Compression stockings

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How do compression stockings work?

Compression stockings apply external pressure on the vein walls through the elastic memory of the stocking once applied and properly positioned. The pressure better supports the veins and allows the valves in our veins to function properly. These one-way valves prevent blood from backflowing and promote venous blood return to the heart.

Medical-grade compression is typically graduated distal to proximal or from the feet to the torso. The pressure will be greatest from the ankle region, and gradually reduced along the length of the stocking to the knee or up to the thigh, depending on the style of stocking selected. This therapeutic pressure profile assists with the promotion of fluid to the trunk. Ensure you are properly fitted with the appropriately sized stocking to provide accurate compression and optimized comfort.

Recent studies have shown that when the calf pump function is enhanced, greater therapy can be achieved. Compression garments can be used to create a “wall of resistance” that allows the calves to pump more efficiently to enhance blood flow. The resistance can vary based upon the stiffness of the garment. In most cases, the stiffer the material, the greater the therapy, and the softer, more pliable material, will provide less therapy.

calf pump depiction

What compression stockings are best for varicose veins or venous health issues?

The heart pumps nutrient and oxygen-rich blood to our extremities though the arterial system. Veins in the legs carry blood back to the heart. Veins have one-way valves that keep bleed from flowing backwards. If you have a form venous disease, the valves won’t work as they should, and blood may retreat back towards the feet. If veins cannot operate effectively, the blood pools in the legs, and various forms of venous diseases can develop like varicose veins or venous leg ulcers.

Most venous-related conditions can be treated with elastic compression therapy stockings like the mediven® or duomed®brands. The mediven and duomed brands are made with the most technologically advanced materials, are machine-washable, and come with a 6-month compression guarantee.

For more serious venous conditions, an inelastic garment like the circaid® juxtalite® works best when there is edema prevalent or when application of traditional stockings is too challenging.

What compression products are best for wound care (venous leg ulcers)?

Venous leg ulcers are a severe venous condition that can be painful to the point of debilitating. These are open wounds that occur typically near the medial malleolus and can vary in size. There are several treatment plans to heal ulcers but they always require some form of compression therapy either as compression garments, bandaging or pneumatic pumps.

At medi®, we break down the venous ulcer healing process into three stages, the Diagnostic/Acute phase, the Treatment phase and the Preventive phase. During the Acute stage, it is recommended to use bandaging or bandaging alternative products for compression while the edema and exudate levels are moderated. The Treatment phase is when compression garments like the circaid juxtalite, the circaid juxtalite hd, or the mediven dual layer products should be used to help accelerate the healing process with a consistent dosage of firm compression. When compared to bandaging or multi-layer compression systems, these garments are proven to heal faster, reduce supply costs, and engage with patients for long-term success. The process is completed at the Preventive phase when the ulcer is closed. The consistent use of either mediven elastic or circaid inelastic products will help keep the venous disease from advancing to severe stages again.

What compression stockings are best for lymphedema?

Lymphedema occurs when the lymph fluid cannot flow towards the lymph nodes in the trunk properly and accumulates in the tissues. It’s often compared to a traffic jam. The arms and legs swell up and edema forms, and with that, chronic swelling.

At medi, we have defined the different uses of compression throughout the three phases of treatment for lymphedema. Treatment for lymphedema should always be conducted by a certified therapist who will incorporate compression therapy with therapeutic massage techniques. During the Decongestive phase, a variety of products can be used to include bandaging, pneumatic pumps and bandaging alternatives like the circaid® reduction kit to bring the affected limb, or limbs, to a more manageable level. The Transition phase begins when a stability garment is introduced like the circaid juxtafit that provides excellent containment, adjustability to wear day and night, and the ability to fluctuate up or down as the patient learns to manage their disease. Once treatment is complete, the patient moves to the Maintenance phase with solutions like the mediven flat-knit product offering or continues with the inelastic circaid products.

What are flat-knit compression garments?

Lymphedema conditions are best treated with stiffer or stronger compression materials that help contain the edema in the affected limb. These products are typically custom-made (made-to-measure) to meet the specific needs of the patient. Additionally, unique solutions can be added to the garment for targeted decongestion, flex zones for greater mobility, and suspension strips to help keep garments in place. The mediven flat-knit collection is available in product choices to meet therapeutic needs and designs to meet personal lifestyles.

What are inelastic compression wraps?

Inelastic compression wraps are typically made from neoprene-like materials that have little stretch to provide excellent containment for edema control. Compression is manually applied via a strapping and Velcro® method to deliver the desired therapy. Inelastic products are a good alternative to elastic garments due to their ease of application, versatility to be worn 24-hours-a-day, and ability to be used during all phases of lymphedema and wound care treatment.

The circaid products by medi are the original Velcro® compression device and the clinically proven brand that all others are measured. circaid products have measurable compression levels for proper therapy, use the Juxta Lock system for instant adjustability, and come with industry-leading warrantees. The circaid collection for lymphedema treatment is made up of juxtafit premium, juxtafit essentials, graduate and the reduction kit.

How do I select the right compression stocking or compression garment?

Choosing the correct compression therapy product best suited for you will depend on the clinical diagnosis of a physician or your therapeutic need when self-treating with lower compression levels. Based on a clinical assessment by a physician, a compression level or pressure will be selected, a style or length, and a product based on the required stiffness desired. In the end, optimized compression therapy plus a high level of compliance will result in the best results.
 

What compression stockings are best for work or long periods of standing?

In a study published in the Journal of Dermatological surgery it was determined that patients with venous health conditions experienced lifestyle benefits when wearing medical-grade levels of graduated compression. Not only physical improvements like swelling and cosmetic enhancements occurred, but lifestyle benefits such as reduction in sleep problems, an increase in patient activity, and an improvement of overall well-being were found.  

The mediven collection of graduated compression products has a wide selection to provide solutions for both men and women. Women who want a more fashion-forward product with maximum transparency typically choose the mediven sheer & soft product. Those who want a smooth and soft product that looks more like today’s opaque tight will select the mediven comfort. Our male customers who want a more traditional look will gravitate to the mediven for men classic while those who are looking for a modern style may choose the mediven for men select. Both men and women who spend long periods of time in casual footwear like boots and athletic footwear, may opt for the mediven active due to the padded footbed which helps fill the volume of the shoe better, while providing some additional cushion.

What compression stockings are best for pregnancy?

Women are more at risk to damage their venous system during pregnancy due to the increase in blood flow during this period of time, the increase in progesterone which “softens” muscle tissue to allow the uterus to expand, but also the muscles that support the vein walls, and the reduction in physical activity that promotes the overall circulation.

The use of graduated compression stockings can help reduce damage to the venous system while alleviating the symptoms during pregnancy of swollen legs and ankles, tired or heavy legs and potential discoloration. The use of compression therapy during pregnancy should always be conducted under doctor supervision as they can recommend appropriate compression levels and style/length of appropriate garment to be worn. It is recommended to obtain multiple pairs of stockings to ensure consistent use during the day and allow for regular wash and dry after every use. Compression stockings come in full-length pantyhose with added material for the late stages of pregnancy, thigh-length and calf-length styles. Many patients will acquire multiple styles for the various needs during pregnancy. There are some days a full-length garment might not be appropriate, and a calf or thigh-length will be sufficient. Again, always consult a doctor on your specific condition and compression treatment plan.

The mediven sheer & soft and comfort product collections have a full range of styles and colors that are ideal for use during pregnancy. These mediven collections are constructed with skin-friendly materials that contain medi Clima Comfort technology that help keep patients cool and dry all-day long. And more importantly, the mediven products are designed with medi Perfect Fit which will ensure accurate compression and therapeutic success.

What compression stockings are best for travel or long flights?

Graduated compression garments can help with the symptoms that occur during air travel such as the swelling, throbbing and even leg pain. The combination of low cabin pressure, low humidity, and inactivity in the air all contribute to the negative leg health outcomes of flying. In most cases, calf-length stockings are sufficient with compression levels greater than 15 mmHg. The use of mediven, duomed, or Rejuva® products can alleviate these symptoms for a fresh and joyful arrival. Always consult a doctor to ensure it is safe for you to wear compression therapy garments.
 

Are compression stockings covered by insurance or Medicare?

Compression stockings and other compression garments are a covered benefit in many cases when a prescription is written by an authorized clinician. The prescription must contain a qualifying compression level (20 mmHg or greater), indicate the style of garment (calf, thigh, pantyhose), and a diagnosis that meets the product requirements. More importantly, the information must be presented to a contracted provider who can bill and fit these products appropriately. You can refer to the dealer locator to contact potential contracted providers.
 

What are the HCPCS codes for compression stockings?

HCPCS codes are billing codes for graduated compression stockings when billed to insurance or a government-assisted program like Medicare or Medicaid. If you are an authorized medi dealer, please contact us to provide the necessary information.

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