Compression garments for lymphoedema
The most effective compression garments for lymphoedema are those that are intended to offer the correct amount of compression. There are numerous types and styles of compression garments on the market, so it is important to understand the complexity of compression garment prescription.
In the blog post below you will learn what the different types of compression garments are and our recommendations of some highly respected brands.
You can think of compression garments like medication. It needs to be prescribed in the correct fabric, dosage of pressure, replacement frequency and with correct care and washing instructions.
What will I learn about?
Who is this for?
Time to read
15 mins to preview (or hours if you read all the PDFs).
Learn from Professor Neil Piller
Professor Neil Piller is a Lymphologist from Flinders University who was trained by Dr John Casley-Smith. A Lymphologist is an expert on lymphoedema.
In this video, of 3 minutes and 27 sec duration, you will learn about the different types of compression therapy. This video shows you how you would teach about compression therapy to your patients.
“Emptying the buckets” refers to clearing the lymph nodes that are responsible for draining lymph fluid.
Professional compression includes bandages, compression garments and pumps.
Learn about the science of compression garments
Six great resources on compression garments from reputable sources around the world are the following:
- STRIDE – This booklet was published by The acronym ‘S.T.R.I.D.E. ‘, incorporating both textile characteristics and clinical presentation, stands for: Shape, Texture, Refill, Issues, Dosage and Etiology. The intent of the technical guide is to highlight that successful compression includes more than dosage alone.
- Australian and New Zealand Clinical Practice Guideline for Prevention and Management of Venous Leg Ulcers. This guideline was developed by the Australian Wound Management Association and the New Zealand Wound Care Society. The guideline presents a comprehensive review of the assessment, diagnosis, management and prevention of venous leg ulcers within the Australian and New Zealand health care context, based on the best evidence available up to January 2011.
- Template for practice: Compression hosiery in upper body lymphoedema. This article is by Wounds International.
- Template for practice: Compression hosiery in lymphoedema. This article is by Wounds International and focusses on the lower limb.
- ALA Position Statement on the use of compression hosiery. This is an Australian document that states that “Compression is considered
both a clinically effective and cost-effective treatment for people
with lymphoedema. Well applied and appropriate compression
improves lymphatic drainage, may reduce inflammatory
processes, and reduces the risk of infection.”
- International Consensus: Best Practice for the Management of Lymphoedema
- EWMA Position Document on Compression
- A great article titled, “Rabe E, Partsch H, Hafner J, et al. Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement. Phlebology. 2018;33(3):163-184. doi:10.1177/0268355516689631“. Access HERE for free.
Why use compression for lymphoedema?
Lymphoedema is a condition that can cause swelling and pain in the arms or legs.
Compression garments are an integral component of lymphoedema treatment. They are the MOST evidence-based modality as part of Complex Lymphatic Therapy.
What effect do compression garments on cellulitis?
Cellulitis is a bacterial infection and can potentially become life-threatening if left untreated.
In a research study conducted in Canberra Australia in 2019 on patients with chronic swelling, half of the group were offered compression garments and half were not. The patients in the study had a history of two or more episodes of cellulitis in the same leg in the 2 years before referral to the trial and had swelling lasting longer than 3 months in one or both legs. The study was stopped as so many of the patients without compression garments were hospitalised for cellulitis.
Compression garments are shown to stop cellulitis in patients with chronic swelling.
What are the different types of compression garments?
There are two types of compression: non professional and professional.
Non-professional is like brands such as “Skins” that hug the tissues but do not provide a therapeutic level of compression. These garments are not TGA registered or recognized as “medical devices”.
Professional compression are brands that are recognised as “medical devices.” They will need to be registered with the TGA and sold by reputable Australian companies.
Professional compression garments are scientifically researched to provide graduated compression which means they move fluid from distal to proximal which means from far away to the centre of the limb. In other words for the arm, they squeeze the wrist tighter than the top of the arm and for the leg, they squeeze the ankle more than the thigh.
What is the TGA?
The Therapeutic Goods Administration (TGA) is part of the Australian Government Department of Health– external site, and is responsible for regulating therapeutic goods including prescription medicines, vaccines, sunscreens, vitamins and minerals, medical devices, blood and blood products.
All professional compression garments must be TGA registered.
Patients should never be encouraged to buy garments from non-reputable sources or overseas. Australian providers, for example, pay for TGA registration and insurances in order to supply garments safely.
What are the different types of professional compression fabrics?
The different types of professional compression garments are:
- Circular knit garments – used for early lymphoedema. Most of these garments are available as off the shelf or ready to wear products. They are highly stretchy products.
- Flat knit garments – used for moderate to severe lymphoedema
- Powernet lycra garments – used when wounds are present due to zippers being needed
- Wraps – used when help is needed with donning and doffing as they have Velcro straps
- Pumps – used instead of compression garments or with compression garments
- Garments for fibrosis – used to soften tissues. These garments can be made from fabric similar to the fabrics in 1 to 3 but include pieces of foam designed to leave bumps in the tissues. Think of it like the swollen area being attacked by a quilt. The bumps don’t last long. They are designed to soften hard areas caused by fibrosis.
2 sets every 6 months $90 +Per MonthStretchy garments knitted on a circular knit machine in a tubular fashion. The shape is changed by tightening the stitch height and width. Generally produced to a standard size called ready to wear (RTW) however, they can also be custom ‘made to measure’ which will increase the cost.
2 sets every 6 months $250 +Per MonthFlat knit garments are knitted on a flatbed machine comprised of rows of hundreds of needles, like knitting a jumper row by row. The needles are larger gauge and able to knit thicker yarns than circular knit machines. They can be ready to wear but also custom made.
2 sets every 6 months $250 +Per MonthElastic fabrics that usually have Velcro used to overlap the garment to form a rigid sleeve. They can be ready to wear and custom made. They are ideal if there are any wounds of if there are problems with putting garments on and taking them off.
1 pump will last years $3000 +Per MonthPumps, also known as pneumatic compression devices, are sleeves that inflate with air in a special pattern. They try to squeeze fluid out of your arm or leg. Lymphoedema pumps will have special programs that start pumping at the top of your arm or leg or on your trunk to try to mimic manual lymph drainage, before the y start squeezing furthermost away then squeezing up the limb.
2 sets every 6 months $500 +Per MonthPowernet lycra garments are like swimming costume material (lycra) with different gram tensions. They are great for wounds to stop any trauma to the wound.
Trusted compression brands
There are numerous lymphoedema compression garments on the market that claim to be the most effective. That’s where we come in. We’ve developed a list of respected lymphoedema brands. These companies attend Australian lymphology conferences and support lymphoedema education.
The most effective lymphoedema compression garments are medically graded and TGA registered. You can think of the TGA like the FDA in America. It means that the garments must meet certain testing standards for effectiveness and quality.
Several compression garments available on the market can assist with lymphoedema.
Some respected garment brands are listed below:
- Sigvaris – well known are the Traditional and Cotton garments
- Essity – well known are the Jobst garments with the Elvarex and Confidence fabrics. For night time is the Relax fabric.
- Haddenham – well known is the Goldpunkt and Pertex garments. For night time is the Comfiwave fabric.
- Medi – well known are the Medi550 garments
- Thusane – well known is the Mobiderm products
- For pumps – Medi-Rent are a trusted brand and affordable monthly hire for patients
To learn more about compression garments you can undertake our Lymphoedema Accreditation Course called CANpractice.