Diabetics Socks and Compression Wear

What are TED stockings?

TED* hose , commonly referred to as non-graduated compression stockings or anti-embolism stockings, are densely woven elasticized non-gradient leg garments that distributes an equal amount of pressure the full length of the stocking.

What do anti-embolism stockings treat?

Anti-embolism compression stockings help to prevent circulatory (blood and lymph fluid) problems, e.g., DVT (blood clotting or pooling), edema, phlebitis and thrombosis in the legs of non-ambulatory (immobile) patients.

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*(TED™ is a registered trademark owned by Tyco Healthcare/Kendall Products company.). The letters T.E.D., when used with the term ‘TED Hose’, ‘TEDs’, ‘TED hose compression’, ‘TED stockings’ or ‘TED support hose’, is an acronym for Thrombo Embolic Deterrent.

All brands of anti-embolism stockings, to include TED hose stockings, can be purchased over-the-counter and with a prescription depending on the compression level. (Anti-embolism stockings can be worn on one or both legs depending on the treatable condition.)

Compression, styles, and lengths of anti-embolism stockings

Compression

The amount of compression and sizing is determined by the circumference and length of the wearers leg and calf and what is being treated.
Over-the-counter – Available at most pharmacies, medical supply stores, and any number of online retailers in 10-20 mmHg. 20-50+ mmHg will generally require the advice of a physician or a prescription.

Custom-made – Requires a prescription. Exact measurements are taken of your leg(s) and ankle(s) and then outsourced to manufacturers that are typically located in Germany although China is now competing for the market by offering custom-made anti-embolism stockings at a lower cost.

Styles – knee-length and thigh-length; open and closed-toe

Knee-length – This style can be worn when active and is available in both open and closed toe and is typically available in three colors – black, beige and white.

Thigh-length – The type of style is for more sedentary people who are either post-op or non-ambulatory for long periods of time.

Hospital non-gradient compression stockings

Hospital anti-embolism stockings are white in color and open-toed which allows a physician or attendant to check their pulse in the patient’s feet.

Unlike over-the-counter non-gradient compression stockings, hospital TED hose are not made to hold up to the wear and tear of continuously putting them on and removing them and will lose their effective elasticity within a week or two at which point a new pair will be issued depending on the amount of time a patient remains bed-ridden.

Non-prescriptive anti-embolism stocking sizes and styles

All brands of over-the-counter anti-embolism compression stockings, to include TED hose, come in various compression ranges (mmHg) and sizes (extra-small, small, medium, large and extra-large and 2X and 3X) and are available in knee-high and thigh-high lengths.

Depending on the severity of the condition and the circumference of the leg, they will typically last around 6 to 9 months when worn daily.

Prescription anti-embolism stocking

Prescription anti-embolism stockings can be purchased at most pharmacies and medical supply stores and in some cases depending on the size of the legs and compression level, they can be custom-made.

How to fit TED hose

Before purchasing TED hose a wearer should always consult with their physician or health care provider as wearing the wrong size can cause serious complications.

Most medical supply and pharmaceutical stores that carry over-the-counter non-gradient compression hose will measure your legs to ensure a proper fit.

If either supplier does not carry your size it can be custom-ordered.

Warnings associated with wearing non-gradient compression stockings

When wearing non-gradient compression stockings, there are some precautions that should be taken.

The legs cannot be massaged or crossed and the hose should be kept as smooth and wrinkle-free as possible and special care should be taken not to let compression stockings bunch up or bind behind the knees or around the thighs.

If sitting, the legs should be elevated. The patient should also check for any allergic reactions or irritations that may occur due to the materials in compression stockings.

There are some circumstances when compression stockings should not be worn (e.g. over recent skin grafts or skin conditions such as dermatitis, when open sores and gangrene are present).

Compression stockings should also not be used if there by those who suffer from some type of severe vascular disease or if extreme swelling of the legs is present.

Should diabetics wear non-gradient compression stockings?

For any diabetic who has circulation problems causing swelling in the legs and feet, a long term condition such as arterial disease or insufficiency, they will usually be fitted for over-the-counter compression stockings in which case it’s a good idea to purchase at least two pair and switch them often.

If their leg size is not available in custom-fitted compression stockings generally they will be measured by a qualified staff person at a pharmacy or medical supply store and the measurements will be sent off to a manufacturer and the compression stockings will then be custom-made.

How often should non-gradient compression stockings be worn?

Depending on your circumstances, the length of time that compression stockings will be worn should be determined by your physician, health care provider, or occupational therapist.

For those who wear anti-embolism hose every day to help prevent swelling, such as diabetics or post-surgery patients, they can be removed for up to one hour a day to allow for bathing, skin care, or to change socks, and they should always be removed before going to bed.

Are non-gradient compression stockings covered by insurance or medicare?

Individuals being treated for an open wound and/or ulcer may have coverage as long as all necessary documentation has been made available to the insurance provider.

Typically this consists of a prescription from your physician as well as a CMN (Certificate of Medical Necessity) completed by a wound care specialist.

Most insurance coverage and reimbursement will differ so be sure to check with both your doctor and your insurance company.

Is there a non-gradient compression stockings donning device?

Because the elderly and post-operative patients may not have the strength to pull on compression stockings, they should get assistance.

Compression stockings will easily slide over plastic so putting a small plastic bag over the foot and then sliding the compression stockings over that is one method. There is a device called a “slip sock,” which works the same way.

For those who are able to put on compression stockings using baby powder or corn starch on the feet and legs as well as inside the compression stockings will assist in getting them more easily.

Simply roll up the hose and place over the toes and gently work it over the heel pulling it up the leg and smoothing out any wrinkles.

There are also latex donning gloves that have textured palms and fingers that are designed to enhance your grip.

For those who may be allergic to latex, there are cotton gloves with rubber coating on the palms and fingers.

How to put on TED stockings

1. Insert hand into Stocking as far as the heel pocket.








2. Grasp the center of the heel pocket and turn Stocking inside out to heel area.







3. Position the Stocking over the foot and heel, taking care to center the heel in the heel pocket.







4. Pull Stocking up and around the ankle and calf, working up the final position.

For Knee Length, top of Stocking should be 1 to 2 inches below bottom of knee cap. For Thigh Length, the stitch change (change in fabric sheerness) should fall between 1 to 2 inches below the bend of the knee, and top band rests on the line at the bottom of the buttocks.

Smooth out any excess material.

How to take care of non-gradient compression stockings

For compression stockings containing latex (i.e., Sigvaris 500 series, Jobst Vairox), washing instructions are included with every pair of stockings or printed on the outside of the box.

Laundering instructions are generally as follows:

1. Wash in warm water (105 degrees F / 40 degrees C). Water temperature should not exceed 160º F (71 º c).
2. Do not add bleach
3. Use a delicate fabric detergent.
4. Rinse well.
5. Air dry To help maintain the stockings

Laundering tips for ant-embolism hose

Compression stockings may be hand washed using a mild laundry detergent (a concentrated liquid detergent works best as it can diluted).

If machine washed use a mesh laundry bag and set to gentle cycle. The stockings dry quickly if laid flat or hung to air dry. A machine dryer may be used on a low or delicate setting.

Laundering increases the life of your stockings by removing body secretions from the elastic threads.

Use of oils, lanolin, and similar substances may deteriorate elastic.