Bandaging

In general, bandages are used to:

1. Support or stabilize a segment

2. Restrict motion of a joint

3. Control edema, swelling or joint effusion

Most common injury that requires bandage

sprain or strain

Types of Bandage Materials

• Muslin (unbleached cotton; most common)

• Others:

  • Woven, elastic, porous cotton

  • Rolled gauze (no elastisticity)

  • Stockinet, loosely knit cotton formed into a tube

  • Adhesive tape

Triangular Bandage

• Large piece or cloth cut or formed into a triangle

• Used as a temporary sling to support the weight of a patient’s UE

Cravat Bandage

• can also be used as a sling

• will not support the pt’s UE

Roller Bandage

• Most commonly seen in the market

• 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

Easiest form of bandaging technique

Circular bandage

(Pattern) Applied in a series of overlapping circular turns around a body part to anchor the bandage initially or terminally

Circular Bandage

Circular Bandage - Proper Applications / Considerations

• Bandage should overlap 50% of its width

• No wrinkles and creases to avoid skin irritation

• Check for the nail beds; blue/whitish nails means that the bandage may be too tight

(Pattern) The bandage is applied in a series of overlapping diagonal turns around a body part

Spiral Bandage

True/False: Spiral Bandage covers a larger area and less likely to cause occlusion

True

Spiral Bandage is beneficial to ___________

reduce edema and swelling of an injured part

(Pattern) series of diagonal turns that do not overlap and have an open space in between each turn; has an open space in between each turn

Open Spiral or Oblique Bandage

Open Spiral bandage is used for?

Used to hold a gauze / dressing; or in acute cases (providing a temporary splint)

(Pattern) series of spiral turns, each of which is folded or reversed on itself midway through its turn

spiral reverse bandage

(Spiral Reverse Bandage) The reverse component allows non elastic bandage to _____________

conform to change in circumference

Reverse Spiral Bandage Procedure

1. Start with 2 circulars

2. Go up as a spiral

3. Reverse the spiral at every turn

4. Finish with 2 circulars and secure the bandage

(Pattern) series of lengthwise layers applied to the anterior-posterior or dorsal-volar surfaces of a body part

Recurrent Bandage

(Pattern) Series of Spiral turns applied in an alternate directions

Figure of Eight

Primary Aim of Figure of Eight Pattern

• position the joint into neutral position

Bandaging size for foot and ankle

4 inch bandage

bandage size for hand and wrist

1-2 inch bandage

bandage size for knee

4 inch; 3 inch for children

Bandage size for elbow

• 3-4 inch for adults

• 2-3 for children

Bandage size for Hip

• 6 inch for adults

• 4 inches for children

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

Shoulder Spica

Shoulder Spica is commonly used for?

• sprains

• dislocations

• post-surgical care

Velpeau bandage is used for?

• fractures of the clavicle

• Shoulder dislocations

• Post-surgical support

True/False: The Velpeau bandage fully restricts arm motion by securing the arm to the chest

True

Specialized wrapping technique used to immobilize the hip joint, pelvis, and upper thigh

Hip SPICA

Hip SPICA is commonly used for?

• hip injuries

• fractures

• post-surgical care

• stabilize the hip in pediatric conditions like Developmental dysplasia of the hip

Taping or bandaging technique used to support the ankle and assist with dorsiflexion

Dorsiflex Assist

Dorsiflex assist is commonly used for?

• foot drop

• peroneal nerve palsy

• post-stroke rehabilitation

Post-Amputation Bandaging is crucial for?

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

Most common deformity in stumps

Dog ears

True/False: the stump is a pain-insensitive structure

False

Indications for Bandaging

1. Wound protection & healing

2. Hemostasis

3. Edema control & compression

4. Immobilization & Support

5. Joint & Soft tissue support

6. Post-Amputation Limb Shaping

7. Orthopedic & post surgical Application

8. Burns & Skin grafts protection

Contraindications of Bandaging - Impaired Circulation

• Peripheral Arterial Disease: bandage → can reduce blood supply, worsening ischemia

Contraindications of Bandaging - Severe Infection or Open Wounds

• Uncontrolled infections: covering an infected wound without proper drainage can trap bacteria and worsen the infection

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

Contraindications of Bandaging - Allergy or Sensitivity to Bandage Materials

• Latex allergy: Some patients may have severe reactions

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

Contraindications of Bandaging - Fragile or Compromised Skin

• Elderly patients with thin skin - can cause tears or pressure ulcers

• Burns or Radiation -damaged skin: can lead to further damage and delayed healing

Contraindications of Bandaging - DVT Risk

• Improper Compression Techniques - can dislodge clots, leading to pulmonary embolism

• Venous Thromboembolism (VTE) Precaution: Avoid Restrictive Bandage in high-risk individuals without medical supervision

Contraindications of Bandaging - Improperly Applied Bandages

• Tourniquet Effect

• Bandage Slippage

Tourniquet Effect

Overly tight bandaging can cut off circulation and cause limb ischemia

Contraindications of Bandaging - Unstable Fractures without proper immobilization

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

Contraindications to Bandaging - Complete list

1. Impaired Circulation

2. Severe Infection or Open Wounds

3. Allergy or sensitivity to bandage materials

4. Fragile or Compromised Skin

5. DVT Risk

6. Improperly Applied Bandages

7. Unstable Fractures without Proper Immobilization

Precautions to Bandaging - Full List

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

Overlap for the Patterns

• ¾ Circular

• ½ Spiral

• ¼ oblique

• pls correct me if i am wrong

(Precautions to Bandaging) avoid wrapping too tightly to prevent _____

ischemia

(Precautions of Bandaging) - Signs of Poor Circulation

• Coldness

• numbness

• bluish discoloration

• increased pain

_____ bandages for sprains and swelling control

Elastic bandages

_____ bandages for wound protection

Gauze

_____ Bandages for venous insufficiency

Compression

Compression bandages are for venous insufficiency, but should be avoided in ________

arterial diseases

(Precautions of Bandaging) Apply Even Pressure

• more pressure distally, less pressure proximally to prevent fluid buildup

• Avoid Tourniquet effect

(Precautions of Bandaging) Ensure the bandage is ___ but not restrictive

firm but not restrictive

(Precautions of Bandaging) Pain, swelling, tingling, or color change →

Loosen the bandage immediately

(Precautions of Bandaging) excessive moisture or foul odor →

may indicate infection, requiring a bandage change

Wound dressings should be changes as per ______

medical guidance

Prolonged bandaging without reapplication can ___________

trap bacteria and cause infections

(Precautions of Bandaging) For limb bandaging, maintain ___________ to avoid ________

functional positioning to avoid stiffness or contractures

Desired shape of stump for BKA

Cylindrical

Desired shape of stump for AKA

Conical