Bandage achieves the purpose of fixing and treating the affected part through physical action. Such as fixing dressing, pressure dressing of bleeding wound, limb support and suspension, splint and plaster fixation of fracture, etc. Wrapping all parts of the body with bandages requires firmness, comfort, neatness, beauty and economy. Bandage is one of the most commonly used basic techniques in clinical surgery.
First, the matters needing attention in dressing
(1) Preparation before bandage dressing:
The dressing site must be kept clean and dry, and the skin folds such as armpit, breast and groin should be covered with cotton pad and folded gauze, and the bone protuberance should be protected with cotton pad.
(2) the position of the bandage:
On the premise of meeting the therapeutic purpose, the patient's position should be as comfortable as possible. Limbs should maintain functional positions or required postures.
(3) bandage selection:
Choose bandages with different widths according to the dressing position. Fingers need to be 3 cm wide, hands, arms, head and feet need to be 5 cm wide, upper arms and legs need to be 7 cm wide, and the body needs to be bandaged with 10 cm wide.
(4) bandage operation:
Generally, the bandage should be wound from the distal end to the proximal end. At first, the bandage head should be fixed in a ring shape for two weeks. After bandaged, the bandage should be placed flat on the limb or trunk, and the bandage should not fall to the ground. When dressing the bandage, the force should be even and moderate every week, covering 1/3 ~ 1/2 of the bandage in the previous week. It is easy to slip if it is too loose, and it is easy to cause blood supply disorder if it is too tight. It is generally best to expose the ends of fingers and toes to observe the blood circulation of limbs. After the bandage is finished, it should be wrapped around the two sides and fixed with adhesive tape, or torn and ligated at the end of the bandage, but pay attention to the knotted part not in the wound, inflamed part, bony protrusion, inner limbs, patient's sitting position, lying position and friction-prone part.
(5) bandage removal:
Remove the bandage from the fixed end, loosen it in the opposite direction of the bandage, and wrap your hands around it. In an emergency, bandages have been
When the wound secretion is soaked and dried up, it can be cut with bandage scissors. In order to save money, if the bandage is still clean, it can be rolled up and used again.
Second, the basic dressing method of bandage
(a) ring dressing method:
Used for small or cylindrical parts of limbs, such as hands, feet, wrists and foreheads, and also for the beginning of various dressings. Roll up the bandage, hold it with your right hand and spread it about 8cm (Figure 1). Fix the head end of the bandage on the part to be bandaged with the left thumb, and wrap the part into a continuous ring with the right hand. The number of rolls depends on the need, and the end of the bandage is fixed with twisted cloth.
(2) Spiral beneficiation method:
Used for parts with roughly equal perimeters, such as upper arms and fingers. Starting from the distal end, the two rolls are wound in a ring shape, and then spirally wound at a 30-degree angle to the proximal end. Each roll overlaps the previous roll by 2/3, and the end is fixed with adhesive tape (Figure 2). When there is a shortage of bandages in first aid or splint is temporarily fixed, the surrounding bandages do not cover each other, which is called snake-shaped dressing.
(3) Spiral reverse folding bandaging method:
Used for forearm, calf, thigh and other parts with different girth. First, do a two-week circular bandage, then do a spiral bandage, then press the center of the upper surface of the adhesive tape with one thumb, and then fold the adhesive tape down from this point with the other hand to cover the front circumference of 1/3 or 2/3. Each fold must be neatly arranged in a straight line, but each fold should not be at the wound and bone protrusion (Figure 3).
It is used for dressing and fixing clavicle fractures in joints such as shoulder, elbow, wrist and ankle. Take the elbow joint as an example. First, wrap 2 rolls in the middle of the joint. Then two coils are wound in the ring above the joint, then wound below the joint through the flexion side, wound above the joint through the back of the limb and then wound above the flexion side of the limb. Repeatedly, they are wound up and down in the shape of an "8", and each roll overlaps the previous roll by 2/3. Finally, wrap 2 rolls in the ring above the joint and fix it with adhesive tape (Figure 4 ~ 8).