What is the correct order for applying Tubigrip® (compression stockinette) to an affected limb?

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Tubigrip Application Instructions

Apply Tubigrip by cutting a length twice the area to be covered, then fold it in half to create a double layer over the affected limb, ensuring proper compression without compromising circulation.

Application Technique

The standard method for Tubigrip application involves:

  • Cut the tubular bandage to twice the length of the area requiring compression 1
  • Fold the material back on itself to create a double-layer application, which provides the appropriate compression gradient 1
  • Ensure the compression does not compromise circulation by checking that the wrap is not overtightened 2, 3
  • Apply from distal to proximal (bottom to top of limb) to promote proper venous drainage, though this is more critical for graduated compression stockings 4

Pressure Considerations

When applying any compression device including Tubigrip:

  • Target pressure at the ankle should be 18-23 mm Hg for prophylaxis, which is lower than therapeutic compression (30-40 mm Hg) used for post-thrombotic syndrome 5
  • Avoid excessive tightness that could cause pain, swelling, or neurovascular compromise 4
  • Monitor for proper fit as compression effectiveness depends on appropriate pressure application 5

Important Caveats

Tubigrip has limited evidence for ankle sprains specifically - multiple studies concluded that Tubigrip provides no positive effect on functional recovery after ankle injuries and may actually increase analgesic requirements compared to no intervention 6. For ankle sprains, semi-rigid ankle braces or lace-up supports are superior to simple elastic bandages like Tubigrip, helping patients return to activity 4.2 days sooner 2, 3.

Contraindications

Do not apply Tubigrip or any compression device when:

  • Dermatitis, skin breakdown, or ulceration is present 5
  • Peripheral vascular disease exists 5
  • Lower-extremity trauma with plaster cast is present 5
  • Recent lower-extremity bypass procedure has been performed 5

References

Guideline

Ankle Sprain Treatment and Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Ankle Sprain Recovery and Return to Work Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

[Dynamic in vivo skin pressure measurement in quality control of compression stockings].

Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete, 1997

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The role of compression in the management of soft tissue ankle injuries: a systematic review.

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2015

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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