Stockinette is a seamless, tubular fabric used primarily in medical settings, acting as the first layer placed directly against the skin before a rigid cast or beneath a compression bandage. Its main role is to provide a smooth, comfortable barrier for the patient’s skin. The correct size is determined by the circumference of the leg to ensure the material lies flat without constricting blood flow.
The Purpose and Types of Stockinette
Stockinette performs two primary functions when applied to the leg: protecting the skin and securing underlying materials. It acts as a gentle shield between the skin and the hard, rough surface of a plaster or fiberglass cast, preventing irritation and rubbing. It also helps secure primary wound dressings before cast padding is applied.
The material composition varies, with common types including breathable and absorbent cotton or cotton-polyester blends for general use. Synthetic stockinette, often made from polypropylene, is used with waterproof casting systems. This open-knit construction allows for air circulation and helps wick away moisture, which aids skin health and reduces the risk of infection under the cast.
Essential Leg Measurements for Selection
Selecting the proper size begins with accurately measuring the leg at its widest point within the area the stockinette will cover. For a lower leg cast, this measurement is typically taken around the largest part of the calf or the ankle, depending on the cast’s length. A flexible tailor’s tape should be used to measure the circumference of the limb.
This circumference measurement is the basis for choosing the correct tubular width. Stockinette is sized based on its flat width. For the stockinette to fit properly, the flat width needs to be slightly more than half of the leg’s circumference to allow for easy application and minimal stretch. For example, a leg with a circumference of 10 inches requires a stockinette wider than 5 inches when laid flat, allowing for slack.
Standard Sizing Codes and Matching
Commercial stockinette is identified by its flat width, measured in inches or centimeters. Common sizes for adult legs fall within the 3-inch, 4-inch, 5-inch, and 6-inch flat width range. A 3-inch stockinette is suitable for the ankle or smaller adult arms, while a 4-inch width is a common choice for an average adult lower leg.
For larger areas like the calf or thigh, a 5-inch or 6-inch stockinette may be necessary to accommodate the greater circumference. The goal is to choose a size that provides a snug fit without requiring excessive stretching during application. Doubling the flat width provides the relaxed circumference; the stockinette should stretch slightly beyond this value, typically an extra half-inch to one inch, to fit comfortably without constricting.
Proper Application and Fit Check
The technique for applying stockinette is important. The material should be rolled smoothly onto the limb, similar to donning a sock, taking care to avoid wrinkles or bunching. Wrinkles under a cast can create high-pressure areas, potentially leading to skin breakdown or sores.
Once applied, the fit must be checked visually and manually to confirm the size is appropriate. The stockinette should lie flat against the skin but must not indent or compress the tissue, as this indicates it is too tight and could compromise circulation. If the stockinette is noticeably baggy or slides easily on the limb, it is too loose, and its protective function will be compromised. The correct size conforms gently to the limb’s contours, providing a smooth layer that extends approximately two to four inches beyond both ends of the planned cast area.