What is a stockinette and what is it used for in clinical settings?

A stockinette (also called tubular stockinette, tubular bandage, or undercast stockinette) is a seamless, knitted tubular fabric made from cotton, synthetic fibre, or a cotton/viscose blend. It has no seams and no fastening — it is slid over the limb as a continuous tube. In clinical settings it serves three primary functions: (1) Undercast protection — applied directly over skin before cast padding and plaster or fiberglass cast material, protecting the skin from cast material contact, reducing pressure sores, and creating a smooth inner surface for patient comfort; (2) Under-compression liner — used as the innermost layer in multi-layer compression bandage systems for venous leg ulcer and lymphoedema management, providing a protective interface between fragile or damaged skin and the compression bandaging layers; (3) Surgical limb cover — sterile surgical stockinettes are used intra-operatively to cover limbs during surgical procedures, maintaining sterility and patient warmth. Each application requires different specifications — non-sterile for orthopaedic casting, sterile for intra-operative use.

What is the difference between cotton and synthetic stockinette and when is each used?

Cotton stockinette (100% cotton or cotton/viscose blend): The traditional and most widely used format. Soft, breathable, and skin-friendly. Absorbs perspiration from the skin under the cast, improving comfort during extended wear. Recommended for use under plaster of Paris (POP) casts and traditional casting applications. Cotton stockinette can be steam sterilized at 121°C if required (confirmed by L&R Global product IFU), making it suitable for sterile applications when needed. Synthetic stockinette (polyester or polyester/cotton blend): Used primarily under synthetic fiberglass casting tape. Synthetic fibres are preferred for synthetic casts because they are more resistant to moisture — when a synthetic cast is exposed to water (e.g., waterproof cast systems), synthetic stockinette retains less moisture than cotton, reducing maceration risk under the cast. For waterproof synthetic cast applications, synthetic stockinette may be specified as part of the casting system. In standard non-waterproof casting, either cotton or synthetic is acceptable.

How do I choose the right stockinette width for a limb?

Stockinette width selection is based on limb circumference. Unlike flat bandages where width equals coverage, tubular stockinette is sized by the diameter it will fit when flat — when opened out, the circumference is approximately double the flat width. The general selection guide for orthopaedic casting: 2 inches (5 cm) for fingers and small paediatric limbs; 3 inches (7.5 cm) for wrist, small forearm, small ankle; 4 inches (10 cm) for forearm, ankle, and lower leg in standard adults — most commonly procured width; 6 inches (15 cm) for knee, thigh, and upper arm; 9–10 inches (23–25 cm) for above-knee amputee stump care and large thigh casts; 12 inches (30 cm) for trunk, body, and thoracic applications. The stockinette should fit snugly without constricting — it should slide on easily but not wrinkle excessively when applied. A snug fit ensures the cast material sits smoothly and prevents pressure points from fabric folds.

Can stockinette be steam sterilized and when is sterile stockinette required?

Cotton stockinette can be steam sterilized at 121°C if required, making it suitable for sterile applications (confirmed by L&R Global product documentation). Sterile stockinette is required in two primary contexts: (1) Intra-operative surgical use — sterile surgical stockinettes are used to cover extremities during orthopaedic and other surgical procedures. The stockinette maintains the sterile field over the limb during surgery. These are typically supplied as pre-cut, pre-rolled sterile units in individual sterile packaging. (2) Post-operative wound care in sterile settings — when stockinette will contact an open or surgical wound in a setting where all wound-contact materials must be sterile. For standard orthopaedic casting applications (applying cast over intact skin), non-sterile stockinette is appropriate and far more commonly procured. For intra-operative use, specify 'sterile surgical stockinette' and confirm sterile packaging with individual sealed units.

What is the difference between stockinette and undercast padding (orthopaedic wadding)?

Stockinette and undercast padding (orthopaedic wadding) serve different functions in the casting layering sequence and should not be confused in procurement: Stockinette is the innermost layer — applied directly over the skin as a smooth, seamless tube. It provides a comfortable skin interface and prevents cast material from contacting skin directly. It has minimal cushioning. Undercast padding (orthopaedic wadding, cast padding) is the next layer — applied over the stockinette before the cast material. It provides cushioning and pressure redistribution over bony prominences, and allows the limb to swell slightly without constriction under the hardened cast. Together, the casting sequence is: skin → stockinette → undercast padding → cast material. Both are required for most casting applications. Stockinette cannot be substituted for undercast padding and vice versa.

Kingphar Medical Group

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6/5 2026

Stockinette: Specifications, Types & Procurement Guide 2026

Orthopaedic · Surgical · Procurement Guide

Stockinette:
Specifications, Types
& Procurement Guide 2026

Stockinette is procured for two entirely different clinical contexts — non-sterile for orthopaedic casting, and sterile for intra-operative surgical use. Cotton and synthetic types serve different casting systems. Width selection directly affects patient comfort under the cast. This guide covers all three decision points, the casting layer sequence, and a procurement checklist.

Cotton vs synthetic types Orthopaedic vs surgical use Width selection by limb Casting layer sequence Steam sterilization Procurement checklist

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Construction

Seamless knit

Circular knit — no seams, no fastening. Slides over limb as continuous tube. Lateral stretch up to 3× original diameter. Source: TruMedical, Tex Care product documentation.

Primary use

Undercast

Innermost layer under cast padding and plaster or fiberglass cast. Protects skin from cast material contact. Also used under compression bandaging and for stump care.

Steam sterilization

121°C

Cotton stockinette can be steam sterilized at 121°C if required. Source: L&R Global product IFU. Enables sterile surgical use when needed.

Standard clinical widths

2"–6"

2" (fingers/small paediatric) to 6" (knee/thigh) for standard orthopaedic use. Larger sizes (9"–12") for stump care and surgical coverage. Source: Mountainside Medical, OrthoTape product specs.

Stockinette — also called tubular stockinette, tubular bandage, or undercast liner — is a seamless knitted cotton or synthetic tube used as the innermost protective layer in orthopaedic casting, compression bandaging, and surgical limb coverage. Its seamless circular knit construction means there are no pressure points from seams or folds against the skin under a cast. Its lateral stretch allows it to conform to the limb without wrinkles.

For procurement managers, the key decisions are material type (cotton or synthetic — determined by the casting system), sterility requirement (non-sterile for casting, sterile for surgical use), and width selection (based on limb circumference). "Stockinette" alone in a purchase order is insufficient — it should always specify material, width, roll length, and sterility. For related orthopaedic procurement guidance, see our Plaster of Paris Bandage product page.

Section 01

Cotton vs Synthetic Stockinette: Material Selection

Traditional — POP and general casting

Cotton Stockinette

100% cotton or cotton/viscose blend (commonly 67% cotton / 33% viscose per North Coast Medical product specification). Soft, skin-friendly, highly breathable. Absorbs perspiration from the skin during extended cast wear, improving patient comfort. Can be steam sterilized at 121°C (L&R Global IFU confirmed). Off-white or beige colour standard.

Best for: Plaster of Paris (POP) casts, general orthopaedic casting, compression bandage liner, stump care, surgical limb coverage (sterile format). Standard procurement for orthopaedic departments.

Synthetic — fiberglass / waterproof casts

Synthetic Stockinette

Polyester or polyester/cotton blend. More moisture-resistant than cotton — retains less water when the cast is exposed to moisture, reducing maceration risk under the cast. Preferred for use under waterproof fiberglass casting systems where the patient will shower or swim. White colour typical.

Best for: Synthetic fiberglass casting, waterproof cast systems. Specified as part of the casting system protocol — always confirm casting system manufacturer's recommended stockinette type.

Always follow the casting system manufacturer's stockinette recommendation

Major casting tape manufacturers (3M, BSN Medical, and others) specify compatible stockinette types as part of their casting system IFU. Substituting a different stockinette material than recommended may affect cast adhesion, patient comfort, and the performance of waterproof casting systems. If in doubt, confirm the compatible stockinette type with the casting tape manufacturer before specifying stockinette separately.

Section 02

Three Clinical Applications and Their Procurement Requirements

Application	Sterility	Material	Format	Key specifications
Orthopaedic casting (POP or fiberglass)	Non-sterile	Cotton (POP) or synthetic (fiberglass/waterproof)	Continuous roll — 25 yards (22.9 m) or 4 m	Width per limb circumference. Continuous roll in dispensing box for efficient cutting to length in plaster room.
Under-compression bandaging liner	Non-sterile	Cotton or viscose blend	Continuous roll — cut to limb length	Provides protective interface between fragile skin and compression bandage. Changed daily or when soiled.
Stump care (amputation)	Non-sterile	Cotton	Continuous roll or pre-cut lengths	Larger widths (9"–10") for lower limb stumps. Seamless construction critical — no seam pressure on sensitive stump tissue.
Surgical limb coverage (intra-operative)	Sterile	Cotton (steam sterilizable at 121°C)	Pre-cut lengths — individually sterile packed	Sterile packaging per ISO 11607. Pre-cut to standard surgical lengths (36"–72"). Used to maintain sterile field over limb during procedure.
Post-operative wound protection	Sterile (if wound contact)	Cotton	Pre-cut or from roll	Sterile for open wound contact. Non-sterile acceptable if covering intact skin only.

Section 03

The Casting Layer Sequence: Where Stockinette Fits

Understanding the casting layer sequence is essential for procurement — stockinette and undercast padding are frequently confused but serve different functions and cannot substitute for each other.

Skin (patient)

No preparation required beyond standard skin care. A suitable skin care lotion may be applied before stockinette if skin is dry or fragile — particularly for compression bandage applications or stump care.

Stockinette (this product)

Slid over the limb as a seamless tube. Provides smooth, comfortable skin interface. Prevents cast material from direct skin contact. Extends beyond the cast edges to fold back over cast ends for finished appearance and skin protection at cast margins. No cushioning function.

Undercast padding / orthopaedic wadding

Applied over stockinette in spiral overlapping layers. Provides cushioning and pressure redistribution over bony prominences. Allows limb to swell under the hardened cast without constriction. This layer provides the cushioning — stockinette alone provides no meaningful cushioning.

Cast material (POP or fiberglass)

Applied over the padding layers. Hardens to immobilise the fracture or injury. The stockinette ends are folded back over the cast edges and secured before final cast layers are applied — this creates clean, padded cast edges that do not cut or abrade the skin at the proximal and distal margins.

Stockinette cannot substitute for undercast padding

A casting sequence that omits undercast padding and applies cast material directly over stockinette will result in a cast with inadequate cushioning over bony prominences — creating pressure sores, particularly over malleoli, ulnar styloid, and tibial crest. Both layers are required. See our Undercast Padding product page for the padding layer specification.

Section 04

Width Selection Guide

Stockinette width is measured as the flat width of the tube. The circumference available when the tube is opened is approximately double the flat width. Select a width that fits snugly over the limb without excessive wrinkling or constriction.

Flat width	Approximate limb fit	Primary applications
2" (5 cm)	Finger, toe, infant limbs	Finger and toe casting; infant/neonatal limb protection
3" (7.5 cm)	Wrist, small forearm, small ankle	Short arm casts, wrist splints, paediatric lower limb
4" (10 cm)	Forearm, ankle, lower leg — standard adult ★	Most commonly procured width. Long and short arm casts, ankle and below-knee casts, adult forearm casting.
6" (15 cm)	Knee, upper arm, thigh	Long leg casts, above-knee casts, cylinder casts, large upper limb casting
9" (23 cm)	Thigh, large limbs, stump	Large thigh casts, lower limb amputation stump care
10"–12" (25–30 cm)	Trunk, body, large surgical coverage	Body casts, thoracic/abdominal surgical coverage, large stump management

Roll length for orthopaedic department procurement

Standard roll format is 25 yards (approximately 22.9 m) per roll in North American format, or 4 m and 25 m rolls in European format (L&R Global product documentation). The 25-yard (25m) continuous roll in a dispensing box is the most efficient format for busy orthopaedic plaster rooms — the dispensing box allows cutting to required length without handling the full roll. For lower volume use or pre-cut surgical formats, shorter rolls or pre-cut lengths are available.

Section 05

Steam Sterilization: Requirements and Compatibility

Cotton stockinette can be steam sterilized at 121°C (confirmed by L&R Global product IFU for their cotton tubular stockinette). This makes cotton stockinette compatible with standard gravity displacement steam sterilization cycles and suitable for sterile surgical applications. Key points for procurement:

Confirm sterilization compatibility before reprocessing — confirm with your specific supplier that the product is rated for steam sterilization. Not all cotton stockinette products are validated for sterilization — a product that has not been validated for sterilization should not be sterilized in-house
Pre-cut sterile surgical stockinette is available — for intra-operative use, pre-cut sterile stockinette in individually sealed sterile packs eliminates the need for in-house sterilization and provides a ready-to-use surgical product with documented sterility
Synthetic stockinette may not be steam sterilization compatible — polyester fibres can be heat-sensitive at sterilization temperatures. Do not assume synthetic stockinette is sterilizable — confirm with supplier before attempting

Section 06

Procurement Specification Checklist

Specify material — cotton (POP casting, compression liner, surgical) or synthetic (fiberglass/waterproof casting) — confirm with your casting tape manufacturer which stockinette material is compatible with your casting system. Do not specify stockinette material without reference to the casting system being used
Specify width — procure a range covering finger to thigh applications — for a general orthopaedic department, a minimum of three widths is practical: 2" or 3" for small limbs, 4" for standard adult limbs (most consumed), and 6" for large limbs. Add 9" or larger for stump care if your department provides that service
Specify sterile or non-sterile — and for sterile, specify packaging format — non-sterile continuous roll for casting. Sterile pre-cut individually packed for surgical use. For in-house sterilization, confirm product is validated for 121°C steam — request written confirmation from supplier
Specify roll format — 25-yard dispensing box for plaster room efficiency — continuous roll in a dispensing box allows cutting to exact length without handling the full roll. Pre-cut lengths are suitable for surgical and low-volume settings
Confirm latex-free — cotton and synthetic stockinette are typically latex-free, but confirm in writing for facilities with latex-sensitive patient protocols
Verify CE marking — Class I for non-sterile; Class Is for sterile — for GCC supply, confirm SFDA registration and Arabic labeling capability

Data Sources

L&R Global (Lohmann & Rauscher). Plain stockinette / Tubular bandage product IFU. "Composed of 100% off-white cotton... can be steam sterilised at 121°C if required... available as 4 m and 25 m rolls." lohmann-rauscher.com.
North Coast Medical. TG Tubular Bandage Stockinette. "Fine, seamless, knitted tube made of 67% bleached cotton and 33% viscose. Material is tightly meshed and can be stretched laterally without creases." ncmedical.com.
TruMedical Solutions. Tru™ Cotton Stockinette. "Knit tubular bandage stretches up to three times its original size for conformability." tru-medical.com.
Tex Care Medical. Cotton Tubular Stockinette. "Stretch up to 3x their size." Standard widths 2", 3", 4", 6". texcaremedical.com.
Mountainside Medical Equipment. Cotton Tubular Stockinette. "Knitted from cotton or synthetic materials in 2, 3 or 4 inch widths. Latex-free. Non-sterile." mountainside-medical.com.
Horizon Medical Equipment. Sterile Surgical Stockinette. Pre-cut sizes 3×36", 4×36", 4×48", 4×60", 6×48", 6×60", 6×72", 8×72" confirmed. horizonmedicalequipment.net.
OrthoTape. 3" Orthopaedic Medical Tubular Cast Stockinette. "Width 3 inches (7.6 cm), Length 10 feet (3 m), Material Synthetic tubular knit." orthotape.com.

Related guides

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Sourcing stockinette for orthopaedic or surgical supply?

Kingphar manufactures cotton stockinette in standard widths 2"–12" — non-sterile continuous rolls and sterile pre-cut formats, CE-certified under EU MDR 2017/745, ISO 13485, with SFDA registration support and Arabic labeling for GCC institutional supply.

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