Main findings

This paper provides a comprehensive guide for selecting compression garments and wraps. It is an essential resource for practitioenrs new to this area and an excellent review for advanced practitioners. Topics include:

• COMPRESSION SCIENCE
  • In vivo dosage testing
  • Compression Dosage Gradient
  • Compression dosage classes
  • Dosage diminished by garment fatigue
  • Adjustable wrap compression dosage
  • Dosage prescription
• STIFFNESS
  • Textile stiffness
  • In vitro stiffness measurement
  • In vivo stiffness measurement
  • In vivo static stiffness index (SSI)
  • In vivo dynamic stiffness index (DSI)
  • Resting and working pressures
• COMPRESSION GARMENT CATEGORISATION
  • Circular knit
  • Stiffer circular knit
  • Flat knit
  • Adjustable wraps
  • Night garments
• T.R.I.D.E. ALGORITHM
  • S = SHAPE Shape of the limb and distribution of the oedema corresponding to garment types, shapes and sizing
  • T = TEXTURE Texture of the oedema and soft tissues and corresponding types of textiles used to treat it
  • R = REFILL Dynamics of the oedema, such as refill during the day or night, and time to refill
  • I = ISSUES Issues including precautions, contraindications and challenges to successful compression usage
  • D = DOSAGE The labelled dosage/ankle pressure (mmHg) versus resting and working pressure, distribution of pressure, and garment fatigue
  • E = ETIOLOGY Consideration of underlying diagnoses, or etiologies, contributing to the oedema presentation and corresponding characteristics regarding tissue texture, shape/distribution and compression therapy needs.
• S = SHAPE

Q: Where is the swelling located? Q: Does the dimension of the limb match with standardised sizing charts, or is custom compression needed? Q: What is the shape of the limb compared to the shape of the garment?

• T = TEXTURE

Q: What is the texture of the tissue? Q: Does the tissue easily pit or does it have a more putty-like consistency? Q: What is the best textile type to match the tissue texture?

• R = REFILL

Q: Does the oedema increase during the day only, or day and night? Q: How fast does the limb increase in size when compression is removed?

• I = ISSUES

Q: Are there medical concerns that would limit compression use/application? Q: What are the barriers to successful oedema management? Q: What modifications can be made to overcome identified barriers?

• D = DOSAGE

Q: What is the appropriate dosage based on medical diagnosis, precautions, contraindications, and underlying oedema etiologies? Q: Do certain areas of the limb require greater compression dosage due to size or texture?

• E = ETIOLOGY

Q: What comorbidities are contributing to the oedema/lymphoedema?