Flat knit hosiery: purpose, selection and application in chronic oedema and lipoedema

摘要

Chronic oedema/lymphoedema and lipoedema are long-term conditions that have no known cure. Variable evidence is available on the success of some surgical techniques, but the availability of these techniques also varies widely (International Lympho edema Framework (ILF), 2012b; National Lymphoedema Partnership (NLP), 2015; Wounds UK, 2017). These conditions can affect anyone, regardless of background, although certain demographic groups are at a higher risk, such as older adults. The estimated prevalence of chronic oedema/lymphoedema ranges from 3.99 to 28.76 affected per 1000 of the population, with lipoedema affecting 1:72 000 of the population, but these figures are believed to underestimate the actual number of people affected (Cooper and Bagnall, 2016; Wounds UK, 2017). One of the main options in the management of chronic oedema/lymphoedema and lipoedema is compression therapy in the form of compression hosiery. This article focuses on the use of flat knit compression garments for the management of chronic oedema and lipoedema and the benefits of this option. The intention of compression therapy is to enhance the lymphatic/venous return and reduce capillary filtrate and other complicating factors, such as inflammation, cellulitis and adipogenic changes (ILF, 2006a; 2012a; Mortimer and Rockson, 2014). Compression therapy is beneficial because it rectifies the impairment that may be present in either or both of the lymphatic and venous systems, such as venous hypertension and lymphatic failure, which is more evident in chronic oedema/lymphoedema patients (NLP, 2015; Balcombe et al, 2017). It has been suggested that any oedema has a lymphatic element, due to the role of this system in maintaining the body's fluid balance (Levick and Michel, 2010).