Understanding Graduated Compression and Proper Fitting

Wound care experts explain how graduated compression works and match products to medical conditions.

• By Joseph Duffy
• Nov 01, 2017

Heather Trumm BSN, RN, CWON, director of wound care for VGM Group Inc., said that some of the top customer categories for compression are seniors, diabetic patients, wound care patients and lymphedema patients. So it’s important to understand what each patient category may need and how compression levels vary.

“There are varying levels of graduated compression,” she explains. “Compression comes in many different shapes and sizes. The measurement the compression is measured in is millimeters of mercury per square inch (mmHg). The greater the mmHg, the higher the compression. One very important factor to consider when choosing the correct compression for the individual is to first measure the ankle brachial index (ABI). It’s done by a health care professional and it measurers the pressure in each limb. If the measurement is greater than 0.8, then compression is contraindicated. If the ABI is greater than 0.8, it generally means that there is an arterial component in the patient’s disease state. The lighter compression worn by the general public tends to be around 10-15mmHg, 15-20mmHg and 20-30mmHg. You always want to consult with your physician to make sure you are in the correct mmHg compression.”

Along with using the right amount of compression, proper fitting is also very important. Kam Howard, executive vice president of Knit-Rite, says a proper fit is crucial for ensuring that the patient is receiving the therapeutic benefits of the prescribed compression. Therefore, make sure that:

• The manufacturer provides detailed instruction and tips on how to get the best measurements for their products. (Article participants Knit-Rite, SIGVARIS and ATN Compression offer such instruction.)
• Attend a fitter’s course or other related training (Knit-Rite and SIGVARIS offer educational courses and/or training). SIGVARIS offers both a basic fitter seminar and an advanced certified compression specialist training course for using their products. Both courses certify fitters in measuring, fitting and selecting the appropriate compression garment for common disease indications. The advanced seminar goes into treatment and longterm management.

Finally, Nikki Jensen, vice president of women’s health provider organization Essentially Women, created this compression therapy table to help in treating common medical conditions with compression:

MEDICAL CONDITION	TYPE OF COMPRESSION THERAPY
Lymphedema	Depends on affected limb. May be arm, hand, leg, foot, trunk
Pregnancy	Hosiery
Varicose veins	Stockings or socks
Diabetes	Stockings or socks
Venous Diseases	Stockings or socks
Deep Vein Thrombosis (DVT)	Stockings or socks

This article originally appeared in the DME Pharmacy November 2017 issue of HME Business.