1. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 53 Bandages and Binders

2. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Bandages Purposes and therapeutic benefits –*To support a limb or joint, a wound or incision –*To support 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 –*To provide compression, to promote venous return or prevent edema or prevent contractures –To shape a stump before fitting a prosthesis –*Wrapped around a clients limbs to provide muscle or joint support or to increase or support circulation

3. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Wrapping of Bandages Type of application –Figure eight –Spiral –Spiral-reverse –Circular –Recurrent

4. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Peripheral Neurovascular Assessment (PNA) Peripheral neurovascular assessment (PNA) Observations (CMS-ET) –Color of toes or fingers –Motion or mobility –Sensitivity or sensation –Edema and swelling –Temperature

5. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins In Practice: The Client’s Circulation When Using Bandages Refer to Data Gathering in Nursing 53-1 CMS-ET

6. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Bandages Roller bandages –All cotton elastic (ACE) bandage Usually provides support Hold a dressing in place Exert pressure over a bleeding point Kerlix-stretchy gauze Stretch-net bandages-tube gauze

7. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Antiembolism stockings –Thromboembolic disease (TED) stockings –To promote adequate return circulation and prevent clots –Remove the stockings at least once every 4-8 hours ad examine the leg carefully for redness, pitting edema, or skin discoloration –Nursing procedure 53-1

8. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Care Guideline 53-1 Applying roller bandage –Use correct size –Elevate extremity to be wrapped just above the level of the clients body –Overlap each layer about ½ the width of the previous strip –Check the clients peripheral neurovascular status at least every 2 hours

9. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins 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.

10. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins The PCD Machine

11. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Binders Binder –Wide, flat piece of fabric that is applied to support a specific body part or to hold a dressing in place. –Arm sling –T-binder Used to hold rectal or perineal dressings in place –Breast binder –Abdominal binder Flat piece of fabric that is secured around the trunk of the clients body to support the abdomen or dressings on the abdomen

12. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Applying a binder Nursing care guidelines 53-3 –Apply firmly but not to tight –Fasten the binder from the bottom up –Rewrap binder every 2-4 hours and check the dressing

13. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins 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 (skin breakdown)

14. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Montgomery Straps May be used if frequent dressing changes are needed Helps prevent skin irritation

15. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Montgomery Straps