STRIDE professional guide to compression garment selection for the lower extremity

Objective: The effectiveness of a compression garment, such as a medical compression stocking (MCS) or adjustable wrap (AW), is dependent on dose (mmHg) as well as the physical and dynamic properties of the textile, including elasticity and stiffness.(1-11) Transparency regarding the comprehensive compression profile is needed to make an appropriate MCS/AW selection. In addition, there are patient- specific characteristics (tissue texture, limb size, location of swelling, quality of oedema, patient functional level) that have clinical relevance on compression garment selection. Although compression therapy options for the management of chronic oedema states are readily available, including chronic venous disease (CVD) and lymphoedema, the practical application of current clinical guidelines for the selection of the appropriate compression garments is limited. The purpose of this body of work is to provide an unbiased algorithm to assist with compression product selection, based on available medical literature, compression science, and clinical expertise. This algorithm, known as S.T.R.I.D.E., incorporates the comprehensive compression profile of MCS and AW currently available. The S.T.R.I.D.E. algorithm incorporates compression dosage, dosage distribution, stiffness and other textile characteristics, and product categories/subcategories. S.T.R.I.D.E. also includes a system for oedema assessment to best match the individual patient presentation with an appropriate compression product. Assessed patient characteristics include distribution of oedema and limb shape, tissue texture, oedema etiology, precautions/contraindications, and time to refill. By defining compression prescription in terms of comprehensive compression product and individualised oedema profile, S.T.R.I.D.E. establishes a foundation for compression product selection to achieve optimal patient outcomes. S.T.R.I.D.E. also provides a platform to showcase the continuum of compression products on the market, and differentiate quality compression products from generic products produced by manufacture's using low-quality materials and knitting technologies. In addition, S.T.R.I.D.E. will further define product profiles and efficacy through additional testing and research, in order to grow the body of clinical evidence to support compression use for chronic oedema conditions.