvaris

Micromassaging Compression Garments

Micromassage knitting features a raised ripple knit which facilitates continuous massaging effects on the skin by creating pressure points and using the body’s movements to move lymph – stimulating superficial lymphatics by stretching the top layer of skin when the body is moving. Along with regenerating compression, this type of compression improves circulation. Bioflect VIDEO and Solidea VIDEO are types of micromassaging compression.

Micromassaging garments have a low compression level, ranging from 12-21 mmHg, and the most stretch of any garment. Because they are not difficult to don or painful to wear, they have the highest rate of patient compliance. However, these garments only focus on the superficial lymphatics.

Inelastic Garments

Inelastic Garments have very little stretch, the theory being that the only way to not “re-swell” is to make them out of something that acts almost like a cast upon the limb. Since there is no ” give” to the material, they are held in place with neoprene straps and Velcro. Inelastic Garments may be suited for limbs that are shaped like an upside-down champagne bottle, have a overhang around the wrist or ankle, have venous and/or lymphatic disease, lipo-lymphatic issues or are painful.
The downside to inelastic garments is that the garment can be difficult to get on, requiring both strength and flexibility.

Circaid – Medi
Farrow
Juzo
Sigvaris (formerly BiaCare)
Solaris

Arm Sleeves

Coming soon!

Brands

Bioflect Micromassage Lymphedema Compression Support
Czsalus
Juzo
Lipoelastic
Marena
Solidea Arm Bands
Solidea Arm Sleeve

Where to Purchase

Ames Walker
Brightlife Direct
Compression Closet
Compression Sale
Czsalus
For Your Legs
Lipoelastic

Bandaging

Coming soon!

Types & Brands

Where to Purchase

Ames Walker
Bandages Plus
Brightlife Direct
The Lymphedema Store

More About Bandaging

How to self-bandage to reduce lymphedema – University Health Network

Leggings Pantyhose & Socks

Coming soon!

Brands

Where to Purchase

Ames Walker
Bioflect Micromassage Lymphedema Compression Support
Brightlife Direct
Compression Sale
Czsalus
For Your Legs

Leg Smart
Lipoelastic
The Lymphedema Store

Jobst FarrowWrap

Nighttime Compression

Patients may require an additional compression garment at night to break up fibrotic tissue and reduce swelling. These garments are typically constructed with a spandex, wicking fabric, padded with foam chips or seams that follow channels of the lymphatic system. A padded sleeve can also be purchased to wear with short stretch bandages. The advantage of nighttime garments is that they help to maintain limb size without frequent trips to a therapist. However, they are thick and bulky, which can be both uncomfortable and hot, as well as expensive.

Brands

Chipsleeve – Sigvaris
Comfiwave – Haddenham
JoViPak (Lower Body) – BSN Medical
JoViPak (Upper Body) – BSN Medical
Profile – Circaid

Peninsula Medical
Solaris

Where to Purchase

Bandages Plus
Compression Closet
The Lymphedema Store

Reid Sleeve Compression Garments

Coming soon!

Reid Sleeve Compression Garments [VIDEO]

Peninsula Biomedical

Short Stretch Compression (Wraps)

Short stretch compression garments are made of a cotton/elastic material that stretches to only 40% of its length, providing a steady, low level of compression when resting that increases when you stand or are active. The result is a more comfortable garment that conforms to the actual needs of your limb. This adaptable compression technology not only significantly improves venous and lymphatic function but also aids active muscle assistance in the vein.

This garment has a spine in the back with short stretch elastic bands that attach with Velcro in front of the limb. They are easier to don than either circular knit/flat or inelastic garments, and if there is still some swelling in the lib, it will help it shrink in size. For patients with frail skin, this garment will need a padded sleeve protector or lining.

Brands

Elvarex – Jobst (_ mmHg)
Circaid – Medi USA (_ mmHg)
Farrow (_ mmHg)
Sigvaris CompreFLEX – Sigvaris (_ mmHg)

Where to Purchase

Ames Walker
Brightlife Direct
Compression Closet
For Your Legs
The Lymphedema Store

Vests & Shirts

Coming soon!

Brands

Where to Purchase

Bioflect Micromassage Lymphedema Compression Support
Compression Closet
Czsalus

Foam and Chip Packs

Foam and chip packs which help with edema and to break up fibrosis are available in a wide range of versatile shapes and sizes that tuck into compression garments or under compression bandages.

Brands

Cherry Pit Pads – Lipedema Products
Jobst PitPaks – JoViPak
Jobst JoViPads – JoViPak
JoViPak Genital Pads JoViPak
Sigvaris GeniFit
SwellSpots Solaris

Where to Purchase

Brightlife Direct
Compression Closet
Lipedema Products

Custom Compression Garments

Off-the-shelf compression is not designed for the contours of late-stage patients, and finding compression that fits properly is a challenge. Custom compression is available at the following:

Bio Concepts Custom Compression Garments

Sellers

https://bubblisar.myshopify.com/
Compression Guru
Compression Store

High Tide Health
Jobst
Lipedema Products
Lipoelastic
Lymphedema Products
Marena
Medi USA
Mediven
Solidea
The Compression Store

Donning/Doffing Aids

Jobst
Juzo
Medi

Body Adhesives

Body adhesives are great for helping compression stay in place. There are many brands to choose from, including adhesives from Ames Walker, Jobst, Jomi, and Mediven, to name a few. All are available at Amazon.

More About Compression

Compression Garments for Lipedema – Dr. Thomas Wright
Compression Garments for Lipedema – Dr. Thomas Wright, Vein Magazine
Donning Compression Stockings – Medi
How to Care for Your Compression Garments – Joachim Zuther

Donating Old Garments

Donate to LIHDA
Lipedema Lymphedema Used and New Compression Facebook Group

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