JOBST FarrowWrap - Australian Physiotherapy Equipment€¦ · JOBST® FarrowWrap® Measurement...

JOBST® FarrowWrap®

Ordering Form

How to measure

JOBST® FarrowWrap® RTW Legpiece size chart

JOBST® FarrowWrap® RTW Thighpiece size chart

XSmall Small Medium Large XLarge

Ready-to-wear pieces

Thighpiece

G Groin 60 - 70 cm 65 - 75 cm 70 - 80 cm 75 - 90 cm 85 - 100 cm

E Above Knee 47 - 52 cm 53 - 59 cm 60 - 66 cm 67 - 73 cm 74 - 80 cm

E-G Short 16 - 20 cm 16 - 20 cm 16 - 20 cm 16 - 20 cm 16 - 20 cm

E-G Regular 21 - 26 cm 21 - 26 cm 21 - 26 cm 21 - 26 cm 21 - 26 cm

E-G Tall 27 - 31 cm 27 - 31 cm 27 - 31 cm 27 - 31 cm 27 - 31 cm

Length E-G = Measure MEDIALLY from just above patella to the groin. Follow outer contour of any skin folds/lobules.

JOBST® FarrowWrap® RTW Footpiece size chart

XSmall Small Medium Large XLarge

Ready-to-wear pieces

Footpiece

A Mid-foot 22 - 24 cm 25 - 27 cm 28 - 30 cm 31 - 34 cm 35 - 40 cm

X Regular 15 - 17 cm 16 - 19 cm 18 - 20 cm 19 - 22 cm 21 - 24 cm

X Tall 18 - 20 cm 20 - 22 cm 21 - 23 cm 23 - 25 cm 25 - 27 cm

The length is measured from the most posterior aspect of the heel to the base of the 5th toe.

XSmall Small Medium Large XLarge

Ready-to-wear pieces

Legpiece

C Calf 36 - 43 cm 42 - 50 cm 48 - 58 cm 53 - 63 cm 58 - 68 cm

B Ankle 21 - 25 cm 25 - 30 cm 30 - 36 cm 36 - 42 cm 42 - 50 cm

A-D Regular 35 - 39 cm 37 - 41 cm 39 - 43 cm 41 - 45 cm 42 - 46 cm

A-D Tall 40 - 44 cm 42 - 46 cm 44 - 48 cm 46 - 50 cm 47 - 51 cm

Length A-D = Floor to 2 finger widths below crease of knee. Measure posteriorly FOLLOWING contour of leg.

Xsmall Small Medium Large X Large

5cm above patella 47 - 52cm 53 - 59cm 60 - 66cm 67 - 73cm 74 - 80cm

Calf 36 - 43cm 42 - 50cm 48 - 58cm 53 - 63cm 58 - 68cm

How to measure

NOTE: Measure length along the lateral outer arm from the wrist to the axilla with a slight bend in the arm.

C GWrist Elbow Axilla

Small 14cm - 18cm 20cm - 27cm 22cm - 31cm

Medium 16cm - 21cm 25cm - 34cm 29cm - 39cm

Large 19cm - 25cm 30cm - 40cm 32cm - 45cm

Length

Short 40cm - 43cm

Regular 44cm - 47cm

Long 48cm - 51cm

JOBST® FarrowWrap® RTW Armsleeve size chart

JOBST® FarrowWrap® RTW Gauntlet sizing chart

Xsmall Small Medium Large

A 16cm - 18cm 18cm - 20cm 20cm - 22cm 22cm - 24cm

B 17cm - 19cm 19cm - 21cm 21cm - 23cm 23cm - 26cm

C 15cm - 18cm 17cm - 20cm 19cm - 22cm 22cm - 24cm

JOBST® FarrowWrap® Liner sizing chart

Terry Cloth Liners Can accommodate the following calf circumferences:

Small (>40 cm), Medium (40-70 cm) and Large (70-120 cm).

Silver LinersSmall – Can accommodate calf circumferences to 60cm.

Large – Can accommodate calf circumferences to 70cm.

Hybrid LinersMeasure the mid foot A circumference.

Two mid foot sizes available: 20-27cm (regular foot) and 28-35cm (wide foot).

Request the patients shoe size (US Sizing).

Jobst® FarrowWrap® Knee piece sizing chart

Male Shoe Size

Female Shoe Size

Small 3 – 6 4 – 7

Medium 7 – 9 8 – 10

Large 10 – 12 11 – 13

XLarge 13 – 15 14 – 16

Note the maximum calf size for Hybrid Liners is 60cm

your care

Supporting

journey

JOBST® FarrowWrap® Ordering FormDoctor/Nurse/Clinician’s name: Phone:

Client’s name: Phone:

Client’s address:

Order No.: Date:

Style Fabric Size Ordering Code Quantity

Hybrid LinerCompression in the foot only

☐ ADI (20-30mmHg)

☐ ADII (30-40mmHg)

☐ Small☐ Medium☐ Large☐ XLarge

☐ Regular Foot

☐ Wide Foot

Footpiece(Fits midfoot 22-40cm circumference)

☐ LITE (20-30mmHg)

☐ STRONG (30-40mmHg)

☐ CLASSIC (30-40mmHg)

☐ Xsmall☐ Small☐ Medium☐ Large☐ XLarge

☐ Regular

☐ Long

Legpiece(Fits 36-68cm circumference, 35-51cm length)

☐ LITE (20-30mmHg)

☐ STRONG (30-40mmHg)

☐ CLASSIC (30-40mmHg)

☐ Xsmall☐ Small☐ Medium☐ Large☐ XLarge

☐ Regular

☐ Tall

Kneepiece☐ LITE (20-30mmHg)

☐ STRONG (30-40mmHg)

☐ Xsmall☐ Small☐ Medium☐ Large☐ XLarge

Thighpiece (Comes with knee piece)

☐ LITE (20-30mmHg)

☐ STRONG (30-40mmHg)

☐ CLASSIC (30-40mmHg)

☐ Xsmall☐ Small☐ Medium☐ Large☐ XLarge

☐ Short

☐ Regular

☐ Tall

Armsleeve

☐ LITE (20-30mmHg)

☐ Left ☐ Right

☐ Black ☐ Beige

☐ Small☐ Medium☐ Large

☐ Short

☐ Regular

☐ Long

Farrow Toe Cap/Glove

(20-30mmHg)

☐ Xsmall☐ Small☐ Medium☐ Large

Gauntlet ☐ LITE (20-30mmHg)

☐ Xsmall☐ Small☐ Medium☐ Large

Liner options

When a foot piece and leg piece are purchased together one pair of AD liners are supplied free. Please state preference:

☐ Silver (closed toe) Size ☐ Small ☐ Large ☐ Soft (open toe) Size ☐ Small ☐ Medium ☐ Large When a foot piece, leg piece and thigh piece are purchased together one pair of AG liners are supplied free. Please state preference:

☐ Soft (open toe) Size ☐ Small ☐ Medium ☐ Large

Left Right Size

Legpiece

Calf

Ankle

Length

Footpiece

Mid foot

Length

Thighpiece

Groin

Above Knee

Length

Kneepiece

Above knee

Calf

Left Right Size

Armsleeve

Wrist

Elbow

Axilla

Length

Gauntlet

Palm A

Palm B

Wrist C

Toe Cap/ Glove

Metatarsal Heads A

JOBST® FarrowWrap® Measurement Record

Local JOBST StockistESS0025 03/2019

BSN medical Australia & New Zealand an Essity company

L6, 211 Wellington Road, Mulgrave, Victoria Australia 3170PO Box 337, Mount Waverley, Victoria 3149

JOBST® Customer Service AustraliaT 1300 998 810 F 1300 998 820 www.bsnmedical.com.auJOBST® Customer Service New ZealandT 0508 998 810 F 0508 998 820www.bsnmedical.co.nz

cA-Circumference (cm)