TED hose stockings improve circulation
TED hose are specialized stockings, often referred to as hospital circulation leg wraps, that apply an equal of pressure on the vascular (veins) system of the thigh, calf muscle and ankle to help prevent circulatory problems such as DVT (blood clotting or pooling), edema, phlebitis and thrombosis.
TED* hose, commonly referred to as Anti-Embolism Stockings or TEDS (T.E.D. is an acronym for Thrombo Embolic Deterrent).
TED support hose are available with and without a prescription and are available in knee-high style and ted-thigh high styles. (TED stockings can be worn on one or both legs depending on the treatable condition.)
Note: TED stockings are often mistakenly referred to as TED socks. TED hose are socks but instead a type of elastic stocking that comes in various densities, depending on the TED hose sizing.
Unlike graduated or gradient compression stockings TED hose stockings distribute an equal amount of pressure from the ankle all the way up the leg.
This compression aids in circulating blood and lymph fluid through the legs in both ambulatory and non-ambulatory patients.
The amount of compression and TED hose sizing is determined by the circumference and length of the wearers leg and calf and what is being treated.
*Although there are numerous brands of anti-embolism stockings, many of which refer to their product as TED hose stockings, they are not true TED hose unless the packaging bares the registered trademark TED™ hose, which is owned by Tyco Healthcare/Kendall Products company.
Compression, styles, and lengths of TED hose
Compression
Over-the-counter TED hose – 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 TED stockings at a lower cost.
Styles – knee-length and thigh-length; open and closed-toe
Keen-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. Those given out in hospitals, post-op, are white in color and open-toed which allows a physician or attendant to check their pulse in the patient’s feet.
Who wears TED hose?
TEDs are generally issued to post-surgical non-ambulatory patients during their recovery period while in the hospital.
TED hose stockings are also worn by Prescriptive and non-prescriptive (over-the-counter) TED hose are also available for home use and can be purchased at most pharmacies and medical supply stores.
The style of TED hose stockings that used in hospitals are usually thigh-high. They are white and open-toed (Open-toe allows a physician or health care provider to check the temperature, color and pulse in the feet.)
Hospital non-gradient compression stockings
Unlike true Kendall’s TED hose, over-the-counter non-gradient compression stockings, high compression level hospital TED hose are not made to hold up to the wear and tear of continuously putting them on and removing them.
As a result they 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 TED hose
Over-the-counter non-compression stockings and true TED hose come in various compression ranges (mmHg) and sizes (extra small, small, medium, large and extra-large) depending on the severity of the condition and the circumference of the leg and will typically last around 6 to 9 months when worn daily.
They generally available in knee-high and thigh-high styles in closed and open toed.
The Kendall brand of non-gradient compression hose are generally available in knee and thigh-length styles, in black, beige, and white, and in various sizes to fit all body types; extra-small, small, medium, large, extra-large, and 2X and 3X.
Those issued in hospitals are only available in white.
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 then they will order your TED hose.
Wearing TED hose daily
For those suffering from poor circulation, commonly seniors or diabetics, non-compression stockings can be worn daily.
TED hose help keep the legs warm and the blood flowing properly to enable the wearer to be more active in their day-to-day lives.
Some people wear non-gradient compression hose on long flights, as high altitudes can impede blood flow, however, unless their condition is serious, gradient compression stockings will usually suffice.
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 T.E.D. 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 TED 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.
