Controlling lymphoedema with compression garments

This is an important way of controlling swelling. Compression sleeves can be used for swollen arms and compression stockings for swollen legs. The garments work by compressing the swollen tissues and stopping fluid from building up. At the same time, they help to move the fluid to an area that is draining well. The support allows the muscles to pump fluid away more effectively. The design of the garments means that more pressure is applied in certain areas to encourage the fluid to drain.

A compression garment should be worn all day, but can usually be taken off at night when you are lying down and resting. If you are travelling a long distance, especially by air, you should make sure that you wear your compression garment for the full length of the journey and for some hours afterwards.

Your surgeon or lymphoedema specialist can prescribe compression garments for you. In many hospitals they are available from the breast care nurse or surgical appliances department.

The garments come in a range of shades to match different skin tones and there are hypoallergenic types for people with sensitive skin. Some garments are available 'off the shelf' or you may need to have them made to measure. We also have a list of suppliers|.

Compression garments must be properly measured and fitted. If they are too tight the blood flow will be restricted.

If the garment causes pins and needles, pain, or a change in colour of your fingers or toes, it is too tight. Remove the garment as soon as you notice any of these signs and ask for advice from the person who supplied it to you.

A sleeve, stocking or bra that is too loose will not control swelling and will need to be refitted. Ask for advice from your lymphoedema therapist.

• It is best to put the garment on first thing in the morning, preferably before getting out of bed, or as soon as possible at the start of your day.
• Start by turning the stocking or sleeve inside out as far as the wrist or heel. Pull the garment over your hand or foot and ease it up - a bit at a time. Make sure you don’t pull it up by the top of the garment. Do not turn or roll the top over - this will restrict the blood flow and cause more swelling.
• A household rubber glove, worn on the unaffected hand, may help when putting on your compression garment. It also helps to hold onto something (so that you have something to pull against) when pulling the sleeve up your arm.
• If you find it difficult to put on, apply a little unperfumed talc to your arm or leg before fitting.
• Make sure there are no wrinkles or creases in the material when your garment is on.
• You may need to wear a glove or mitten as well as your sleeve if you have swelling in your hand.
• Don’t try to put the sleeve on straight after a bath, as dampness makes it very difficult to get on.
• Moisturise your skin every day. It is best to do this at night after you have taken off your garment, rather than in the morning - cream makes the sleeve or stocking very difficult to put on.

You should be given at least two garments so you can have one in the wash. The manufacturer will supply washing instructions. Worn on alternate days, compression garments will last up to six months. If your sleeve or stocking no longer fits properly, contact your nurse or therapist.

In some circumstances a compression garment should not be worn, for example if the skin is very fragile, or if there is an infection. Your doctor, nurse or lymphoedema specialist can advise you about this.

Compression garments should not be used on very swollen or misshapen limbs or where the skin is pitted or folded. In this situation compression garments can be harmful and will not help the swelling to go down. The material can form tight bands across the skin and even damage it. If in doubt ask your doctor, breast care nurse or lymphoedema therapist for advice.

If your arm or leg is very swollen or misshapen it may be difficult to fit a compression sleeve or stocking. In this case, multi-layer, elasticated bandages are used as the first part of treatment.

A lymphoedema therapist, nurse or physiotherapist will usually put the compression bandages on for you daily. It may take two or three weeks of bandaging before it is possible to fit a compression sleeve or stocking. Manual lymphatic drainage massage| or simple lymphatic drainage massage and bandaging are often combined with exercises and skin care to reduce the size of a badly swollen limb.