Throughout my career as a PTA, I have had little success with TED hose in use for edema. They are primarily intended for anti-embolism. Some patients are fitted with TED hose when they should be in a gradient compression stocking such as JOBST stockings when edema is the concern. I have had great success with JOBST stockings. Many residents in Long Term Care can be affected with swelling in the lower legs (edema). Many times the attending physician will prescribe TED hose, but I have found that the swelling remains. These physicians are unaware of other, possibly more effective options. A physician may not be prescribing JOBST stockings because they are not familiar with or feel they are more difficult to apply. Well, if they were easy to put on then they would not be as effective.
The JOBST stocking is specifically designed to treat edema caused by venous insufficiency in the lower extremities. Facility staff & residents can be shown how to put them on and once the edema is under control they will become easier to apply . To measure a resident for a JOBST stocking, use a measuring tape and measure around the calf and where the ankle is the smallest. These measurements can be applied to the chart and appropriate size can be determined. The sizes range from Small through Extra Large. Stockings can be obtained from a DME company or a pharmacy. Medicare will not pay for them, but at around $30 a pair, they could prove to be money well spent. Some precautions/contraindications are CHF and skin conditions. If you have residents with white TED hose on and edema is the primary concern talk to the medical staff about trying JOBST stockings. You may need to communicate with and educate the medical team in regards to using JOBST stockings as a valuable alternative to TED hose.
PTA & Clinical Manager of the Therapy Department