How do I measure the size of a compression stocking?

How to Measure the Size of Compression Stockings

To properly measure for compression stockings, take circumference measurements at specific points of the leg while standing, and measure leg length from floor to the desired stocking height. 1

Proper Measurement Technique

Required Measurements

• Ankle circumference: Measure at the narrowest part above the ankle bone (cB level)
• Calf circumference: Measure at the widest part of the calf
• Thigh circumference: For thigh-high stockings, measure at the widest part of the thigh
• Leg length: Measure from the floor to the desired height (knee or thigh)

Measurement Protocol

1. Patient position: Measurements should be taken in the morning when swelling is minimal, with the patient standing with weight distributed equally on both feet
2. Measuring tool: Use a flexible measuring tape that doesn't stretch
3. Measurement timing: Take measurements early in the day when edema is minimal

Compression Levels and Selection

Compression stockings come in different pressure gradients:

• Low compression: 10-20 mmHg
• Moderate compression: 20-30 mmHg (most commonly prescribed) 1
• High compression: 30-40 mmHg
• Very high compression: 40+ mmHg

Stocking Length Options

• Knee-high: Most commonly used and generally as effective as thigh-high stockings 2
• Thigh-high: Used for varicosities extending above the knee
• Pantyhose/waist-high: Used for bilateral symptoms or varicosities extending to the groin

Fitting Considerations and Pitfalls

Common Fitting Errors

• Too tight stockings: Can prevent essential venous return, causing blood to pool around the knee and potentially increase DVT risk 1
• Too loose stockings: Will not provide therapeutic benefit
• Incorrect length: If a stocking is too tight around the knee, it can impede venous return 1

Special Considerations

• Foot deformities: Patients with arthritis, hallux valgus, or digitus flexus (claw toe) may require lower compression (18-21 mmHg) for better comfort 3
• Elderly patients: Often tolerate lower compression levels (18-21 mmHg) better than higher compression (23-32 mmHg) 3
• Try before purchase: It's advisable to wear stockings around the house before extended use to ensure proper fit 1

Proper Application

1. Apply stockings in the morning before swelling occurs
2. Ensure the stocking is smooth with no wrinkles or bunching
3. The top band should not roll down or constrict circulation
4. For knee-high stockings, the top should be 1-2 inches below the knee crease

Contraindications

• Severe peripheral arterial disease
• Skin conditions that could be exacerbated by compression 2

Proper measurement and fitting are essential for compression stockings to be effective. Ill-fitting stockings not only reduce therapeutic benefit but may potentially cause harm through improper pressure distribution or by creating a tourniquet effect if too tight at specific points.