As one of the critical elements in recovering from many plastic surgery procedures, the post-surgical garment is designed to evenly compress a specific area of the patient's body. After procedures such as abdominoplasty, brachioplasty, liposuction, breast reduction and even facial lifts, the compression garments help the patient's skin heal back to the muscle from which it's been loosened due to the removal of excess skin and fatty tissue.

The garments keep swelling down and prevent the buildup of excess fluid between loose skin and muscle, a condition that could create a serious problem. Secondarily, they can also serve to hold post-surgical dressings in place and help patients avoid discomfort during recovery. They're generally prescribed to be worn around-the-clock for a week or more after surgery and removed only when the patient bathes.

If you've considered the purchase of these post-surgical garments for your patients, you may have been overwhelmed by the number of choices in manufacturer and style. How can you know which garment works best for a particular procedure? This is knowledge that stems largely from experience.

Because the majority of procedures performed at my surgical facility are plastic surgery procedures, my staff and I have experimented with a variety of garments ranging in price from the moderate to the expensive. Here are a few factors to keep in mind to ensure that you'll have more trial and less error.

Basic principles
A note on terminology: Many manufacturers classify their post-surgical garments into two different stages or phases. The garments are generally similar, if not exactly the same. The distinction is when during the procedure they're put into use.

Stage one garments are those that are put on the patient after the procedure, while the patient is still on the OR table. They frequently include zippers and hook-and-eye closures to assist nurses in dressing the patient.

Stage two garments are those that the patients put on themselves once they've been discharged from the surgery center and are recuperating at home.

Any post-surgical compression garment you can buy will provide uniform compression to facilitate healing - I don't ever think I've seen a nylon-and-Lycra blend garment that didn't provide adequate compression - but you'll probably want to make sure that the construction is latex-free. You'll also want to keep in mind when choosing a range of sizes that the bodies the garments are going to be supporting are going through radical changes in measurements, from their arrival in the OR to their departure from the table to their eventual recovery.

Patient comfort and everyone's ease
Skin is very sensitive after surgery, especially cosmetic surgery. It's hypersensitive. So you'll want to choose garments that are as comfortable as possible for the patient. Pay close attention to the texture of the fabric. Smooth is preferable to rough when it comes to fabrics: Sometimes you see a garment made from a coarser fabric and you just know it's going to chafe the patient. And take note of the size and locations of a garment's seams - or, even better yet, its seamlessness.

You'll also want to seek out garments that are easy to put on, for you and for the patient. Stage one garments, particularly full-body garments, can be difficult to pull onto patients when they're still under anesthesia or just emerging from it and generally unresponsive. Remember, too, that patients are eventually going to have to remove and redress themselves in the garments once they get home, or in the case of stage two garments, put them on without your example.

Zippers and hook closures can help in securing the garments, but I've also found that softer fabrics slip onto the patient a little easier, and the stretchier fabrics, the ones that have a little more give, are easier to pull onto the patient and pull the edges closed. The better quality garments have what textile manufacturers call omnidirectional stretch, which is to say that they stretch both horizontally and vertically, not just one way.

Softer, stretchier, more durable fabrics may cost a little more, but they're often more comfortable for the patient and can be easier for your staff and patients to use them. Cost containment is an important consideration in supplies that literally walk out the door, as these do, but I know I'll spend more on post-surgical garments that are more comfortable and easier to use. It makes recovery that much more convenient for everyone.

Options and responses
Vendors will oftentimes give you a couple samples of their post-surgical garments to trial with patients, and experience will show you what works. But it's also extremely important to listen to what patients say in judging the effectiveness of the garments. If five patients in a row, for instance, say that their recovery experience was terrible on account of discomfort or difficulty with the garment, you'll know what doesn't work. We've noticed it ourselves. When we started using better garments, we noticed we got fewer patient complaints.

As with many types of surgical supplies, you always have your eye out for something better. Luckily, there's always another option. There are a lot of vendors out there; with a bit of research, you'll find one that offers a garment that does what you need it to do.

Annette International
The Versatile Bra (no. 10579)
(877) 883-0822
www.annettepostsurgery.com
Price: $25
FYI: Available in a range of sizes, this garment features smooth, seamless cups that support and center the breasts, adjustable open straps and an adjustable hook-and-eye front closure. The wide, supportive back design provides comfort for patients with larger bust sizes, says the company, describing the product as ideal following biopsy, lumpectomy, breast augmentation and breast reduction procedures.

Connie Elder International, LLC
Lipo In A Box phase2wear
(866) 547-6269
www.lipoinabox.com
Price: $30 to $84
FYI: Lipo In A Box phase2wear is a complete line of stage two compression garments, says the company, whose comfort and support encourage patient compliance. Many styles are seamless and others include minimal seams. A high-tech, patented design weaves comfort and compression into the same garment. The garments are available in sizes from XS to 2X, and in nude and black.

Expand-A-Band Medical
Breast Binder
(800) 582-5332
www.breastbinders.com
Price: $27
FYI: Expand-A-Band Breast Binders are washable, durable, attractive compression garments that help reduce bruising, swelling and incidences of hematomas after invasive breast procedures, says the company. The garments are easy to apply, comfortable to wear, latex-free and more appealing to patients than elastic bandage wraps or other available post-op compression dressings.

Garments Select, LLC
Post-surgical compression garments
(678) 455-6237
www.surgicalgarments.com
Price: $15 for bra products to $60 for full-length body girdle
FYI: Garments Select provides post-surgical wear for women and men with a wide selection of breast wear, full-body wear and facial wear, says the company. Designing and manufacturing compression wear in the United States for more than a decade, the company's staff says it offers the highest quality and most advanced lines of compression garments available.

Innovative Health Products, Inc.
The Goldy Ice Cap
(619) 440-4800
www.thegoldy.com
Price: $54.95 for garment and four gel packs
FYI: The Goldy Ice Cap offers a unique, hands-free, soothing thermal therapy product for the facial and neck areas after cosmetic procedures, says the company. Providing ease of use and convenience in application of cold therapy to speed the healing process, the Goldy Ice Cap has led many patients to find they have a decreased need for prescription pain medication, thus allowing the body a more gentle and natural recovery.

Marti Era Designs, Inc.
Post-surgical bras
(217) 427-2198
www.martieradesigns.com
Price: $48.95
FYI: A line of post-surgical bras designed by a breast cancer survivor, these garments feature a side opening that lets you immediately apply the bra after surgery and adjust it on each breast to accommodate incisions, drains and swelling, says the company. Ideal for augmentation, mastectomy, lumpectomy or other types of breast surgery, the bras are available in sizes from XS to XXL as well as custom fits.

Slender Touch
Compression garments
(800) 324-2409
www.slendertouch.com
Price: $140 to $180
FYI: Slender Touch's compression garments are designed to provide support to patients undergoing many kinds of surgical procedure, including liposuction, tummy tuck and gastric bypass, says the company. The garments provide gradual compression and steady massage that stimulate lymphatic drainage and blood circulation, diminish tissue flaccidity and provide corporal support.

The do-it-all, one-handed dictation device
The new generation of SpeechMike dictation devices from Philips Electronics provides greater ease of use, improved ergonomic design and unique functionality, says the company, by combining intuitive navigation tools (such as an optical trackball and a scroll wheel) and building the dictation microphone, playback speakers, dictation control and PC navigation into a single device. According to Philips, the SpeechMikes are the first dictation devices to feature a scroll wheel for both volume control and navigation, letting users move through forms or documents using only one hand. The new SpeechMikes are available in two types: the Classic, with the four-position switch, and the Pro version with push buttons. The fully programmable buttons are said to be larger and more sensitive so that the user doesn't have to look away from the computer screen. The Classic version's switch is also programmable. All microphones feature a wide frequency and sensitivity range. All SpeechMike products are based on the latest USB 2.0 technology and are the first dictation devices to comply with the European Union's "Restriction of Hazardous Substances in Electrical and Electronic Equipment" directive that takes effect July 1, says the company. The SpeechMike Classic Plus lists for $279, the SpeechMike Pro Plus for $259, the SpeechMike Classic for $249 and the SpeechMike Pro for $229. For more information, call (888) 260-6261, visit www.speech.philips.com or circle number 167 on your Reader Service Card.

Now you can provide stable head positioning for difficult airways
To aid airway management of morbidly obese and other difficult airway patients, the Troop Elevation Pillow might be a good option. The single-use, solid foam positioner is latex-free and anti-static. Designed and developed by a physician, the Troop Elevation Pillow eliminates the problems inherent in stacking blankets under the patient's head while quickly achieving the head-elevated laryngoscope position that is recommended for airway management of obese patients. The pillow is indicated for use with difficult-airway patients in a variety of procedures with any kind of anesthesia or sedation. Troop Elevation Pillows come four to a box and costs $198. For more information, call (800) 237-6418, visit www.mercurymed.com or circle number 168 on your Reader Service Card.

Patient ID bracelets that let you track and scan
Precision Dynamics Corporation is set to launch two patient ID bracelets for use at the point of care throughout your facility. The PDC Smart Station and Smart CompuBand-S RFID Wristbands let you incorporate patient tracking and barcode scanning. The Smart Station (right), a mini-kiosk, lets staff process such patient transactions as appointments, consent forms, co-pay collections and positive identification. You can print the wristbands (bottom right) with bar code information and program them with RFID information on demand using an RFID printer/programmer, while the tamperproof and secure lanyard snap closure provides maximum security. The Aztec two-dimensional bar code wristband can encode up to 3,750 characters. Two-dimensional code stores information vertically and horizontally, radiating outward from a center point, letting you store more information in more fields and keeping you from disrupting patients in order to find the code to scan, says the company. Traditional barcodes (such as UPC codes) are one-dimensional. That is, the same information can be repeated vertically - the heights of the bars on the barcode can be any size, and the same information will be read when scanned (though the taller the bars, the higher the scanability). The company has not yet set pricing on the products. For more information, call (800) 772-1122, visit www.pdcorp.com or circle number 169 on your Reader Service Card.