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Paste Bandages

Paste Bandages. Indications. Management of leg ulcers. Some are also indicated for use in the management of chronic eczema / dermatitis. Seen used to protect legs from incontinence. They have mild astringent and antiseptic properties . Contraindications:

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Paste Bandages

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  1. Paste Bandages

  2. Indications • Management of leg ulcers. • Some are also indicated for use in the management of chronic eczema / dermatitis. • Seen used to protect legs from incontinence. • They have mild astringent and antiseptic properties. • Contraindications: • Occasional sensitivity / allergy to ingredients

  3. Types • Zinc paste bandage (Viscopaste PB7, Steripaste) • Zinc paste and ichthammol (Ichthopaste) • Zinc paste and calamine • Zinc paste and coal tar bandage • Zinc paste impregnated stocking (Zipzoc)

  4. How could they work? • Array of properties that can enhance the healing of wounds. • Zinc ions stay within the wound bed for an extended period of time, ensuring a constant tissue zinc level. • Zinc: • increases the degradation of collagen in necrotic tissues, • promotes epitheliazationand • increases the expression of insulin-like growth factor, essential for the production of granulation • also required for collagen and protein synthesis, cellular growth and replication, reduction in free radical activity and inhibition of bacterial growth. • Bandaging also promotes venous return

  5. Application Methods • Various suggested: • cutting and overlap • pleating • applying the bandages in strips (can be layered) • cutting to form stirrups • applying in a series of loose folds rather than a continuous spiral • No controlled trials support one best method of application • A 2007 paper recommend that zinc paste bandages should be applied loosely and lightly with a pleat at each turn to accommodate for oedema and the primary bandage covered by compression bandaging or retention bandages as tolerated by the patient. • Instruction leaflets for viscopaste and icthopaste both state that it can be applied in a spiral or with a pleat at the front on every turn.

  6. Evidence • Meyer et al (2002) used zinc paste bandages as a primary dressing in their study of 112 patients. They could not rule if zinc oxide paste affected the rate of healing achieved. • Strömberg and Agren (1984) performed a randomized trial where patients were treated with either a gauze compress medicated with zinc oxide or with an identical compress without zinc oxide. Patients treated with a zinc oxide compress responded significantly better (83% success rate) compared with the placebo group (42% success rate). Limitations of the study included a small sample size, mixed aetiology and outcome measurement at only 8 weeks. • Bradley et al (1999) reported significant increase in ulcers healed with zinc oxide impregnated bandages at 58% compared with alginate at 35%. • Lack of evidence concerning best practice bandaging technique. • A Cochrane review (O’Meara et al 2010) on antibiotics and topical antiseptics for venous leg ulcers makes no mention of paste bandages in this context. • Paste bandages are mentioned in a review on compression for venous leg ulcers (O’Meara et al 2009) but it states that the relative effects of 4 layer compression and paste bandage systems are unclear.

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