Bandaging methods

1. Dr. Tamás Gál Semmelweis University Department of Traumatology February 24, 2009 Bandaging methods

2. Forthepurpose of holding dressings of allkindsinplace, toobtaincompression, togivesupport, orcorrectdeformities, and finally, toimmobilizesplints. Uses of Bandages:

3. We can increase theirusefulnessbyapplyingcertainsubstancesafterthebandage has beenputonorwemayapplythesamesubstancesinthebandagematerial and hardeningwilloccurinthemeshes of thebandage. Thesematerialsareplaster of paris, starch, glucoseorsilicate of sodium.

4. Why do we need to know how to bandage wounds?

5. To stop or slow bleeding To prevent (further) infection Therefore, only sterile dressings should be used. Wounds should be dressed for two reasons:

6. The area of the wound must be cleaned (lots of water or weak disinfectant) • The area of the wound is disinfected (iodine, Betadine, Dodesept, mercurochrome) • If possible, particles or debris should be removed via sterile tweezers • If the debris is deep or is large in size, it should not be removed – only in ER/Trauma Center Wound management

7. Covers the wound in case of minimal bleeding. • Sterile gauze is placed onto the wound, then wrapped with gauze bandage. • Bandaging should exceed the length of the wound by at least 1-1 cm. • Extremity injuries should be wrapped from distal to proximal direction. • Joint movement should not be impaired. Top Bandage

8. Hat bandage for head wounds

10. Nose/chin bandaging

11. Finger/hand bandaging

12. Can be used for both arterial and venous bleeding • If extremity bleeding – raise the extremity above the level of the body • Cover the wound with a sterile gauze • Wrap the dressing with gauze bandage • Cover the sterile dressing with thicker padding, then tightly wrap the padding to the extremity • The patient must be transported to the ER/Trauma Center Pressure bandages

13. Trauma Center • Tetanus vaccination • Passive immunization:tetanospazminbinding - human tetanusimmunoglobulin, • Activeimmunization: Tetanusanatoxin • Clean, disinfect wound. Debridement. • Check circulation, sensation, movement • Look for signs of infection Definitive treatment of wounds:

14. Radiologic examination: x-ray (can help determine bone injury, metal debris in wounds) • Go to operating room • Lidocain allergy • Administer anaesthetics(and wait it out) • Clean and disinfect the wound again • If necessary, excise the edges of the wound • Place monofil sutures loosely, never a continuous suture • Dress the wound Definitive treatment of wounds

15. Complication - strangulation

16. Distorsions, sprains • Fractures WhaT ELSE CAN WE BANDAGE?

19. Used for injuries of the shoulder area • Acromioclavicularluxation, fracture • Fracture of the surgical neck of the humerus • After the reduction of shoulder dislocations • Alternatively, Ramofix with triangle splint can be used Desault Bandage

20. Desault bandage

22. Fracture of the fifth metacarpus • Occurs in fights – punching • If reduction is stable, a fist bandage can be used rather than a cast splint • Fixation time is still 6 weeks Fist bandage

23. Symptoms include swelling, pain to pressure and movement • Treatment: • Rest • Ice the area (Chloraethyl spray) • Raise the extremity to a level above the heart • Wrap the joint with elastic (Ace) bandage • If necessary, NSAID (diclofenac or ibuprofen) gel or oral administration Knee and ankle distorsions/contusions

24. Ankle bandage

25. Knee bandage

27. Used as transport splints for fractures of extremities • It is a wire ladder like splint, wrapped with gauze • Should be shaped to the healthy extremity • Fixation of both joints surrounding the injury • Aluminum splints are used for finger injuries Kramer (wire) splints

28. Transport splint

29. Tubular bandage/aluminum finger splint

30. Used for contusions, distorsions, non-dislocated fractures, reduced fractures • Requires min. 6-8 layers of plaster cast, gauze bandage (non-stitched) • After drying, must be cut and rewrapped • Check circulation, sensation, movement • After swelling has gone down, circular cast can then be administered Cast splints

31. Thank you for your attention!