For lymphedema therapists and referring providers
Bandaging, adjustable wraps and compression garments all have a place in lymphedema care. The best choice depends on the phase of treatment, the limb's shape and stability, and what the patient can manage at home.
At a glance
Main use — Multilayer bandaging: Reduction (phase 1); Adjustable wraps: Reduction, transition or maintenance; Compression garments: Maintenance (phase 2)
Adjusts to volume change — Multilayer bandaging: Yes, reapplied each time; Adjustable wraps: Yes, straps tighten as limb shrinks; Compression garments: No, fixed size
Who applies it — Multilayer bandaging: Therapist, or trained patient or caregiver; Adjustable wraps: Patient, with simple straps; Compression garments: Patient, with donning aids
Skill needed — Multilayer bandaging: High; Adjustable wraps: Low to moderate; Compression garments: Moderate
Best for — Multilayer bandaging: Active reduction, irregular shapes, fibrosis, wounds; Adjustable wraps: Limbs still changing, patients who can't bandage, nighttime; Compression garments: Stable, reduced limbs
Multilayer bandaging
The standard for the intensive reduction phase. Short-stretch bandages with padding create high working pressure and low resting pressure, and they can be shaped around folds and fibrotic areas. The downside is that bandaging takes skill and time, and it's hard for many patients to do well at home.
Adjustable wraps
Wraps such as CircAid and ReadyWrap use inelastic panels with hook-and-loop straps. Patients can tighten them as swelling goes down, often using a built-in pressure guide. They work well:
Between bandaging and a custom garment, while the limb is still changing
For patients who can't bandage or can't pull on a garment because of arthritis, weakness or limited reach
As a nighttime option
For self-management when swelling fluctuates
Compression garments
Once the limb is reduced and stable, garments maintain the result. Circular-knit works for regular limb shapes. Flat-knit custom garments suit irregular shapes, lipedema and moderate to severe lymphedema.
Combining approaches
Many patients use more than one: a garment during the day, a wrap or padded garment at night, and short-term bandaging during flare-ups. A home pump may be added when swelling isn't controlled with these alone.
How Midwest Compression can help
We supply bandaging systems, adjustable wraps and ready-to-wear and custom garments, and we can help choose what fits the patient's stage and abilities. Email customersupport@midwestcompression.com or call 800-883-1549.
Need forms? Find every measurement form, sizing guide and order form on our Measurement & Sizing Forms page, and manufacturer charts on our Size Charts page.
This article is general guidance and not a substitute for clinical judgment.
