Wound Care

Lower Extremity Wounds of Venous Insufficiency 117
• Low compression stockings
— Class 2: 18 to 24 mmHg, Relief (Jobst), elastic wraps,
paste bandages provide medium compression.
— Used in edematous, nonambulatory patients when
antiembolism stockings have failed; acute DVT, treatment
and prevention of venous ulceration.
• Low to moderate compression stockings and wraps
— Class 3: 25 to 35 mmHg, Fast-Fit (Jobst), Custom Fit,
double reverse elastic wrap, four-layer bandage.
— Used when edema is secondary to venous insufficiency;
severe chronic venous hypertension, severe varicose
veins, ulcer prevention and treatment in patients with
very large diameter calves.
— Patient participates in exercise rehabilitation while wearing
the stockings.
• Moderate compression stockings and wraps
— 30 to 40 mmHg, Ultimate (Jobst), Custom stocking
(Jobst, Sigvarus), Sequential pump, four-layer bandage
(Profore, Smith & Nephew or SurePress, Convatec-
Squibb)
— Used for the patient with or without wounding, persistent
edema despite lower level compression options, or in the
ulcer that failed to heal after 6 months.
• High compression stockings and devices
— 30 to 40 mmHg, Vairox (Jobst), Custom stockings (Jobst,
Sigvarus), Sequential pump
— Used with lymphedema patients
— Class 4: 40 to 50 mmHg compression
• General information on compression garments and stockings:
— Usually wounds must be healed before using stockings.
— Wound must be healed to 1 cm length by l cm width by
1 cm shallow depth; compression hosiery (30–40 mmHg)
or milder compression (10–30 mmHg) may be appropriate
to use after other forms of compression have been used
successfully.