Clinical Perspectives
Key Considerations for Garment Selection By Jean Ann Ryan
ompression is an important element of lymphedema management for both active treatment and maintenance of the condition. Often patients are treated with some form of compression bandaging to first decrease the amount of swelling, and then they are ready to be prescribed and fitted with a compression garment. Choosing the right garment can be challenging. A poor choice can lead to the patient simply choosing to not wear the garment or to wear it for less than optimal time. A few key considerations will help ensure the correct style and fit are obtained,
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increasing the likelihood that the garment is worn in the prescribed way. The first step in proper garment selection begins with a thorough assessment, including a complete medical history, review of any comorbidities, social history and supports, as well as a complete physical evaluation. Upon assessment the client, together with their healthcare provider will choose a style and compression that is best suited to the individual client’s needs. Sometimes the optimal therapeutic choice needs to be balanced with what is practical and acceptable to the patient. A certified compression garment fitter is required to ensure that an appropriate product is selected and specific measurements are taken to get the proper fit. Compression garments for the upper extremity are available as prepackaged or custom made sleeves, gauntlets, and gloves. For arm lymphedema most patients require either a compression level or Class I (20 –
Jean Ann Ryan, RN, CDT is an oncology nurse working in St. John’s, NL., at the Dr. H Bliss Murphy Cancer Centre. She has been working with lymphedema patients and fitting compression garments for over 15 years. She is actively involved in the CLF and the Atlantic Clinical Lymphedema Network.
A certified compression garment fitter is required to ensure an appropriate product is selected. 30mmHg) or a Class II (30 – 40mmHg). For the lower extremity compression typically Class II (30 – 40mmHG), Class III (40 – 50mmHg), and very occasionally Class IV (60mmHg or higher) is required. Lower extremity garments come in a variety of lengths and styles including knee high, thigh high, and pantyhose style. There are options for either open or closed toes. Other compression garments available include brassieres or vests for breast or chest wall edema, Whittaker pouch for scrotal/genital edema, and a variety of compression masks for facial edema. Flat knit garments are typically custom made and may provide a superior fit. These garments are “tailor made” specifically for the individual patient. The fitter will take numerous measurements of the limb so the manufacturer can produce a garment
You Are Not Alone You have access to information, resources, contacts and support from people who know what you’re going through from their own personal experience. You have the following organizations on your side.
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Alberta: Alberta Lymphedema Association
www.albertalymphedema.com
British Columbia: BC Lymphedema Association
www.bclymph.org
Manitoba: Lymphedema Association of Manitoba
www.lymphmanitoba.ca
Ontario: Lymphedema Association of Ontario
www.lymphontario.ca
Quebec: Lymphedema Association of Quebec
www.infolympho.ca
Saskatchewan: Lymphedema Association of Saskatchewan
www.sasklymph.ca
Ly m p h e d e m a p a t h w a y s . c a
Fall 2012