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Compression Garment and Skin Care Guidance for Carers
The above patient has been prescribed compression garments. Why: Compression garments reduce swelling in the limb and
prevent the swelling from coming back. People should wear compression garments when most active as the muscle pump works
with the garment, usually during the day. But some people wear the garments at day and during the night.
People have to look after their skin with washing and moisturising. Why: This is part of personal care and also reduces the risk of
infection, developing wounds and fluid leaking from the limb.
If a person is unable to perform their own self care they will require your assistance to apply and remove their garments
and to wash, dry and moisturise their limb.
1. Ensure that the person’s arm / legs are washed (as instructed in the carers guide): using a soap substitute or emollient
and water. – Why: The skin is the barrier to infection, it is important to wash removing the bacteria and old moisturising cream
from the skin and to prevent dryness and cracking of the skin. This reduces their risk of developing an infection or wounds.
2. The arms/ legs must be dried thoroughly. – Why? : If areas are left wet or moist fungal infections such as athletes’ foot (a
fungal infection) could develop especially between the fingers and toes. Fungal infections require prompt treatment and you should
refer the patient to the GP / Nurse for prompt review. Fungal infections can develop into bacterial infections such as Cellulitis.
Fungal Infections and Cellulitis can cause further skin breakdown and hospital admission – Cellulitis requires prompt
treatment with antibiotics thus notify senior staff or the GP as soon as possible. Signs of Fungal infection – cracking and
itchy skin usually between the toes or fingers. Signs of Cellulitis – Skin may be red and hot or a rash. With increased swelling and
pain. Patients can complain of flu like symptoms and feel generally unwell.
3. Apply compression garments as per instructions and demonstration.
Avoid over pulling the top of the garment- Why? As this causes damage to the garment and it could slip or roll cutting into the
limb.
Compression Garment and Skin Care Guidance for Carers Vs 02. 06112015KMMT
Do not fold or turn the garment down at the top- Why? This causes increased pressure at that point and prevents the garment
from working as will be a tourniquet effect which could cause friction or a wound.
Use rubber gloves and a garment applicator if necessary- Why? - To reduce friction on the skin.
Ensure there are no creases in the garments and that it is applied evenly onto the Limb- Why? – If the garment is not evenly
distributed it will cause uneven pressure and could increase the swelling and cause friction over the skin.
The garment needs to be washed before reapplication. (Wash the garment as per manufactures instructions). A minimum of
two garments are always issued per limb and these last between 6-12 months (allowing for one to be worn and one to be washed)
Please contact the Lymphoedema Service/ District or Practice Nurse If
 Garment becomes too tight or is loose and slipping
 Garment develops ladders or holes
 Require further advice or have concerns regarding the garments
4. Encourage movement why? The lymphatic system depends on muscle movement to encourage lymph fluid to move, this is
enhanced when you wear a compression garment. Exercises will have been issued to all patients who are currently being
managed by the Lymphoedema Services in Wales. Please encourage and assist the patients to follow these to control their
swelling well.
The patient currently receives compression garments and review by the following serviceIf you have any concerns please contact
them for further advice.
Inset HB sticky label
Appendix 1
Lymphoedema Network Wales - Carers Plan - v1.0 22.10.15.pdf
Compression Garment and Skin Care Guidance for Carers Vs 02. 06112015KMMT
Appendix 2
Case study 1
Patient A
A 75 year old retired lady had been admitted to hospital on 3 occasions with Cellulitis (Cellulitis is an infection of the skin and tissue
which causes damage to lymphatic system-the Lymphatic system helps to drain away fluid from the tissues. Cellulitis can also
cause the skin to blister and breakdown wounds) the patients had also been having frequent visits for many years from the District
Nurses with leaking wet legs.
The District Nurses would wash and dry the legs and apply the bandages but when the patient was not being bandaged she was
unable to reach the lower part of her legs and feet to wash, dry and moisturise them effectively. This was due to her limited
function, ability and mobility.
Effective Skin Care is essential to try and prevent the legs from breaking down and leaking again. It also can prevent
repeated Cellulitis
The patient also found compression stockings uncomfortable, and wouldn’t wear them. Compression Stockings/ Garments help
move the fluid away from the tissues and are essential in oedema (swelling) management. Prevent limbs from leaking
fluid and reduce the risk of infections and wounds.
The patient was referred to a joint clinic to see the Dermatology (skin) Specialist Nurse and the Lymphoedema (swelling) Specialist
Nurse for assessment. The patient was measured and fitted for Flat Knit compression stockings although the patient was able to
wear them and found them comfortable, she was unable to put them on or remove them herself.
We referred the patient to home care / social care for support and assistance with washing, drying, application of a
moisturiser and to also assist with putting on and taking off her compression stockings three times a week. The home care team
now visit three times a week and since they have been involved in her personal care her legs have remained intact and she has
had no episodes of cellulitis requiring admissions to hospital and no longer requires a District Nurse visit either. Her mobility has
improved because she no longer requires bandaging and her swelling remains reduced in the compression stockings.
An example of the importance of a carers input to maintain and improve the patients well being and reduce the need for
District Nurse visits or hospital admission.
Compression Garment and Skin Care Guidance for Carers Vs 02. 06112015KMMT
Case Study 2
A 70 year old Gentleman had carers calling daily to assist him with washing and drying of his legs, applying and removing his
compression garments. The Lymphoedema Service was contacted in March 2015 by his District Nursing team to inform them that
his legs had broken down and started weeping fluid. The carers had been withdrawn the week before, and as he was unable to
wash, dry, moisturise his legs and apply his compression garments they had started to break down and leak fluid. On discussing
with the Social services department within the Community Resource Team (CRT), they stated the patient had declined the care and
support and stopped the carers calling. When the Lymphoedema Service contacted the patient he agreed that he had declined the
carers on a few occasions as he was under the impression if he agreed to care, he may have to go into a nursing home, he did
want and need their support in managing his legs but was afraid if he admitted this he may have to leave his home and forsake his
independence. Effective Communication with patients is essential to ensure patients understand the importance of
support in maintaining their well being.
The Lymphoedema Service contacted CRT to discuss this further and explained the importance of assisting the patient with his
oedema management and the high risk of cellulitis and development of wounds if the legs were not washed, dried thoroughly and
moisturised. Assisting the patient with his self care reduces his risk of these complications and prevents hospital admission keeping
the patient well at home.
Effective Skin Care is essential to try and prevent the legs from breaking down and leaking again. It also can prevent
repeated Cellulitis.
CRT then referred him for ongoing support and the Patient has carers supporting him three times a week, and to date his legs have
remained intact. He wears his compression garments all the time and only removes them when the carers assist him.
Stockings/ Garments help move the fluid away from the tissues and are essential in oedema (swelling) management.
Prevent limbs from leaking fluid and reduce the risk of infections and wounds.
An example of the importance of a carers input to maintain and improve the patients well being and reduce the need for
District Nurse visits or hospital admission.
Compression Garment and Skin Care Guidance for Carers Vs 02. 06112015KMMT