Compression garments are specialized elastic medical devices designed to apply controlled pressure to a limb or body part. This pressure promotes better circulation by assisting the veins in pushing blood back toward the heart, reducing swelling and preventing conditions like deep vein thrombosis. The therapeutic effectiveness depends on graduated compression, meaning the pressure is strongest at the ankle and gradually decreases further up the leg. Because they fit tightly and exert significant force, compression stockings and sleeves are difficult to apply correctly. Proper application ensures the pressure gradient is maintained, allowing the garment to provide its full medical benefit while remaining comfortable.
Essential Preparation Steps
The process of donning a compression garment begins with preparing the skin and environment to minimize friction and prevent material damage. Apply the garment early in the morning when the limb is least swollen, often before getting out of bed. Ensuring the skin is completely dry and free of lotions or oils is crucial, as moisture dramatically increases friction, making the garment stick and pull.
A light dusting of talcum powder or cornstarch acts as a dry lubricant, helping the stocking slide more easily. Before starting, remove all jewelry, especially rings, to prevent snagging or running the delicate elastic fibers. Finally, check the stocking to ensure it is not twisted and that the heel and toe portions are correctly oriented.
Step-by-Step Donning Instructions
The manual technique for applying a compression stocking relies on turning the material inside out to manage the high tension of the elastic fabric. Begin by reaching into the stocking and grabbing the heel pocket, then folding the upper portion of the material back over your hand until the garment is inside out, stopping at the heel. This creates a small pouch for the foot, exposing the high-compression foot and ankle sections for easier placement.
Carefully slide the foot into the stocking until the heel is centered in the heel pocket and the toes are positioned at the end of the toe box. With the foot situated, grasp the gathered material just above the ankle and slowly pull the fabric up over the ankle and calf. Use the palms of your hands to work the garment up the leg in short, gradual sections, avoiding forceful tugging from the top band. The goal is to slowly roll the fabric up the limb, minimizing stretching and preventing creases or wrinkles.
Utilizing Specialized Application Aids
Specialized tools can simplify the process of applying high-compression garments, particularly for individuals with limited mobility or reduced grip strength. Donning gloves, typically made of rubberized material, provide enhanced friction and grip on the smooth fabric. These gloves make it easier to pull the garment up and protect the delicate fabric from fingernails, which can cause runs.
Rigid metal or plastic frames, sometimes called butlers or sock aids, are designed to hold the stocking open, allowing the foot to slide into the garment without bending. Other aids include slippery liners or “slippies” that are worn over the foot and ankle, temporarily reducing friction so the stocking can slide easily into place. Once the stocking is pulled up past the ankle, the slick liner can often be removed through the open toe of the compression garment.
Checking for Correct Placement
Once the garment is fully on, a final inspection ensures the compression is applied safely and effectively. Run your hands over the entire surface to smooth out any wrinkles, folds, or bunching. Wrinkles create concentrated bands of pressure that may act like a tourniquet, compromising circulation. Confirm that the heel pocket and toe box are correctly positioned and that the top band, or welt, lies flat against the skin. The top edge should never be rolled down, as this doubles the pressure and can lead to constriction.