Lymphedema Care
Popular Compression Garments and Devices:
Comparing Your Options
Compression therapy is not “one size fits all.” Even within each category—flat-knit, circular-knit, wraps, or pumps—there are different styles, fabrics, and technologies that make a big difference in comfort and effectiveness.
Here’s a closer look at popular options, what sets them apart, and how to know what might work best for you.
1. Flat-Knit Garments:
Character:
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Made with thicker yarn, cut-and-sewn with seams.
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Provide firm containment (strong resistance to swelling pushing out).
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Usually custom-made, so they match irregular limb shapes.
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More durable than circular-knit, but thicker and less cosmetic (International Lymphedema Framework [ILF], 2020; Reich-Schupke, 2019).
Differences within Flat-Knit:
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JOBST & Medi → very firm, long-lasting, less stretch = best for severe cases.
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Sigvaris & Juzo → softer feel, more comfort, may be preferred for sensitive skin or active patients.
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Tribute® → unique foam features, better for fibrotic tissue.
Best fit: Moderate–severe lymphedema, irregular limb shape, or post-surgical contours.

2. Circular-Knit Garments:
Character:
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Knitted in a seamless tube; thinner and more elastic.
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Stretchy, breathable, and more cosmetic (look like normal hosiery).
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Not as effective for severe swelling or irregular shapes (ILF, 2020).
Differences within Circular-Knit:
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JOBST Bella & Juzo Soft → thinnest, most cosmetic.
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Medi Mediven Plus & Juzo Dynamic → more durable, stronger hold.
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Sigvaris Comfort → best for sensitive skin.
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CEP & Therafirm → lifestyle/sports focus.
Best fit: Mild or early lymphedema, venous disease, athletes, or patients prioritizing appearance and comfort.

3. Adjustable Compression Wraps (Velcro-Type):
Character:
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Wide bands with Velcro closures.
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Quick to adjust throughout the day.
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Easier for those with hand weakness or fluctuating swelling.
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Bulkier under clothing than knit garments (Reisshauer, 2025).
Differences within Wraps:
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Juxtafit → precise adjustments.
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FarrowWrap → strong containment, multiple versions.
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Compreflex & ReadyWrap → easiest for self-management.
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Juzo Wrap → softer, good for sensitive patients.
Best fit: Fluctuating swelling, limited hand strength, self-care at home, or during intensive reduction phases.

4. Nighttime Garments:
Character:
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Quilted, foam-lined, padded structures.
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Provide gentle, sustained compression overnight.
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Encourage lymph movement by micro-massaging tissue.
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More comfortable than daytime garments for sleep (McNeely, 2022).
Differences within Night Garments:
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JOBST Relax & Medi Mondi → easier pre-made options.
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Sigvaris Transition → hybrid, budget-friendly.
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TributeNight & JoviPak → customized, best for fibrosis.
Best fit: Patients who need 24-hour compression, especially with fibrosis or stubborn swelling.

5. Pneumatic vs. Non-Pneumatic Compression Devices:
Character:
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Devices that provide compression by squeezing the limb in cycles.
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Two main types: pneumatic (air-inflated chambers) and non-pneumatic (mechanical tension systems).
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Always used as adjuncts to garments, not replacements (Lerman, 2019; Ridner, 2020; Rockson, 2022).
Pneumatic Devices (IPC/APCDs)
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Inflating sleeves with air in programmed sequences.
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Basic pumps give uniform pressure; advanced pumps give adjustable segmental compression.
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Examples:
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Basic: Bio Compression Systems®, Lympha Press® Mini Press.
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Advanced: Flexitouch Plus® (Tactile Medical), Lympha Press Optimal Plus®, Entre® by Tactile Medical.
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Non-Pneumatic Active Compression Devices (NPACDs)
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Provide compression without air, using mechanical tension or powered strapping.
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Lightweight, wearable, allow mobility during treatment.
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Examples:
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Dayspring® (Koya Medical) – Portable, battery-powered.
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NanoviCare® prototypes (Europe) – Early mechanical models.
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6. Donning & Doffing Aids:
Character:
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Tools to help apply or remove compression garments.
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Essential for high-compression classes or patients with arthritis/hand weakness (Zuther & Norton, 2018).
Differences:
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Butler/frames → best for lower limb garments.
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Gloves & sliders → best for arms and delicate fabrics.
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Juzo Slippie Gator → good for mobility-limited patients.
Best fit: Anyone struggling with applying garments, especially with high compression or limited hand mobility.

Key Takeaway:
Each brand and model within a category has its own character:
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Flat-knit: best containment, custom options, different levels of stiffness and comfort.
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Circular-knit: cosmetic, softer, easier for mild cases.
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Wraps: adjustable, easier to self-manage, bulkier.
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Night garments: comfortable for 24-hour care, especially fibrosis.
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Pneumatic & non-pneumatic devices: valuable adjuncts, with pneumatic pumps best for advanced cases and non-pneumatic options offering mobility.
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Aids: make life easier and improve adherence.
Most patients benefit from a mix (e.g., flat-knit in daytime + night garment for sleep, plus pump for flare-ups).
Scientific References:
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International Lymphedema Framework (ILF). (2020). Best Practice for the Management of Lymphoedema. Wounds International.
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Reich-Schupke, S. (2019). Differences between flat-knit and circular-knit compression stockings. Phlebology, 34(1), 36–44.
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Reisshauer, A. (2025). Adjustable compression wraps: Clinical efficacy compared to multilayer bandaging. Journal of Lymphology, 58(2), 45–53.
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McNeely, M. L., et al. (2022). Nighttime compression therapy for breast cancer-related lymphedema. Supportive Care in Cancer, 30(7), 6001–6010.
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Lerman, M., et al. (2019). Advanced pneumatic compression devices in lymphedema management. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 7(6), 829–838.
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Ridner, S. H., et al. (2020). Pneumatic compression for lymphedema: Clinical outcomes. Cancer, 126(2), 435–445.
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Rockson, S. G., et al. (2022). Non-pneumatic active compression treatment for lymphedema: Early clinical trial outcomes. Journal of Lymphatic Research, 56(4), 210–219.
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Zuther, J. E., & Norton, S. (2018). Lymphedema Management: The Comprehensive Guide for Practitioners. Thieme.