1. Chapter 53:
Bandages and Binders

2. Purposes and Therapeutic Benefits of Bandages
To support a limb or joint, a wound or incision
To hold dressings, splint, cold pack or warm pack in place, or to hold a pad to absorb drainage
*To immobilize a joint or limb or maintain a limb in a specific position
Example-sprain*
To provide compression, to promote venous return or prevent edema or prevent contractures
To shape a stump before fitting a prosthesis

3. Bandages *may be clean or sterile *maintain sterility if sterile
Available in various widths and sizes

4. Wrapping of Bandages: Types of Application
Figure eight
Spiral
Spiral-reverse
Circular
Recurrent
**wrap the bandage around the clients limb twice, below the joint to anchor it, use alternating ascending and descending turns to form a figure eight
*overlap each turn of the bandage by one half to two thirds the width of the strip, fasten end securely

5. Types of Bandages Roller bandages All cotton elastic (ACE) bandage
*may be wrapped around a body part to exert pressure over a bleeding point
Assess PNS every 2 hours*
*Nursing care guidelines 53-1

6. Types of Bandages Kerlix Stretch-net bandages Antiembolism stockings
*Thromboembolic disease (TED) stockings
Help ensure adequate return circulation to the heart and may help prevent blood clots
Measure the clients thigh or calf, according to the manufacturers instructions and select the appropriate size
Check PNA every 2 hours
Remove them every 4-8 hours and examine the leg for redness, pitting edema or skin discoloration

7. Peripheral Neurovascular Assessment (PNA)
Observations (CMS-ET)
Color of toes or fingers
Motion or mobility
Sensitivity or sensation
Edema and swelling
Temperature

8. The PCD Machine **To provide alternating pressure to the legs
Pneumatic compression device (PCD)
Sequential compression device (SCD)
Intermittent sequential compression device (ISCD)
These machines support circulation and are used primarily for clients immediately after surgery and for those with circulatory disorders.

9. The PCD Machine

10. Binders
Wide, flat piece of fabric that is applied to support a specific body part or to hold a dressing in place.
Types
Arm sling
T-binder
*CAN BE USED TO HOLD RECTAL, PERINEAL OR GROIN DRESSINGS IN PLACE
Breast binder
Abdominal binder
*supports the abdomen or large abdominal dressings, may be used after cesarean delivery

11. Nursing care guidelines 53-4
*Perform PNA q 2 hours
*remove bandages q 4 h, inspect skin and re-wrap
Replace soiled bandages

12. Hypoallergenic Tape Holds a client’s dressings in place
Supports sprained ankles, fractured ribs, or fractured toes
Allows ventilation and helps to prevent skin maceration

13. Montgomery Straps *May be used if frequent dressing changes are needed
*Helps prevent skin irritation

14. Montgomery Straps