GRADIENT COMPRESSION HELPS MAINTAIN LIMB VOLUME
During the maintenance phase of CDT, most patients will be transitioned into a gradient compression stocking or armsleeve and glove or gauntlet to manage their lymphedema daily. As you and your therapist start talking about which garment might work best for you, you will probably hear words like “flat-knit vs. circular-knit” and “custom vs. ready-to-wear.” It’s important to understand the different types of compression garments when deciding the best choice for your lymphedema care.
Flat-knitted garments are custom garments that are knitted on specially made machines that have a double row of needles facing each other at a 90-degree angle. The advantage of flat knitting is that exceedingly complex shapes can be knitted. Additionally, flat-knit garments have less stretch, and so generally provide better edema control than circular knit garments. Flat knit garments usually require custom fitting and manufacture for optimal results. These garments come out of the machine in a flat format and must be sewn together at a later stage.
Once sewn together, the garments will look just like your arm or leg! Flat-knitted garments are extremely well suited for larger or unusually shaped limbs and for those patients with difficult-to-manage swelling. The flat-knitting process allows for garments to bridge the gaps of any skin fold or crease preventing the garment from digging in and irritating the skin.
Circular-knit garments are those that are knitted on a round cylinder. Circular knitting has been around for a very long time and is basically an automated version of the Knitting Nancy. These machines have a fixed number of needles – the more needles a machine has, the wider the garment. These garments are seamless and more tubular shaped versus custom garments. Circular knitted garments have a bit more stretch and are best suited for patients with mild to moderate lymphedema with normally shaped limbs.
Gradient compression stockings and armsleeves can come in standard “off-the-shelf” sizes. Meaning, they are predetermined sizes such as small, medium and large. If you have mild to moderate edema and normally shaped limbs, you may be able to fit into a RTW garment. However, if your swelling is difficult to manage, or you have an abnormally shaped limb, you may be best suited in a custom-made garment. The benefit of a RTW garment is that it is immediately available to you as it is sold directly from your therapist or at your local Durable Medical Equipment (DME) store.
Custom-made gradient compression garments are those that are knitted specifically to your limb shape and size. Nothing fits better than a garment created especially for you! Your therapist, or another fitter specifically trained to measure and fit for custom garments, will take a series of circumferential and length measurements that will, in essence, design the garment to fit your limb. Since a properly fitting garment is essential to its comfort and effectiveness, it is important that it be measured by someone who has been professionally trained.