ASSTECH: BANDAGING TECHNIQUES

Purpose of Bandages

• Support or stabilize a segment

• Restrict motion of a joint

• Control edema, swelling, or joint effusion

  • Depends on technique that you will apply

• Common remedy for acute cases = first aid

• NOT a stand alone treatment

  • Can use other interventions such as massage

Most common injury that requires bandage?

Sprain or strain

Types of Bandage Materials

• Muslin (Unbleached Cotton)

• Woven, elastic, porous cotton

• Rolled gauze (cotton)

• Stockinet, loosely knit formed into a tube

• Adhesive tape

Stockinette

Used to protect end stump

Most frequently used material for badaging?

Muslin (Unbleached Cotton)

What are the types of bandages?

• Triangular

• Cravat

• Roller Bandage

Triangular Bandages

• Large piece of cloth cut or formed into a triangle

• Used as TEMPORARY SLING to support the weight of a patient’s UE

• For first aid

Cravat

• Flat, can also be used as a sling

• Cannot support the pt’s UE and the triangular sling

• Also used temporarily used for emergency purposes only

• Can be used with triangular bandage as added pressure/support

Roller Bandage

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

• Used to maintain and protect a dressing, to provide pressure, maintain a splint, support a joint, restrict motion or control edema

• Prevent the person from incurring further injury

Patterns used for bandage

• Circular Bandage

• Spiral Bandage

• Open Spiral or Oblique Bandage

• Spiral Reverse Bandage

• Recurrent Bandage

• Figure of Eight

Circular Bandage

• Bandage is applied in a series of overlapping circular turns around a body part to anchor the bandage initially or terminally

• Careful application must be observed to avoid occlusion

• Overlap ¾ of its width

• Bandage is anchored with 2 circular turns at the distal end of body part

Spiral Bandage

• Applied in a series of overlapping diagonal turns around a body part

• Covers a larger and less likely to cause occlusion

• Tends to cover a larger surface area on the injured body part

• Covers ½ or 50% of the bandage

Open Spiral or Oblique Bandage

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

• Covers ¼ of the previous bandage

• Used to hold gauze or dressing

• Used in acute cases just to provide a quick and temporary splint on an injured body part

• Decrease heat and allow wound to “breathe”

Spiral Reverse Bandage

• A series of spiral turns, each of which is folded or reversed on itself midway through its turn

• Allows non-elastic bandage to conform to change in circumference

• To conform to irregular surface such as the elbow joint (calf thigh)

Recurrent Bandage

• A series of lengthwise layers applied to the anterior-posterior or dorsal-volar surfaces of a body part

Figure of Eight

• A series of spiral turns applied in an alternate directions

• Can be applied to the foot and ankle, knee, shoulder, hand and wrist, and elbow

Most common body part that uses the Figure of Eight pattern?

Ankle

Bandage for hand and wrist

1-2 in. bandage

Bandage for ELBOW

3-4 in. bandage for adults, 2-3 in. for children

Bandage for KNEE

4 in. bandage, 3 in. for children

Bandage for SPICA

• Usually used for pts with hip injury

• Incorporates figure eight patterns. Used for transfemoral amputation or strained groin

• 6 in. for LE, 4 in. for UE

Bandage for FOOT AND ANKLE

4 in. bandage

Bandage for HIP

6 in. for adults, 4 in. for children

Most common amputation deformity and reason why they are needed to be bandaged?

Dog ears deformity

Applications of Bandage

• Shoulder Spica

• Velpeau Bandaging

• Hip Spica

• Dorsiflex Assist

• Post-Amputation Bandaging

Shoulder Spica

• A figure-of-eight wrapping technique used to support the shoulder joint, secure dressings, or provide mild immobilization.

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

Velpeau Bandaging

• A technique used to immobilize the shoulder, upper arm, and forearm

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

• Unlike the shoulder spica, which allows some movement, the veleau bandage fully restricts arm motion by securing the arm to the chest

Hip Spica

• A specialized wrapping technique used to immobilize the hip joint, pelvis, and upper thigh. It is commonly used for hip injuries, fractures, post-surgical care, or to stabilize the hip in pediatric conditions like developmental dysplasia of the hip (DDH)

Dorsiflex Assist

• A taping or bandaging technique used to support the ankle and assist with dorsiflexion, which is the upward movement of the foot.

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

Post-Amputation Bandaging

• Crucial for edema control, shaping the residual limb, and preparing for prosthetic fitting

Indications for bandaging (WEHIJBOP)

1. Wound Protection & Healing

2. Hemostasis (Bleeding Control)

3. Edema Control & Compression

4. Immobilization & Support

5. Joint & Soft Tissue Support

6. Post-Amputation Limb Shaping

7. Orthopedic & Post-surgical Applications

8. Burns & Skin Grafts Protection

Immobilization & Support

Indication of badaging where it restricts movement in fractures, sprains, or joint injuries

• Used in technique like velpeau bandage (shoulder immobilization) and hip spica (pelvic stabilization)

Orthopedic & Post-surgical Applications

• Indication of bandaging where it secures splints or casts in place

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

Contraindications of Bandaging (ISAFUDI)

1. Impaired Circulation

2. Severe Infection or Open Wounds

3. Allergy or Sensitivity to Bandage Materials

4. Fragile or Compromised Skin

5. Deep Vein Thrombosis Risk (DVT)

6. Improperly Applied Bandages

7. Unstable Fractures Without Proper Immobilization

Impaired Circulation (PDS)

• Peripheral Aterial Disease (PAD): Tight bandaging can reduce blood supply, worsening ischemia

• Diabetic Foot Ulcers: Poor circulation increases the risk of tissue necrosis

• Severe Edema with Arterial Insufficiency: Compression can worsen ischemic conditions

Sever Infection or Open Wounds

Uncontrolled Infections: Covering an infected wound without proper drainage can trap bacteria and worsen the infection

Necrotic Tissue without Debridment: Bandaging over dead tissue without treatment can promote further decay

Allergy or Sensitivity to Bandage Materials

• Latex Allergy: Some patients may have severe reactions to latex-based bandages

• Adhesive Sensitivity: Skin irritation or rashes can occur with certain medical tapes or adhesives

Fragile or Compromise Skin

• Elderly Patients with Thin Skin: Tight bandages can cause skin tears or pressure ulcers

• Burns or Radiation-Damaged Skin: Improper bandaging can lead to further damage and delayed healing

Deep Vein Thrombosis (DVT) Risk

• Improper Compression Techniques: Can dislodge clots, leading to pulmonary emolism

• Venous Thromboembolism (VTE) Precautin: Avoid restrictive bandages in high-risk individuals without medical supervision

Improperly Applied Bandages

• Tourniquet Effect: Overly tight bandaging can cut of circulation and cause limb ischemia

• Bandagong Slippage: Loose bandaging can fail to provide support and protections

Unstable Fractures Without Proper Immobilization

• Bandaging alone is not enough for fractures needing splinting or casting

Precautions to Bandaging (CECUCAPS)

• When applying a bandage, proper technique is essential to ensure safely and effectiveness.

1. Ensure proper circulation

2. Use the right bandage for the condition

3. Apply even pressure

4. Secure the bandage properly

5. Check for signs of complications

6. Consider skin sensitivity

7. Change bandages regularly

8. Properly position the limb

Ensure Proper Circulation

• Avoid wrapping too tightly to prevent ischemia (reduced blood flow)

• Check for signs of poor circulation: coldness, numbness, bluish discoloration, or increased pain

Use the Right Bandage for the Condition

• Elastic bandages: For sprains and swelling control

• Gauze bandages: For wound protection

• Compression bandage: For venous insufficiency (but avoid in arterial disease)

Apply Even Pressure

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

• Avoid tourniquet effect by preventing excessive tightness in one area

Secure the Bandage Properly

• Ensure the bandage is firm but not restrictive

• Avoid loose ends that can unravel or cause tripping hazards

Check for Signs of Complications

• Pain, swelling, tingling, or color change → Loosen the bandage immediately

• Excessive moisture or foul odor → May indicate infection, requiring a bandage change

Consider Skin Sensitivity

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

• Avoid tight adhesives in patients with allergies or sensitive skin

Change Bandages Regularly

• Wound dressing should be changed as per medical guidance

• Prolonged bandaging without reapplication can trap bacteria and cause infections

Position the Limb

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

• Elevate swollen limbs to help reduce edema