Ral gz 387 compression underwear. Compression jersey. Trademarks of an affordable price category. Classification of compression products

Diseases of the venous system - such as chronic venous insufficiency (CVI), varicose veins, phlebitis, thrombosis and thrombophlebitis - have become an urgent problem of our time. The high prevalence (according to some data, up to 70% of the population of developed countries are subject to them), the constant increase in the number of patients and the high percentage of disabilities make prevention and early treatment especially important. Due to the fact that in the initial stages the signs of the disease are almost invisible (there may be minor cosmetic defects), most people simply do not attach importance to this and do not go to the doctor. Then the disease progresses and leads to complications: pains, swelling begin to disturb, and in advanced cases trophic ulcers appear. Compression therapy is often used both in treatment and in order to prevent diseases of the venous system. Developed at the beginning of the twentieth century, now it is an integral part of the effective treatment of CVI, varicose veins and other vein diseases. In today's article we will talk about what compression hosiery is, to whom it is shown, and what should be guided in its choice.

What is compression hosiery?

Compression knitwear is jersey with special healing properties due to precisely calculated and dosed pressure on the veins of the lower extremities (100% - lower leg, 70% - calf muscle, 40% - thigh). As a result, these products create a "frame", in fact, take over the work of muscles, which normalizes blood flow and prevents stagnation of blood in the veins.

How does compression hosiery work? Its therapeutic effect consists of the following main mechanisms:

• Pressure on the intermuscular and perforating veins and, as a result, a decrease in the pathological volume of venous blood in the lower extremities;
• Narrowing of the veins, which improves the functioning of the valve apparatus and increases venous return (the volume of blood that flows to the heart through the superior and inferior vena cava per minute);
• An increase in tissue pressure, due to which the reabsorption of extracellular fluid is enhanced;
• Activation of the fibrinolytic (antipode of the coagulation) blood system due to the production of the proenzyme plasminogen.

Due to these mechanisms, the patient is less likely to form blood clots and the risk of stretching the veins, and swelling is reduced.

Compression hosiery has a number of advantages over the other traditional type of compression therapy - elastic bandaging:

1. The pressure is distributed more evenly, regardless of the skill of the medic or patient.
2. The correct choice of the compression class of the product allows you to select the optimal pressure level (when bandaging, the level of compression depends on how it was carried out).
3. When using, the participation of a doctor is not required, putting on is faster.
4. They are comfortable, do not slip, unlike bandages. Provides a more secure fit.
5. Compression tights and stockings look more aesthetically pleasing than bandages.
6. More durable with daily wash.
7. The necessary water and temperature balance of the skin of the legs is maintained.

The disadvantages of compression hosiery compared to elastic bandages are the price, it is significantly higher (on average, 20 times); selection of a factory product for a non-standard leg shape will also be problematic.

Who should wear compression hosiery?

Compression knitwear is indicated not only for people suffering from diseases of the venous system, but also as a prophylaxis - for those who have one or more risk factors:

• Female;
• Hereditary predisposition to venous diseases;
• High viscosity or blood clotting;
• Sedentary / standing work (salespeople, hairdressers, cooks, office workers, surgeons, conveyor workers);
• Recurrent swelling of the legs, evening fatigue and heaviness in the legs;
• Sedentary lifestyle;
• Hereditary predisposition to diseases of the venous system;
• Multiple pregnancies;
• Being overweight, gaining or losing weight quickly;
• Diseases leading to increased intra-abdominal pressure (chronic constipation, chronic lung disease, etc.);
• Drinking alcohol / smoking;
• Taking hormonal drugs;
• Walking in high heels;
• Long journeys.

Nowadays there is a wide selection of medical jerseys. To make the right choice, it is advisable to consult a phlebologist who will assess the condition of your veins and give recommendations on the treatment or prevention of possible diseases. Most likely, one of its purposes will be the use of compression hosiery of one or another compression class.

There are also contraindications for wearing compression products: infectious and allergic skin diseases, bedsores, trophic wounds, atherosclerosis, ischemia of the 2nd or 3rd degree, Takayasu's syndrome, Raynaud's syndrome.

Types of compression hosiery

All compression hosiery is divided into three types: prophylactic (0 compression class), therapeutic (I - IV compression class) and hospital antiembolic. Medical compression hosiery can only be used as directed by a specialist.

0 compression class (15-18 mm Hg). It is used without a doctor's prescription to prevent the development of chronic venous insufficiency. Please note: if spider veins and dilated veins are already pronounced, preventive compression hosiery will not solve the problem. Preventive compression hosiery is indicated when the above risk factors are present.

Compression class 1 (18-21 mm Hg). These products are recommended for use at the initial stage of varicose veins - to prevent its development. Compression hosiery of the 1st class of compression improves blood circulation, relieves puffiness and “heavy legs” syndrome. Indications for use are vascular "mesh", a clear pattern of the saphenous veins and their varicose veins, hormonal changes (including those associated with the intake of hormonal drugs), periodic leg edema, cramps and heaviness in the legs, a sedentary lifestyle.

Compression class 2 (23-32 mm Hg). Compression hosiery of the 2nd class of compression is used for the treatment and prevention of the further development of moderate chronic venous insufficiency. It is indicated for use in persistent leg edema, stages 2 and 3 of varicose veins, acute thrombophlebitis, post-thrombophlebitic disease, postoperative conditions.

Compression class 3 (34-46 mm Hg). Products of this compression class are used in the treatment of the most severe forms of venous diseases. Indications for the use of compression class 3 products are persistent severe edema, congenital vascular insufficiency, lymphovenous insufficiency (lymphedema, phlebolymphedema), deep vein thrombosis of the lower extremities, varicose veins and post-thrombophlebitic disease, recovery after vein surgery.

4 class of compression (more than 49 mm Hg) is used extremely rarely. It is indicated for the most severe forms of varicose veins, when the walls and valves of the vessels can no longer cope with the task of transporting blood from the legs to the heart.

Via antiembolic hospital jersey (15-18 mm Hg), blood circulation in the legs is activated, blood flow in the deep veins of the legs is increased, blood stagnation is eliminated, which significantly reduces the risk of deep vein thrombosis. Use hospital jersey as directed by your doctor. Indications for use are childbirth (including cesarean section) and the postpartum period, epidural anesthesia, surgery, intensive care in a hospital, prolonged bed rest (from 4 days).

Compression knitwear is produced in various types: knee-highs, stockings, and tights.

Compression hosiery manufacturers

Today, the most famous manufacturers of compression hosiery are Medi, Sigvaris, Orto, Venoteks, Venosan, Relaxsan, BSN-Jobst, OFA Bamberg, Thuasne, Bauerfeind, Intex and Luomma Idealista. The main characteristics of the products of these companies are shown in the table below.

Compression hosiery brand	Manufacturer country	Types, compression classes	Knitting	Compound	Medical and environmental standards	Average price (class II tights comp.)
Medi	Germany		circular, flat	Polyamide, elastane. In some models, the fabric is treated with lanolin for increased comfort of use.		RUB 6500
Sigvaris	Switzerland	Preventive, I-IV grades	circular	Polyamide, elastane. There are models with cotton (comfort, but less elasticity), there are models with rubber (adds stiffness, but may cause allergies).	RAL GZ (387), Oeko-Tex Standard 100	RUB 7800
Orto	Russia		circular			2000 RUB
Venoteks	USA	Preventive, I-III classes, hospital	circular	Nylon, elastane.	FDA certificate (Certified by the US Food & Drug Administration) for products of 1 and 2 classes of compression, Oeko-Tex Standard 100	RUB 2900
Venosan	Switzerland	Preventive, I-IV classes, hospital	circular, flat	Polyamide, Silver Thread, Cotton, Active Marine Cells, Nylon, Lycra.	RAL GZ (387)	RUB 9300
Relaxsan	Italy	Preventive, I-III classes, hospital	circular	Polyamide, elastane. There are models with cotton in the composition.	RAL GZ (387), FDA Certified by the US Food & Drug Administration	4200 RUB
Jobst	Germany	Preventive, I-IV classes, hospital	flat	Nylon, Spandex, Cotton.	RAL GZ (387)	RUB 6,000
OFA Bamberg	Germany		circular	Polyamide, elastane, microfiber, cotton.	RAL GZ (387), Oeko-Tex Standard 100	RUB 4500
Thuasne	France	Preventive, I-III classes	circular	Elastane, polyamide, polyester.	RAL GZ (387), Oeko-Tex Standard 100	RUB 6,000
Bauerfeind	Germany	Preventive, I-IV classes	circular	Microfiber, polyamide, lycra, elastane.	RAL GZ (387), Oeko-Tex Standard 100	RUB 8500
Intex	Russia	Preventive, I-IV classes, hospital	circular	Polyamide, Lycra.	TU meeting the requirements of the RAL GZ (387) standard	RUB 2,600
Luomma idealista	Russia	Preventive, I-II grades	circular	Polyamide, elastane.	Oeko-Tex Standard 100	RUB 3000

Let's clarify some points from the above table.

Manufacturer country compression hosiery speaks volumes. The highest quality and proven products are from Germany and Switzerland.

Type of mating(circular or flat) determines the purpose and differences in the performance properties of knitwear. Circular knitting is used for the treatment and prevention of diseases of the venous system, flat knitting - mainly for the treatment of lymphedema (swelling of soft tissues associated with insufficiency of the lymphatic drainage system). Compression products of circular knitting do not have seams, unlike products of flat knitting. Due to this, flat-knit compression hosiery can be equipped with additional elements that make it easier to put on - zippers, Velcro. Circular knits are more elastic and can exert less pressure than flat knits. Usually flat knit compression garments are made to order, according to individual measurements, while circular knit garments are available in both standard and custom form.

Medical quality standards compression products guarantee the receipt of the necessary medical effect, namely the pressure indicated on the label, and its correct distribution over the leg. Compression hosiery whose manufacturer has not been certified for compliance with the medical standard is always a risk for the buyer. The following medical standards are currently used: British Standard - BS: 6612; 1985; German Standard - RAL-GZ 387; 1987; French Standard - ASQUAL; A draft European Standard - ENV 12718; 2001; USA Standard. Among them, the German standard RAL-GZ 387 uses the greatest "weight" in medical circles. Well-known world brands are regularly certified for compliance with this particular standard. Environmental standard Oeko-Tex Standard 100 confirms the hypoallergenicity of the compression product.

How to choose compression hosiery?

The choice of compression hosiery can be difficult - after all, the assortment on the market is very large, and besides, these products are not cheap. How not to miscalculate, what to look for when choosing? Let's consider the main factors:

1. Compression Product Certification ... For safety and the necessary medical effect, the stockings or tights you choose must meet a medical and environmental quality standard. The use of compression hosiery complying with the RAL-GZ 387 standard is described in the Russian clinical guidelines for the diagnosis and treatment of chronic venous diseases. Therefore, this standard is an unmistakable choice.
2. Compression class ... It should be determined by your attending physician - according to individual indications. Medicinal products are sold exclusively by prescription.
3. Knitwear manufacturer ... Russian doctors most often recommend Medi and Sigvaris. However, there are many positive reviews about other brands on the Internet.
4. Product price ... Remember the simple truth: "The miser pays twice." A seemingly advantageous offer will most likely not be such - after all, cheap compression products often do not last long. And, worst of all, they do not have a sufficient therapeutic effect, being simply of poor quality. Compression hosiery is not cheap, due to the peculiarities of its production and certification. On average, the price for a quality product is 50-100 euros. The buyer’s task is to assess the adequacy of the seller’s markup, because it’s no secret that some stores "wind up" prices to a completely unacceptable level. When buying products from European brands, compare their prices in Russia with prices in the producing countries. The markup above 20-30% is most likely too high. Too low a price, of course, should also alert you.

Would you buy a drug knowing that it did not undergo proper clinical trials and is not registered at all? Probably only in the case of a completely hopeless situation!

Anti-varicose compression hosiery is the same remedy, therefore, compliance with specialized (for this type of medical product) standards is the first thing a responsible buyer should turn to when choosing a product. It's no secret that more and more Russians are beginning to take a more responsible approach to their health and follow the recommendations of experts to wear compression tights, stockings or knee-highs to prevent the development of varicose veins. On this wave in the Russian market - in pharmacies and special orthopedic salons - a huge variety of brands of compression hosiery have appeared and are now represented. And without proper preparation, an inexperienced and poorly informed consumer can "get in" - buy a useless, low-quality, short-lived, or even completely harmful product.

And here specialized standards rush to the rescue, which are the MAIN indicator that the product will effectively and truly help you. So, remember three basic rules when choosing a brand of compression hosiery:

1. Buy medical compression hosiery only from brands that have at least one of the generally recognized international quality standards for compression garments.
2. Make sure that the given brand complies with the standard on the website of this standard. Unfortunately, some unscrupulous manufacturers and distributors consider Russian consumers “naive suckers” (and at the same time their competitors) and mold the logo of the standard for packaging without any reason.
3. The greater the need for a therapeutic effect (and the less acceptable the "Efficacy-Effectiveness" trade-off), the more stringent the standard you need to take as a basic selection criterion.

Now let’s explain each rule in more detail.

We choose the generally recognized quality standards for medical compression hosiery

So why is it important for a medical compression device to comply with a specialized standard? The main and decisive difference between compression hosiery, which complies with the international quality standard, from “non-conforming” products is that such hosiery has passed precise and strictly regulated procedures for checking medical quality and safety, namely:

• compliance with the declared (on the package and label) pressure level - compression class; the presence of the correct ("physiological") distribution of pressure throughout the product - that is, a guarantee of the desired therapeutic effect with benefit and without harm;
• guarantee of the preservation of compression properties during daily use and throughout the entire service life;
• the degree of rigidity / elasticity of the product;
• all this taking into account the patient's anatomical measurements - that is, for each size and within the existing dimensional step;
• the composition of the material and the textile safety of the product are also regulated.

As we can see - everything is very serious and harsh! It is not enough just to buy the appropriate equipment, raw materials and start production in the nearest Skovje!

At the moment, the following quality standards for medical compression hosiery are most widespread in the world (that is, represented by product and geography):

• German standard RAL-GZ 387
• French AFNOR standard
• American standard
• British BSI standard

Recently, great efforts have been made to create a single European standard, but in the end, the preliminary version of ENV 12718 was rejected by the majority of the members of the standardization committee after more than 13 years of work. Only the German standard and later, following its example, the Dutch regulatory enactments took into account the reasonable requirements of the working version of the unified standard, so that it is the German standard that currently reflects to the maximum extent the unified approaches to the production and testing of the effectiveness of medical compression products, having rightly received the status “ gold standard "in this category. In particular, we are talking about those important requirements that are defined as mandatory for effective medical compression hosiery. We have already talked about them above.

There have been attempts to develop a similar standard in the American market in order to provide the medical community and patients with medical compression products with a truly controlled therapeutic effect. As a result, a certain compromise was reached, not enshrined in any single standard: the working group on standardization agreed on the basic requirements of the European pre-standard ENV 12817 (largely implemented in the German RAL-GZ 387), with the exception of such as pressure levels for compression classes. It was decided to use the historical ranges in the USA.

It is logical to ask the question - what about the Russian quality standards for MKT? Unfortunately, the level of the Russian research, expert and production base in this area is so low that the absence of any control system for the medical quality of MCT should hardly surprise anyone. It remains to be content with the fact that we carry out a formal procedure for checking the compliance of products with the general technical requirements of GOST (in fact, checking the textile quality and safety of the product).

So, having studied the current state of affairs in the world, we can confidently summarize: a) either the German standard RAL-GZ 387 is used as the main regulatory document for the certification of medical compression products; b) either there is a general understanding and consensus that the German standard RAL-GZ 387 guarantees the highest quality and medical efficiency of medical compression hosiery.

Table 1. Quality standards for medical compression products

Table 2. Ranges of compression classes, mm Hg. Art.

The second table shows us the properties of an elastic material and gives an answer to this question. Compression garments are made from elastic threads that naturally have certain tensile tolerances (highlighted in yellow). In order to ensure that the compression product clearly belongs to a specific pressure range (and class), it is necessary to lay the gaps between these ranges.

This is a prerequisite for conducting quality tests in the "field". Without observing this condition, it will not be possible to determine to which exact compression class this product belongs.

For clarity, consider a "bad" example - so, according to the American standard, a compression product with a pressure of about 20 mm Hg. Art. in the ankle area, it can belong to both the first (15-20) and the second (20-30) compression class. And in what box should I pack it?

Since such quality control is associated with the cost of prototypes, it should be possible to obtain samples from the manufacturer, dealers or medical centers. Today, this option is guaranteed only for manufacturers certified according to RAL-GZ - and this is in addition to the mandatory annual certification by the manufacturer of each type of product. This dual control system is unique and makes the German standard stand out from its peers.

It is important that in the framework of quality control procedures for compression properties (accuracy of pressure ranges) in accordance with the RAL-GZ standard, the use of the most modern and advanced equipment is prescribed, namely, the HOSY-System device, which allows several points to be compared with each other during the measurement measurements (the MST also provides a similar capability). The rest of the measuring devices allow you to measure pressure only at one point apart from the others.

Finally, in order to ensure that the patient is able to obtain the therapeutic effect here and now, it is extremely important to implement the correct compression characteristics into a serial product with a standard set of sizes. The RAL-GZ standard solves this problem thanks to the so-called "pressure corridor", which guarantees a designated compression level (for example, 18-21 mm Hg) for a certain range of circles at the measured points. This "corridor" allows serial production of effective medical products for 95% of patients. For the rest, there is always the possibility of making a product to order according to individual measurements.

Thus, we will further narrow the first golden rule - choose compression hosiery that meets the most thoughtful and advanced German standard RAL-GZ 387 - knitwear with maximum efficiency and reliability!

Choosing a certified brand of medical compression hosiery

Now we know that the main question for the sales assistant of an orthopedic pharmacy or salon is "What brand do you have that meets the international quality standard for medical compression hosiery?" Next, you may have three tricks waiting for you:

Choosing the right model range

It is important to understand that if medi is included in the list of companies certified according to RAL-GZ 387, this does not mean at all that all medi compression hosiery is suitable for the treatment of varicose veins and other venous pathologies.

Choosing compression hosiery is a daunting task. If the dimensions can be easily selected on your own, and the compression class - with the help of a doctor, then it is not so easy to determine the manufacturer. To make this process easier for you, we will tell you about the main manufacturers of knitwear with a brief description of each of them.

Foreign manufacturers of compression hosiery

Medi and Sigvaris take about 60% of the total European market for compression hosiery. For several decades, these enterprises have been rightfully considered the leaders in the industry in terms of product quality, medical properties of knitwear, innovative production technologies and their contribution to clinical research in the field of lymphology and phlebology.

This is followed by less expensive, but also upscale brands. They are distinguished by a wide range of products (both in terms of the number of offered collections and the breadth of the dimensional grid, as well as colors), the use of natural materials (for example, cotton and rubber threads), the ability to manufacture products for individual orders.

Economy class jersey produced by foreign factories Tonus and Relaxsan is quite comparable in quality and reliability with domestic production.

Domestic manufacturers of compression hosiery

Leading Russian brands today are able to offer products that are quite comparable to the level of the best foreign samples. This is achieved through the use of high-quality imported raw materials, a multi-stage quality control system, and regular training of employees abroad. Due to the fact that the production of compression hosiery is carried out on the territory of our country, they manage to produce goods at an affordable price for buyers.

Remember that compression hosiery is a medical underwear that is necessary for the proper functioning of the human circulatory system and prevention of serious pathologies. Buy it only in trusted stores, in particular, in the NetRan online store. In this case, you will receive guaranteed quality and original products, accompanied by all the necessary certificates.

Modern compression socks or stockings have a good healing effect, are comfortable in everyday use and have a completely aesthetic appearance. They reduce the load on the veins, normalize venous outflow, and prevent venous blood congestion. According to randomized trials, systemic compression therapy results in a steady improvement in the condition of the problem area.

In order to choose the right size for compression stockings or golf, it is important to pay attention to the markings. As a rule, the packaging contains the compression class and pressure in mm. rt. Art. or GPa (1 mm Hg = 1.333 hectopascals). When buying, it is important to know not only the size, but also what compression class you need.

Classification of compression products

Specialized jerseys are classified into compression classes (RAL-GZ 387):

• Compression class A - from 10 to 14 mm. rt. Art. (13 - 19 GPa)

Products for prevention.

• Compression class I - 15 - 21 mm. rt. Art. (24 - 28 GPa)

The products are used to eliminate spider veins and pain in the legs.

• Compression class II - 22 - 33 mm. rt. Art. (31 - 43 GPa)

The products are used to treat thrombophlebitis and varicose veins.

• Compression class III - 34 - 46 mm. rt. Art. (45 - 61 GPa)

The products are used for the treatment of venous insufficiency, trophic disorders.

• Compression class IV -> 49 mm. rt. Art. (›65 GPa)

Products are used to normalize lymph flow and eliminate edema.

Compression knee-highs or stockings are selected individually, in accordance with the anatomical profile of the limb and the nature of the pathology. As a rule, the wearing of compression products is prescribed by a doctor, especially when it comes to compression over 21 mm. rt. Art.

How to determine the correct size?

To do this, you need to make the following foot measurements:

What is important to know for choosing the right compression product?

1. When buying stockings or knee-highs made of compression fabric, pay attention to the special labels on the packaging indicating:

• Breathable effect.
• Antimicrobial effect.
• Hypoallergenic effect.

Having bought such a product, you can be sure that your feet will remain dry and an unpleasant odor will not appear.

2. You should not prescribe yourself to wear a compression product, but purchase it strictly according to the doctor's prescription. The phlebologist will diagnose, accurately determine the stage of the disease, and select the degree of necessary compression.

3. If the packaging for stockings or golf contains the inscription Oko-Tex Standard 100, it means that the product is made of environmentally friendly material.

4. An important characteristic is the standard, which is marked on the packaging as RAL-GZ 387 or Quality mark RAL. This mark indicates that the product has been tested, its composition is regulated, and the fabric is durable.

5. Pay attention to the warranty period of the product. As a rule, this period is up to 12 months.

6. Both stockings and socks should be free of seams.

Today, medical compression knee-highs and stockings are created for both women and men, and in general for those people who lead an active lifestyle. But remember, if the purchased product is small or large for you, then there is a violation of the distribution of compression and the healing effect disappears. Therefore, it is so important to correctly determine the correct size.