This page was printed from the Northern & Eastern Devon Formulary and Referral site at
Please ensure you are using the current version of this document
This is a newer combination of hosiery, colloquially called Class 4, which has been designed to provide an option to standard 4 layer bandaging. However, these guidelines need to be followed to obtain maximum clinical and cost-effectiveness.
No form of compression should be used without a full leg ulcer assessment, with Doppler, being undertaken.
To get the best use from compression hosiery we suggest that a few simple guidelines are adhered to.
Stockings should only be considered for those patients who have had at least 2 weeks in standard 4-layer bandaging or short stretch.
This is for two reasons:
Mainly for use for those patients with an Ankle Brachial Pressure Index (ABPI) of above 0.8 they could possibly be considered for someone with a slightly lower ABPI providing there are no other arterial signs. However, advice should be sought from Tissue Viability Nurse Specialists.
No reshaping of the leg is required. This is important because it would be very difficult to apply the hosiery without wrinkling the extra padding.
Consideration needs to be given to the length of the leg if using a stocking that does not specify short or long. Take care when ordering to specify size and, where, appropriate length.
Choose patients that have a degree of dexterity and can use an application device or who have family who can help apply the hosiery on at least a twice-weekly basis.
Ensure that patients/carers understand the need for appropriate care of hosiery. Products may have different washing instructions; ensure that patients are aware of specific recommendations for selected product.
The hosiery can be used for those patients who continually have recurrent leg ulcers. Those patients who have already started to use this hosiery for this purpose are finding it extremely useful because of the ease of application.
As with other compression, holistic leg ulcer assessment, with Doppler and ABPI calculation, must be performed prior to use.
Specialist use only, Consider referral to Tissue Viability for advice about fitting with Juxta CURES or Juxta Fit if unable to manage ulceration or oedema with compression bandaging or treatment hosiery. This garment may also be suitable for patients who wish to be self-caring but have moderate to high exudate levels or require some leg reshaping.