Stage 2 – Lymphedema - Moderate

Definition: Spontaneously irreversible, very little pitting, some skin changes, fibrotic pitting swelling. Swelling and compression is difficult to maintain or manage. Need full CDT to reduce.

Day Compression:

Compression choice:

Class 2:

• (23-32 mmHg) flat knit / seamed (made to measure)
• Indicated for lower fibrosis, compression for softer tissue

Class 3:

• (34-46 mmHg) flat knit / seamed (made to measure)
• Indicated for moderate fibrosis present, pitting and restricted ROM due to volume, high BMI

Class 4:

• (50+ mmHg) flat knit / seamed (made to measure)
• Indicated for significant fibrosis present, pitting and restricted ROM due to volume, high BMI

Containment choice:

Juzo Expert

• Flat knit / seamed product options: Expert AD (knee),  Expert AG (thigh), Expert AT (pantyhose)
• Indicated for low stretch with higher containment to break down fibrosis and odd shape limb, cotton for sensitive skin, or silver for antimicrobial protection of the garment.

Juzo Strong

• Flat knit / seamed product options: Strong AD (knee),  Strong AG (thigh),  Strong AT (pantyhose)
• Indicated for the lowest stretch and highest containment to break down fibrosis and high BMI, or silver for antimicrobial protection of the garment.

Night Compression:

Mandatory:
Optimize treatment outcomes by using a night compression garment.

 

Juzo Reversa & SoftCompress

• Product options: Reservsa AB (foot) Reversa BD (calf), Reversa DF (knee), Reversa FG (thigh), SoftCompress AD (Calf Liner) , SoftCompress (Roll)
• Indicated to be worn with SoftCompress, the Reversa is a short stretch wrap with high working and low resting pressure. It is also for patients experiencing difficulty reaching or inability to manage knit garments.

Juzo Bandaging

• Product options: SoftCompress Short-Stretch Bandage
• Indicated for the reduction of volume and fibrosis

Tips:

• Expert/Strong- Can be paired with various styles: BG, CT, CG, FT, BT, (see Expert & Strong Product Guide)
• Combinations: to adjust compression or to get higher than compression class 4: A-D + B-G, A-G + shorts, toe glove with all, can combine compression wrap over any/all.
• These patients have difficulty/inability to manage consistent compression for the fluid and have significant fluctuations in size not appropriate for knit garments at this time: compliance issues, active disease (cancer, tumor, etc), limited mobility, limited assistance, medication interactions, post-operative swelling.
• Reversa wrap extension straps to adapt the Reversa garment
  • USA Only: Use of a pressure monitor can accurately give pressure objectives
• The goal for unstable patients is to get them stable for knit garments designed to maintain stable limb size.
• Flat knit: choose comfort patch, knee dart & slant top, 5cm top band silicone border
• Expert & Strong with silver that protects the garment from microbial growth. Note: Juzo Silver garments should be removed prior to MRI Scans and cardiac defibrillations.
• Daytime compression should maintain decongested size and, if not, increase containment material.
• Watch a video demonstration on how to measure lower extremities.
• Access educational resources via Juzo Academy.
• Compression 101