Compression hosiery formulary: Highland HSCP only (Formularies)

TAM (Treatments and Medicines) NHS Highland
NHS Highland

Purpose:

To support the effective management of patients affected by chronic oedema and/or lymphoedema.
Compression hosiery is used for the management of venous and lymphatic disorders by helping to minimise swelling and aid the flow of blood and lymph (Neil & Turnbull, 2012).

This formulary is for any health practitioner who recommends or prescribes compression garments. It should be used for any patient who requires compression garments as it includes all compression garments/hosiery that is used to treat a wide range of conditions:

  • Venous leg ulcers
  • Chronic venous insufficiency
  • Lymphoedema, primary and secondary
  • Dependency oedema
  • Venous oedema
  • Lipoedema
  • Other types of chronic oedema (oedema > 3 months)

Compression hosiery is NOT the same as anti-embolism stockings.

  • Each has a specific clinical role.
  • Anti-embolism stockings are NOT intended for long term use.

Assessment

A comprehensive medical and social history should be undertaken with all patients regardless of vascular status (NWCSP, 2020).

Before prescribing compression hosiery, the patient should be assessed for the following:

  • Absent foot pulses, or diminished compared with other side
  • Poor capillary refill – should be less than 3 seconds
  • Cold leg and/or foot when compared with the other side
  • Painful cramping in calf muscles brought on by activity, such as walking or climbing stairs (intermittent claudication) and relieved by rest
  • Obvious lower limb ischaemia, especially rest pain and/or gangrene/ ischaemic ulceration.

If any one or more of these is present, the calculation of an Ankle Brachial Pressure Index (ABPI) may be considered necessary.  Those patients with suspected peripheral arterial disease should be referred to the vascular department for assessment.  It is important to be aware that an ABPI can only be recorded accurately in a non-oedematous limb, therefore it may be necessary to apply 20mmHg compression to reduce the swelling before undertaking ABPI measurement (NWCSP, 2020).

The condition of the skin must be considered as fragile skin may be damaged whilst donning or doffing compression hosiery.  Dexterity and the ability of the patient to reach their feet must also be considered, appropriate donning aids and/or assistance arranged if necessary.  A wrapping device may be more appropriate in these instances.

Lower limb compression therapy selection guide

For use following full patient assessment.

Is the patient at risk / have oedema but no wounds? 

Does the patient have oedema and wounds? 

Provide advice on skin care, exercise and movement, weight management, leg elevation and sleeping in a bed.

If the patient has oedema, refer to referral pathway

Provide advice on skin care, exercise and movement, weight management, leg elevation and sleeping in a bed.

If the patient has oedema, refer to referral pathway

Follow the wound management formulary for dressing choice

Consider referral & collaboration with your local Tissue Viability service for advice and support on dressings.

Garments for at risk / mild oedema:

  • Below knee or thigh length. Class 1 or 2 as indicated: Duomed Soft, Jobst Ultrasheer, mediven Elegance
  • If skin sensitivity: consider Haddenham Star Cotton

Bandaging for moderate / severe oedema 

Consider collaboration with lymphoedema services to apply multi-layer bandaging (MLLB) if indicated to reduce or reshape the limb

  • Bandages: short stretch inelastic Actico or similar or consider ‘Wrap’ - Juzo ACS Light, L& R ReadyWrap, Jobst Farrowwrap,
  • Toe caps: Haddenham Microfine or Jobst Farrow toecaps

If oedema is present above the knee, consider applying compression to the whole leg

Garments for moderate / severe oedema

If good / normal shape limb: 

  • Circular Knit Below Knee or Thigh CCL1-2: Jobst Opaque or Ultrasheer, Mediven for Men, Mediven Active, Juzo Soft or Move, Mediven Elegance or Plus,
  • Circular Knit Tights CCL1- CCL2: Jobst Opaque or Ultrasheer, Juzo Soft, Mediven Elegance
  • Lower Compression Below Knee or Thigh (for palliative use): Duomed Soft

If poor shape limb (skin folds, distorted shape):

  • Custom Flat knit below knee, thigh length or tights CCL1-3: Jobst Elvarex / Elvarex Soft, Mediven Mondi / Cosy, Haddenham Pertex

Toe Caps: Haddenham Microfine Toecaps / Jobst Farrow Toecaps

If hosiery cannot be donned/doffed, consider donning aids such as: Medi 2in1, Easy Slide, Magnide, Medi Big Butler, Sigvaris Rolly,

If the patient has difficulty with compression garments consider a “wrap” which can be adjusted independently: Juzo ACS Light, L&R ReadyWrap, Jobst Farrowwrap


Ankle Brachial Pressure Index (ABPI) / Toe Brachial Pressure Index (TBPI)

ONLY needs to be taken if there are clinical signs and medical history indicating arterial problems that would contraindicate compression including:

  • Diminished or absent foot pulses
  • Poor capillary refill: should be less than 3 seconds
  • Cold leg and/or foot, when compared with the other side
  • Painful cramping in calf muscles brought on by activity, such as walking or climbing stairs (intermittent claudication) and relieved by rest
  • Obvious lower limb ischaemia, especially rest pain and/or gangrene / ischaemic ulceration.

If the patient has UNSTABLE Cardiac Failure then collaborate with GP/ Consultant prior to treatment.

Guidance for compression therapy for patients with heart failure

If patient is already stabilised on compression and has an acute episode of deteriorating heart failure, DO NOT REMOVE COMPRESSION

flowchart for compression therapy for patients with heart failure

 

For further information on the management of lymphoedema in heart failure, see: British Lymphology Society - BLS (thebls.com)

General hosiery considerations

  • Choice of garment depends on the individual circumstances of each patient, eg dexterity, ability to reach feet, availability of assistance, and condition of skin.
  • Circular knit hosiery is not suitable for limbs with skin folds, eg at ankle or knee, as these garments will create a tourniquet effect in the skin folds.
  • Most patients will be suitable for a below knee option but thigh-length stockings or tights are required for oedema that extends to the thigh and groin area.
  • Most patients will be suitable for stock size, however made to measure garments are required for those with disproportionate limbs, skin folds, or severe oedema/lymphoedema with skin changes.
  • Scrupulous washing and drying of the skin followed by moisturising is required at each stocking change.
  • Ensure folds and creases in the garment are smoothed out during application and wear to prevent pressure damage.
  • Hosiery should usually be removed at night and applied first thing in the morning. If oedema reoccurs overnight (rebound oedema), garments may be worn at night.  In patients who cannot apply the garment without assistance and rely on health and social care services to assist them, it can be left on for up to three days.
  • Application aids may be required to assist self management and should be offered to all patients.
  • Hosiery should be washed in mild detergent and hung dried.  Fabric softener should not be used.  Most garments can be washed on a cool (30⁰C) cycle.  A spin cycle can be used to assist drying if washing by hand.  Some garments can be tumble-dried on low setting but check manufacturers’ instructions.
  • RAL classes of hosiery should be renewed every six months or earlier if damaged, eg ladders, holes.  The compression in British Standard class hosiery is only guaranteed for three months.  If the stockings are effective and remain a good fit, repeat garments can be prescribed without the need for further measurement.
  • British Standard Class 1 Hosiery can be bought over the counter; however patients should not be commenced in any hosiery with higher compression capabilities without full holistic assessment.

Choice of prescribable garments in presence of chronic oedema in lower limb

Assess texture of tissues and choose appropriate texture of garment

Texture of tissues

Type of garment

Prescribable garments

Watery

Soft, easily pits, rebound <30 seconds

Negative Stemmer’s sign *

 

Elastic

Stretchy and gives sustained pressure even at rest but lower containment capability

Wide range of ‘off the shelf’ garments

Circular knit garment  (do not use in presence of skin folds)

Adjustable wraps are useful over wound dressings and can accommodate reduction in girth.

British standard

  • Medi Duomed Soft

RAL standard – class 1

  • Jobst Opaque
  • Mediven for men
  • Mediven Active
  • Haddenham Veni
  • Haddenham Star Cotton – 100% cotton next to skin
  • Juzo Soft

Adjustable wrap – choice depends on shape of leg and patient dexterity

  • Jobst Farrowwrap Lite
  • L&R ReadyWrap

Fatty

Spongy with redundant tissue

Loss of shape with/without skin folds and fat pads

Negative Stemmer’s sign*

Stiff

Stiffer fabric that supports and shapes the tissues and bridges skin folds

Offers higher containment

Stiff circular knit garment (do not use in presence of skin folds), custom flat knit or adjustable wrap

Adjustable wrap can accommodate reduction in girth. May be easier to don and doff.

RAL standard – class 2

Circular knit

  • Jobst Opaque
  • Mediven for men
  • Mediven Active
  • Haddenham Veni
    Haddenham  Star Cotton – 100% cotton next to skin
  • Juzo Soft

Custom flat knit

  • Jobst Elvarex (contains latex) or Elvarex Soft (latex free)
  • Mediven Mondi or Cosy
  • Haddenham Pertex – palliative use only

Adjustable wrap – choice depends on shape of leg and patient dexterity

  • Jobst Farrowwrap Lite or Strong
  • L&R ReadyWrap

Putty

Early fibrotic changes with putty consistency

Pits with prolonged pressure, rebound >30 seconds

Positive Stemmer’s sign*

Stiff

Stiffer fabric  supports and shapes the tissues and bridges skin folds

Offers higher containment

Stiff circular knit garment (do not use in presence of skin folds), custom flat knit or adjustable wrap.

May benefit from textured insert or garment, eg night garment.

Adjustable wraps are useful over wound dressings and can accommodate reduction in girth. May be easier to don and doff.

RAL standard – class 2 or 3

Circular knit

  • Mediven plus
  • Juzo Dynamic

Custom flat knit

  • Jobst Elvarex (contains latex) or Elvarex Soft
  • Mediven Mondi
  • Haddenham Pertex - palliative use only

Adjustable wrap – choice depends on shape of leg and patient dexterity

  • Jobst Farrowwrap Strong or Classic
  • L&R ReadyWrap

Woody

Fibrotic changes with firm, woody texture

Does not pit even on deep pressure

Positive Stemmer’s sign*

Stiff

Stiffer fabric  supports and shapes the tissues and bridges skin folds

Offers higher containment

Stiff circular knit garment (do not use in presence of skin folds), custom flat knit or adjustable wrap.

May benefit from textured insert or garment, eg night garment.

Adjustable wraps are useful over wound dressings and can accommodate reduction in girth. May be easier to don and doff.

RAL standard – class 2 or 3

Circular knit

  • Mediven plus
  • Juzo Dynamic

Custom flat knit

  • Jobst Elvarex (contains latex)

Adjustable wrap – choice depends on shape of leg and patient dexterity

  • Jobst Farrowwrap Strong or Classic
  • L&R ReadyWrap

Fragile

Thin, fragile skin prone to skin tears, usually watery oedema

 

 

Layered

Layering one compression garment over another increases stiffness and may protect fragile skin from damage during donning and doffing. It is also useful over a wound dressing.

Garments can be layered using leg ulcer kits or using two lighter compression garments, eg Duomed Soft plus a RAL class 1 garment.

 

British standard

  • Medi Duomed Soft

Compression hosiery kit

  • BSN Ulcercare – outer stocking available with zip
  • Urgo Altipress  40
  • L&R leg ulcer hosiery kit
  • These options offer a separate pack of 3 liners

Adjustable wrap – choice depends on shape of leg and patient dexterity

  • Jobst Farrowwrap Lite
  • L&R ReadyWrap

* Stemmer’s sign is considered as diagnostic of lymphoedema/chronic oedema.  A positive Stemmer’s sign is the inability to pinch the skin at the base of the second toe due to oedema and fibrosis.

European/RAL Standard Circular Knit

Is made from stiffer yarn. It is suitable to manage symptoms of chronic venous insufficiency and prevent venous ulcer and ulcer recurrence in the presence of oedema/lymphoedema. It is only suitable for use in a normal shape limb, ie no skin folds or oedema that is greater in one part of the limb such as around the ankle.

Precautions/contraindications

Occasionally the wearing of compression garments can lead to problems in the following situations:

  • Immobility (confinement to bed)
  • Skin infections
  • Weeping dermatoses
  • Incompatibility to fabric
  • Impaired sensitivity of the limb

Absolute contraindications:

  • Severe arterial insufficiency
  • Uncontrolled congestive cardiac failure
  • Untreated infection

Relative contraindications:

  • Concomitant dermatoses
  • Intolerance to compression fabric
  • Sensory disturbance of the limb
  • Advanced peripheral neuropathy
  • Primary chronic arthritis.

Application

  • Step-by-step directions included with every garment ordered.
  • Reduces the risk of incorrect application technique leading to skin problems or trauma.
  • Advise the use of rubber gloves to help with application and assess for need for application aid.

Jobst Ultrasheer

RAL Class 1:
18-21mmHg

 RAL Class 2:
23-32mmHg
Below knee, size: I to VI petite or regular

For mild to moderate oedema and venous disease.

The fine yarn offers improved breathability and moisture management.
Thigh length, size: I to VI petite or regular
Tights, size: I to VI petite or regular

Jobst Opaque

RAL Class 1:
18-21mmHg

 RAL Class 2:
23-32mmHg
Below knee, size: I to VI petite or regular

For mild to moderate oedema and venous disease.

Stiffer fabric, more opaque fabric.
Thigh length, size: I to VI petite or regular
Tights, size: I to VI petite or regular
Juzo Soft Class 1:
18-21mmHg		 Class 2:
23-32mmHg
Below knee, size: I to VI, regular, short, extra short

For mild to moderate oedema and venous disease.

Soft knitted microfiber fabric, comfortable to wear but check leg shape.  Open or closed toe, grip top available below knee.
Thigh length, size: I to VI, regular, short, extra short
Tights, size: I to VI, regular, short, extra short
Juzo Move Class 1:
18-21 mmHg		 Class 2:
23-32 mmHg
Below knee, size: I to VI, regular, short, extra short, with/without grip top

For mild to moderate oedema and venous disease.

Soft knitted fabric, high microfiber content.  Unique knitting technique at ankle for easy donning and doffing.  Open or closed toe, grip top available on below knee.
Thigh length, size: I to VI, regular, short, extra short
Haddenham Veni  Class 1:
18-21mmHg		 Class 2:
23-32mmHg
Below knee, size: I to VIII, short, regular, long, with/without grip top

For mild to moderate oedema and venous disease.

Made to order (MTO) option offers extra wide, also short, regular and long leg and foot lengths, open or closed toe making custom fit unnecessary.  See website code finder for options.
Thigh length, size: I to VIII, short, regular, long
Tights, size: I to VIII, short, regular, long
Hadenham Star Cotton  Class 1:
18-21mmHg		 Class 2:
23-32mmHg
Below knee, size: I to VIII, short, regular, long, with/without grip top

For mild to moderate oedema and venous disease.

100% cotton next to skin so suitable for sensitive skin eg allergies, varicose eczema, psoriasis.

MTO options as above.
Thigh length, size: I to VIII, short, regular, long
Tights, size: I to VIII, short, regular, long
Mediven Elegance Class 1:
18-21mmHg		 Class 2:
23-32mmHg
Below knee, size: I to VII, petite or regular

For mild oedema and venous disease.

The fine yarn offers improved breathability and moisture management.

Only available in closed toe.  Extra wide option in thigh length.
Thigh length, size: I to VII, petite or regular
Tights, size: I to VII, petite or regular
Mediven Plus Class 1:
18-21mmHg		 Class 2:
23-32mmHg
Below knee Size I to VII petite or regular, open or closed toe

For mild to moderate oedema and venous disease.

Stiffer fabric but remains comfortable to wear.

Extra wide option available.
Thigh length size I to VII petite or regular, open or closed toe
Mediven for men  Class 1:
18-21mmHg		 Class 2:
23-32mmHg
Below knee, size: I to VII, petite or regular, closed toe

For mild to moderate oedema and venous disease.

Fine, ribbed ‘dress’ sock. Suitable for wide foot and/or longer second toe. Ideal for foot size 39-46.
Mediven Active Class 1:
18-21mmHg		 Class 2:
23-32mmHg
Below knee, size: I to VII, petite or regular, closed toe

For moderate oedema and venous disease.

Thicker, ribbed sock with padded sole, toe and heel.  Suitable for longer leg and wide foot.  Ideal for use with wellies or steel toe caps.
Mediven Cotton Class 1:
18-21mmHg		 Class 2:
23-32mmHg
Below knee, size: I to VII, petite or regular, closed toe

For mild to moderate oedema and venous disease.

100% organic cotton next to skin so suitable for sensitive skin eg allergies, varicose eczema, psoriasis.

European/RAL flat knit products

is made from a stiffer yarn knitted into a flat piece of fabric that is stitched together by a seam. It is suitable for disproportionate limbs with skin folds and patients with severe chronic oedema and lymphoedema. It is available in class 1 (18-21mmHg), class 2 (23-32mmHg) and class 3 (34-46mmHg). Higher classes and more complex garments are available for specialist use, contact Highland Lymphoedema Service for advice nhsh.highland-lymphoedema@nhs.scot.

Flat knit fabric lies flat against the skin and does not work in at skin folds.  Although these are a thicker material, they are more comfortable to wear for many people.

The basic stocking for a flat knit garment is beige below knee or thigh stocking with open toe.  Other options that can be added include slant foot, closed toe, silicone band to help keep the stocking in place, silk pocket to protect sensitive/vulnerable areas such as healed ulcers or skin folds, zips and special shaping at the ankle to ease don and knee to improve movement and prevent pinching behind the knee.

Precautions/contraindications

Occasionally the wearing of compression garments can lead to problems in the following situations:

  • Immobility (confinement to bed)
  • Skin infections
  • Weeping dermatoses
  • Incompatibility to fabric
  • Impaired sensitivity of the limb.

Absolute contraindications:

  • Severe arterial insufficiency
  • Uncontrolled congestive cardiac failure
  • Untreated infection.

Relative contraindications:

  • Concomitant dermatoses
  • Intolerance to compression fabric
  • Sensory disturbance of the limb
  • Advanced peripheral neuropathy
  • Primary chronic arthritis.

Application

  • Step-by-step directions included with every garment ordered.
  • Reduces the risk of incorrect application technique leading to skin problems or trauma.
  • Advise the use of rubber gloves to help with application and assess for need for application aid.
Jobst Elvarex  Class 1
 Class 2
 Class 3-4S: refer to Lymphoedema Clinic
Custom fit.  Refer to Jobst Elvarex custom-fit measuring form.

Custom fit flat knit garment for the management of moderate to severe lymphoedema. Firm material with high resistance, especially important for stubborn and rebound oedema.

Contains latex.
Jobst Elvarex Soft Class 1
 Class 2
 Class 3
Custom fit.  Refer to Jobst Elvarex custom-fit measuring form.

Custom fit flat knit garment for the management of mild to moderate lymphoedema. Unsuitable for severe lymphoedema.

Well suited for patients with poor dexterity, sensitive or fragile skin due to kin-protecting softness and good breathability.
Mediven Mondi Class 1
 Class 2
 Class 3
Custom fit.  Refer to Monidi custom-fit measuring form.

Custom fit flat knit garment for the management of mild to moderate lymphoedema.

Soft, firm material with high resistance for more stubborn and rebound oedema.
Haddenham Pertex Class 1
 Class 2
 Class 3
Custom fit.  Refer to Haddenham Pertex custom-fit measuring form.

Custom fit flat knit garment for the management of mild to moderate lymphoedema.

Soft, stretchy flat knit that is easy to don but conforms without cutting in.

Class 1 is especially suitable for palliative or very frail patients.

The most up to date order forms, including for flat knit garments can be found on the company websites:

Inelastic adjustable compression garments

These garments provide an effective alternative for patients who are able to self manage their care, those with rebound oedema when changed to stockings and for those with fragile skin or dexterity problems.

Dressings can be applied below these garments offering an effective alternative to bandaging (Damstra & Partsch, 2015). They are useful in ensuring consistency of sub-garment pressure in settings where several carers may be involved in the application of compression.

Despite their relatively high initial cost there is evidence that they can be a cost effective alternative to bandaging when nursing time and the cost of bandages is taken into consideration (Williams, 2016). They are supplied with a liner stocking.

Farrowwrap, and Juxta Fit are all available as a custom option for those who do not fit into standard sizes.

Precautions/contraindications

NOT to be used in cases of:

  • Untreated cardiac failure
  • Untreated cellulitis
  • Severe peripheral arterial disease
  • Untreated DVT
  • Known allergy to any of the materials.

Application

  • Step-by-step directions included with every garment ordered.
  • Reduces the risk of incorrect application technique leading to skin problems or trauma.
  • When using foot and leg pieces, apply foot piece then leg pieces, ie distal to proximal.

ReadyWrap
Foot CT, left/right size: S-XXL, regular and long foot

ReadyWrap is a short stretch wrap compression system comprising a liner and outer wrap piece.  The liners offer no therapeutic compression.  The bands are applied with a 50% overlap.  Matching colour coded Velcro straps makes this especially suitable for use by home care.

For use in patients with leg ulcers and/or oedema.  Any open wounds should be dressed prior to application of the wrap.
Calf wrap, size S-XXL, lengths 30cm and 35cm
Knee wrap, size: S-XXL
Thigh wrap, size: S-XXL, lengths 25cm and 30cm
Jobst FarrowWrap Lite

Light: 20-30mmHg

Strong: 30-40mmHg
Foot piece, size: XS-XL, lengths regular and long

FarrowWrap is a short stretch wrap compression system comprising a liner and outer wrap piece.  The liners offer no therapeutic compression.  The bands are applied with a 50% overlap.

For use in patients with leg ulcers and/or oedema.  Any open wounds should be dressed prior to application of the wrap.
Leg piece, size XS-XL, lengths regular and tall
Thigh piece (includes knee), size: XS-SL, lengths short, regular and tall
Juzo ACS Light Variable compression up to 40mmHG
Foot wrap, size: XS-SL, lengths regular and long

ACS Light is a short stretch wrap compression system comprising an integral liner and outer wrap piece, which can be adjusted to vary the compression.

For use in patients with leg ulcers and/or oedema.  Any open wounds should be dressed prior to application of the wrap.
Calf wrap, size: XS-XL, lengths regular and long
Knee wrap, size: XS-XL, lengths regular and long
Thigh wrap, size: XS-XL, lengths regular and long

Compression toe garments

Precautions/contraindications

  • Be careful not to remove too much when cutting.

Application

  • Position toe cap so that it fits comfortably over the toes and foot.  Work the toe cap between toes to web space.

Tip: Can be worn under bandaging, open toe stockings and compression foot wraps instead of toe bandaging.

Jobst Farrow toe caps Class 1 and class 2, size: x-small to large Mild to moderate toe oedema.  Smooth fabric and ultra-thin seams which cuts without fraying.  Ambidextrous.

Haddenham Microfine toe caps

 20-36mmHg, size: x-small to large
ReadyWrap toes size: small to xx-large, right or left foot

Wrap garment for toes and dorsum.

British Standard products

Is made from light, thin fabric in a circular knit.  It is suitable to manage symptoms of chronic venous insufficiency and prevent venous ulcer and ulcer recurrence in the absence of oedema in a normal shape limb.

Can be used for palliative patients (Class 1), elderly patients (Class I) and as low compression option for venous oedema.

British standard hosiery provides a lower level of compression in comparison to RAL, this may be beneficial for patients who have a low tolerance to compression hosiery, patients who have a regular shaped limb or palliative patients.

Duomed Soft should be used instead of other British standard hosiery such as Scholl.

Precautions/contraindications

  • Concomitant dermatoses
  • Intolerance to compression fabric
  • Sensory disturbance of the limb
  • Advanced peripheral neuropathy
  • Primary chronic arthritis.

Application

  • Step-by-step directions included with every garment ordered.

Duomed Soft 

Class 1:
14-17mmHg
Below knee, sizes 2-6

For the treatment of venous disease with little oedema. Can be applied without a Doppler.

Only available on one length.  If more compression is required, change to RAL Class 1.
Thigh length, sizes 2-6

Leg Ulcer Hosiery Kits

Although compression bandages are the recommended first line treatment for venous leg ulcers, hosiery kits provide a useful alternative in patients who prefer to self manage their care.  They are recommended for the management of venous ulcers after oedema reduction and for helping to prevent the recurrence of such ulcers for people who may otherwise have difficulty in donning garments as they comprise two components which together provide a nominal compression of 40 mmHg at the ankle with a decreasing gradient from distal to proximal.  Separate liner packs are available.

Precautions/contraindications

NOT to be used in cases of:

  • Untreated cardiac failure
  • Untreated cellulitis
  • Severe peripheral arterial disease
  • Untreated DVT
  • Known allergy to any of the materials.

Application

  • Liner stocking and outer stocking.

Tip: Outer stocking can be removed at night without disturbing underlying dressings.

Jobst Ulcercare Liner and outer stocking (provides 40mmHg at ankle), size: small-4XL Management of venous leg ulcers.

Mediven ulcer kit

 Liner and outer stocking (provides 40mmHg at ankle), size: I-VII

Appendix 1 - Donning aids

Examples of donning aids available on Scottish Drug Tariff (June 2020)

Easy Slide for open toe stocking

Product code PIP code Size Shoe size
EO 1102  266-9935 Small 2-4
EO 1202 266-9943 Medium 5-7½
EO 1302 266-9950 Large 8-11
EO 1352 266-9968 XL >11

Website for video showing application: http://www.daylong.co.uk/brand/brand/arion/easy-slide-hosiery-application-aid.html

Magnide Hosiery Applicator for closed or open toe stockings

Size
Medium
Large
Extra large

Website information: http://www.daylong.co.uk/other/products/application-aids/arion-magnide-hosiery-application-aid.html

Medi 2in1 Donning and doffing aid

Product code: DT904

Website for video: https://www.mediuk.co.uk/drug-tariff/medi-2in1/

Sigvaris Rolly

Product code 64655

Medi Big Butler

Compression hosiery applicator

Product code     DT9008                                  
One size

EZY-As

Compression hosiery applicator

Product code PIP code  Size
SAS-08017  354-5886 Small
SAM-06264  354-5878  Medium
SAL-06264    354-5880 Large
Ezy-As Handle for greater length
UHA-07246    354-5852  

Website: http://www.ezyasabc.co.uk/

References

BLS, (2021), Assessing vascular status in the presence of chronic oedema prior to the application of compression hosiery, British Lymphology Society 

NWCSP, (2020), Lower limb: Recommendations for clinical care, National Wound Care Strategy Programme

Neill K, Turnbull K, (2012) Use of specialist knowledge and experience to manage patients with mixed aetiology ulcers, Journal of Wound Care 21 (4), pp168-174

Best Practice Statement: Compression Hosiery: A Patient-Centric Approach (3rd Edition), (2021) Wounds UK

Editorial Information

Last reviewed: 27/02/2025

Next review date: 27/02/2028

Author(s): Wound and Tissue Viability.

Version: 2

Reviewer name(s): Louise Shakespeare, Advanced Nurse Lymphoedema.

Document Id: AF011