BANDAGING

3 Purpose of Bandaging (CRS)

• Control edema, swelling or joint effusion

• Support or stabilize a segment

• Restrict motion of a joint

MOST COMMON INJURY THE REQUIRES BANDAGE

Sprain or strain

Most frequently used material for bandage

Muslin

• Unbleached Cotton or Gauze Bandage

Bandage Material

For post-op

Cotton Rolled Gauze

Bandage Material

For covering the limb; protection of the end-stump before putting it in a prosthetic limb

Stockinet, Loosely Knit Cotton Formed

Types of Bandage

Serves as a Large piece of cloth cut or formed into a triangle .Temporary sling to support weight of UE

Triangular

Types of Bandage

Used as a sling but will not support UE and triangular sling

Cravat

Types of Bandage

• Made of elastic or non-elastic material formed in a cylindrical roll 

• To maintain or protect dressing, provide pressure, maintain splint, support joint, restrict motion, or control edema 

Roller Bandage

Patterns

Series of overlapping circular turns around a body part to anchor (securing) the bandage internally or terminally

Circular Bandage

• Horizontal in nature

• overlaps 3/4 of last layer 

Patterns

Series of overlapping diagonal turns around a body part. Covers a larger area and less likely to cause occlusion 

Spiral Bandage

• Overlaps 1/2 of last layer 

Patterns

Series of diagonal turns that do not overlap and have an open space in between each turn 

Allow for gaps between each turn for ventilation or acute ankle sprains where more space is needed for less compression (so limb won’t swell more); can also be used to secure dressings while avoiding perspiration 

Open Spiral or Oblique Bandage 

Patterns

Series of spiral turns, each one folded or reversed on itself midway through each turn 

• Indicated for extremities with uneven turns (calves, thigh, etc.) 

• To conform change in circumference

Spiral Reverse Bandage

Patterns

Series of lengthwise layers applied to the anterior-posterior or dorsal-volar surfaces of a body part .Used to cover tips of extremities; involves looping forwards and backwards of extremity to be secured 

Recurrent Bandage

Patterns

Series of spiral turns applied in alternate directions which can be applied to the foot and ankle, knee, shoulder, hand and wrist, and elbow

Commonly indicated for when there is an intermediate joint in the bandage application

Figure-of-Eight

Applications

Figure-eight wrapping technique used to support the secure joint, secure dressings, or provide mild immobilization

Shoulder Spica

• Commonly used for sprains, dislocations, or post-surgical care

• FABER = burns and open wounds, prevent contractures

• EADIR = dislocations

Applications

Used to immobilize the shoulder, upper arm, and forearm

• fractures of the clavicle, shoulder dislocations, or post-surgical support

Most restrictive bandaging type

Velpeau Bandaging

• Indicated when restriction of motion is necessary for the limb

Applications

Used to immobilize the hip joint, pelvis, and upper thigh 

Commonly used for hip injuries, fractures, post-surgical care, or to stabilize hip in pediatric conditions like developmental hip dysplasia

Hip Spica

• FABER → OA

Applications

Used to support the ankle and assist with dorsiflexion. Indicated for weak dorsiflexors

• For conditions like foot drop, peroneal nerve palsy, or post-stroke rehabilitation to improve foot clearance during walking

Dorsiflex Assist

Applications

Post Amputation Bandaging is crucial for (3)

• edema control

• shaping residual limb

• preparing for prosthetic fitting

Indications for Bandaging

• Wound Protection and Healing

• Hemostasis (Bleeding Control)

• Edema Control and Compression

  • Use rigid bandage for compression 

  • Use elastic bandage 

    • Greater pressure on distal and lesser pressure proximally → fluids to return to circulation 

    • Make sure that circulation is not impeded (color of feet, nailbeds, cyanosis, etc.) 

• Immobilization and Support 

  • Restricts movement in fractures, sprains, or joint injuries 

  • Used in techniques like Velpeau bandage (shoulder immobilization) and hip SPICA (pelvic stabilization) 

• Joint and Soft Tissue Mobilization

• Post-Amputation Limb Shaping

  • One bone → conical shape bandaging 

  • Two bones → cylindrical shape bandaging 

• Orthopedic and Post-Surgical Applications

  • Secures splints and casts in place 

  • Supports post-operative recovery (i.e. after orthopedic surgeries)

• Burns and Skin Grafts Protection

  • protect with gauze

Contraindications of Bandaging

1. Impaired Circulation

   1. ______ : tight bandaging can reduce blood supply, worsening edema 

   2. ______: poor circulation increases the risk of tissue necrosis

   3. _______: compression can worsen ischemic conditions

• Peripheral arterial disease (PAD)

• Diabetic foot ulcers

• Severe edema with arterial insufficiency

Contraindications of Bandaging

1. - Severe Infection or Open Wounds

   1. _________: covering an infected wound without proper drainage can trap bacteria and worsen the infection 

   2. __________: bandaging over dead tissue without treatment can promote further decay

• Uncontrolled Infections

• Necrotic Tissue without debridement

Contraindications of Bandaging

• Allergy or Sensitivity to Bandage Materials

  • ______: some patients may have severe reactions to latex-based bandages 

  • ________: skin irritation or rashes can occur with certain medical tapes or adhesives

• Latex Allergy

• Adhesive Sensitivity

Contraindications of Bandaging

• Fragile or Compromised Skin

  • ______: tight bandages can cause skin tears or pressure ulcers 

  • _______: improper bandaging can lead to further damage and delayed healing

• Elderly patients with thin skin

• Burns or radiation-damaged skin

Contraindications of Bandaging

• Deep Vein Thrombosis (DVT) Risk

  • _______: can dislodge clots, leading to pulmonary embolism

  • _______: avoid restrictive bandages in high-risk individuals without medical supervision.

• Improper compression techniques

• Venous thromboembolism (VTE) precaution

Contraindications of Bandaging

• Improperly Applied Bandages

  • ________: overly tight bandaging can cut off circulation and cause limb ischemia 

  • ________: loose bandaging can fail to provide support and protection

• Tourniquet effect

• Bandage slippage

Contraindications of Bandaging

• Unstable Fx Without Proper Immobilization

Bandaging alone is not enough for fractures needing splinting or casting (Primary Intervention)

Precautions

• Ensure Proper Circulation

  • Avoid wrapping too tightly to prevent ischemia

  • Check → Coldness, numbness, bluish discoloration or inc pain

• Use the Right Bandage for the Condition

  • Elastic bandages for sprains and swelling control

  • Gauze bandages for wound protection 

  • Compression bandages for venous insufficiency (but avoid in arterial disease)

Precautions

• Apply Even Pressure

  • More pressure distally (farther from heart) and less pressure proximally (closer to the heart) to prevent fluid build-up 

  • Avoid “tourniquet effect” by preventing excessive tightness in one area

• Secure the Bandage Properly

  • Ensure bandage is firm but not restrictive

  • Avoid loose ends that can unravel or cause tripping hazards

Precautions

• Check for Signs of Complication

  • If there is pain, swelling, tingling or color change → loosen bandage immed.

  • Excessive foul oder or moisture → infection or bandage change

• Consider Skin Sensitivity

  • Elderly pts or those with fragile skin may be prone to tears or bruising

  • Avoid tight adhesive in pts with allergies or sensitive skin

Precautions

• Change Bandages Regularly

  • Wound dressing should be changed as per medical guidance

  • Prolonged bandaging with reapplication can trap bacteria and cause infections

• Properly Position the Limb

  • For limb bandaging, maintain functional position to avoid stiffness or contractures

  • Elevate swollen limbs to reduce edema

Bandaging for Specific Parts of the Body

Measurement of Bandage for Foot & Ankle (children & adult)

4in bandage

Bandaging for Specific Parts of the Body

Measurement of Bandage for hand & wrist (children & adult)

1-2 in bandage

Bandaging for Specific Parts of the Body : ADULT

• For Knee?

• Elbow?

• Hip?

• 4in

• 3-4 in

• 6in

Bandaging for Specific Parts of the Body : CHILDREN

• For Knee?

• Elbow?

• Hip?

• 3in

• 2-3in

• 4in

Bandaging for Specific Parts of the Body : CHILDREN & ADULT

• Spica?

• Incorporate figure-of-eight pattern; used for transfemoral amputation or strained groin

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