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Lymphedema Care 

Compression Garments & Devices for Lymphedema:
What to Choose, Why, and When

Why Compression Matters:

Compression is the cornerstone of lymphedema care. It doesn’t just “squeeze swelling down” — it helps your limb hold the improvements made with therapy, reduces daily fluid shifts, and keeps you moving. But with so many garment types and devices available, knowing what’s right for you can feel overwhelming.

 

This guide breaks down the science, garment options, and practical tips so you can make informed choices.

Types of Compression Garments:

Flat-knit vs Circular-knit

  • Flat-knit (seamed, firmer): Best for irregularly shaped or more advanced lymphedema. Provides strong containment, resists rolling, and is often custom-made (ILF, Wounds International; Reich-Schupke 2019).

    • Examples: JOBST Elvarex®, Medi 550 Flat-Knit, Sigvaris Compreflex® Custom.

  • Circular-knit (seamless, stretchier): Often off-the-shelf, comfortable, and cosmetically smooth. Best for early or mild swelling with regular limb shape. May cut in on skin folds if more compression is needed.

    • Examples: JOBST Bella Lite® Arm Sleeve, Medi Mediven Plus®, Sigvaris Essential Comfort®.

 

Custom vs Off-the-Shelf

  • Custom-made: Tailored fit, usually flat-knit, ideal for asymmetry or complex contours.

  • Ready-to-wear: Faster and cheaper, often circular-knit, suitable for straightforward shapes.

 

Garment Components & Extras

  • Upper limb: sleeve + glove/gauntlet.

  • Lower limb: knee-high, thigh-high, pantyhose, with optional toe caps/foot pieces.

  • Extras: silicone top bands (reduce slippage), zippers/liners (comfort), donning/doffing aids.

    • Examples: Medi donning butler, Sigvaris Melany gloves, JOBST donning aid kits.

 

Adjustable Wraps (Velcro-type)

  • Easy to self-manage, great for intensive treatment or patients with hand strength issues. Recent trials show they work as well as traditional bandaging (Reisshauer 2025).

    • Examples: Circaid® Juxtafit, Sigvaris Compreflex®, JOBST FarrowWrap®.

 

Nighttime Garments

  • Quilted/foam “night sleeves” keep swelling down while you sleep. Studies show they can further reduce limb size and support self-management (McNeely 2022).

    • Examples: JOBST Relax® Night Garment, Sigvaris Transition Night®, Medi Mondi Esprit® Night Garment.

Compression Classes: How Much Pressure?

Garments Classes: garments are made in classes, describing how much pressure they provide

  • Class 1: 15–21 mmHg (light)

  • Class 2: 23–32 mmHg (moderate)

  • Class 3: 34–46 mmHg (firm)

  • Class 4: >49 mmHg (very firm)

 

General Recommendations (ISL, 2023; ILF Best Practice; Lozo et al., 2022):

Upper limb (arm/hand)

  • Mild/early: Class 1–2

  • Moderate/chronic: Class 2 (most common)

  • Severe/fibrotic: Class 3 if tolerated

 

 Lower limb (leg/foot)

  • Mild/early: Class 2

  • Moderate/severe: Class 3

  • Very advanced: Class 4 (selective use only)

 

Trunk, head & neck, genital

  • Usually custom-made; pressures similar to Class 1–2 for safety/comfort.

 

Key tip: The “right” class balances containment with comfort. Too low = ineffective. Too high = hard to tolerate. Always get fitted by a trained lymphedema professional.

Devices on the Market:

Intermittent Pneumatic Compression (IPC) “Pumps”

  • Basic pumps: Simple pressure sleeves, help reduce swelling short-term, but gains only last with ongoing garment use (Hou 2024).

    • Examples: Bio Compression Systems®, Lympha Press® Mini Press.

  • Advanced Pneumatic Devices (APCDs): Segmental and programmable; include options for trunk/head/neck. Studies show improvements in limb size, comfort, and fewer cellulitis episodes (Maldonado 2021; Lerman 2019; Ridner 2020).

    • Examples: Flexitouch Plus® (Tactile Medical), Lympha Press Optimal Plus®, Entre® by Tactile Medical.

 

New Wearable Devices (Non-pneumatic Active Compression)

  • Examples: Dayspring® (Koya Medical). Battery-powered, wearable, and designed for daily mobility. Early trials show promising results for volume reduction and patient satisfaction (Rockson 2022; Barfield 2025).

 

Takeaway: Devices are adjuncts, not replacements. They may help when garments alone don’t control swelling or in hard-to-treat areas like trunk, head, or neck.

Getting the Best Fit from Compression (Why Sizing After Reduction Matters)

CDT has two phases:

  1. Intensive decongestion: daily bandaging + manual lymph drainage (MLD) + exercise.

  2. Maintenance: garments + self-care.

 

Garments are meant to maintain the smaller limb—so they should be measured and fitted after you’ve achieved your best reduction, usually right when you move from intensive to maintenance (ILF; Wounds International; ISL, 2023).

 

Why timing matters:

  • Too early = garment will become loose as swelling decreases.

  • Too tight = can pinch, roll, irritate skin, or be intolerable.

  • Proper post-reduction measurement by a trained fitter improves comfort, adherence, and outcomes (Dzupina 2025; Cigna 2025).

Key Takeaways:

  • Compression is the foundation of long-term lymphedema care.

  • Garment choice depends on shape, severity, and lifestyle needs.

  • Flat-knit/custom = stronger containment, irregular limbs.

  • Circular-knit/ready-to-wear = good for early/mild cases.

  • Wraps/night garments and devices are helpful add-ons.

  • Correct class depends on limb, severity, and tolerance 

  • Always measure after reduction for best fit and adherence.

Scientific References:

  • Barfield, M., et al. (2025). Comparative study of a nonpneumatic compression device vs APCD for lower-extremity lymphedema. JVS-Venous and Lymphatic Disorders.

  • Damstra, R. J., & Partsch, H. (2013). Adjustable compression wraps vs multilayer bandaging in lymphedema: RCT. JVS-Venous and Lymphatic Disorders.

  • Dzupina, A., et al. (2025). Compression garment adherence and timing of fitting: clinical outcomes. Phlebology.

  • Hou, S., et al. (2024). Intermittent pneumatic compression as adjunct to CDT in breast-cancer–related lymphedema: Meta-analysis. GS (AME Publishing).

  • International Lymphoedema Framework (ILF). (2019). Best Practice for the Management of Lymphoedema.

  • International Society of Lymphology (ISL). (2023). Consensus Document: Diagnosis and Treatment of Peripheral Lymphedema. Lymphology.

  • Lerman, M., et al. (2019). Health and economic benefits of advanced pneumatic compression. Journal of Vascular Surgery.

  • Lozo, M., et al. (2022). Compression structure and pressures of medical stockings. Polymers.

  • Maldonado, T. S., et al. (2021). Quality-of-life improvements with APCD in lower-extremity lymphedema. JVS-Venous and Lymphatic Disorders.

  • McNeely, M. L., et al. (2016). Feasibility of nighttime compression in breast-cancer–related lymphedema. BMC Cancer.

  • McNeely, M. L., et al. (2022). Nighttime compression improves self-management in lymphedema: RCT. Cancer.

  • Reisshauer, A., et al. (2025). Adjustable wraps non-inferior to inelastic bandaging in CDT. Phlebology.

  • Reich-Schupke, S., et al. (2019). Flat-knit vs round-knit compression garments: Expert consensus. Phlebology.

  • Ridner, S. H., et al. (2020). APCD for head & neck lymphedema: Waitlist trial. Supportive Care in Cancer.

  • Rockson, S. G., et al. (2022). Safety and effectiveness of a novel non-pneumatic compression device. Scientific Reports.

  • Wounds International. (2021). Lymphoedema practice patterns: garment definitions and fitting.

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