"Compression stockings, 20-30 mmHg" is one of the most common orders we receive, and the length is often missing. Length matters as much as the compression level. A garment that stops below the edema leaves the proximal tissue uncompressed and can create a tourniquet effect at the band. Here's a quick guide to choosing and writing the length.
Choosing the length
The garment should extend past the most proximal point of edema or venous disease.
Knee-high (AD): edema or venous disease limited to the foot, ankle and calf. This includes most CVI, below-knee varicosities, venous ulcer prevention and recurrence, and post-thrombotic symptoms below the knee. It's the best starting point when adherence is a concern.
Thigh-high (AG): edema extending above the knee, varicosities of the thigh or great saphenous distribution, post-ablation or post-sclerotherapy protocols that call for thigh-length, and lower-extremity lymphedema or lipedema involving the knee or thigh.
Pantyhose or waist-high (AT): edema reaching the proximal thigh, hip or genital area, pregnancy-related varicosities, and patients whose thigh-high bands roll or cause a proximal tourniquet.
Single-leg with waist attachment: unilateral proximal edema when a thigh band won't stay up.
Signs the current length isn't enough
Edema or a fluid "cuff" just above the top band
Deep indentation or skin breakdown at the band
Thigh girth continuing to increase while calf girth stays controlled
Before you order
Screen arterial status in patients with diabetes, absent pedal pulses or PAD risk. Assess ABI before prescribing higher levels of compression.
Consider dexterity and hand strength. Thigh-high and higher-class garments are harder to put on. Donning aids, zippers or adjustable wraps may make the difference between a garment that's worn and one that isn't.
Patients with significant shape distortion, deep skin folds or lymphedema stage II or higher usually need flat-knit custom garments rather than ready-to-wear.
What to write on the order
Diagnosis and affected side: left, right or bilateral
Compression level in mmHg (15-20, 20-30, 30-40 or 40-50)
Length: knee-high, thigh-high, pantyhose or waist-high, or chaps or single-leg
Ready-to-wear or custom (circular-knit or flat-knit)
Toe: open or closed, if it matters clinically
Quantity and wear schedule, for example "2 pairs, daytime wear"
If the length is left off, we'll fit to the extent of the edema we see and contact your office to confirm before ordering.
Let us do the fitting
Our certified fitters measure, fit and follow up on every patient you send. Fax referrals to 800-886-4201 or use our secure referral form. Patients can book a fitting or call 800-883-1549.
Patient-facing version you can share: Knee-High or Thigh-High? Choosing the Right Length.
