Bandages – basic types and their application

Proven content

I think that each of us has encountered the situation at the counter in the pharmacy more than once, when after saying “bandage please” we had to answer a number of support questions before receiving the product he needed. What are the main types of bandages available at the pharmacy and what is their purpose?

Bandage – definition

The root of the word “bandage” is derived from the French “bandage”. It is a gauze ribbon, available in the form of a rolled tape. Bandages are made of linen, muslin, woven, knitted and knitted fabrics. They are used to wrap damaged parts of the body in order to immobilize limbs and joints, or to protect against venous stasis in varicose veins. The method was already used in ancient Egypt during mummification.

It is worth mentioning that the bandage is not used to dress wounds. Its purpose is to support a dressing applied to the body, so it is not applied directly to the wound. Bandages are usually available in two versions – a knitted bandage or an elastic band. The same function as the bandages is performed by the dressing nets, which are also flexible, so they can be used to protect different parts of the body.

Basic bandaging techniques – ear dressing

1. Ear dressing – consists in making and repeating circular wraps.
2. Circular dressing – consists in making layers that completely overlap.
3. Screw dressing – consists in making new, overlapping layers. Each subsequent layer overlaps with 2/3 of the previous one.
4. Double-headed dressing – involves making a bandage on each side.
5. Triaxial dressing – consists in making layers around three axes.
6. Snake dressing – consists in making diagonal layers. Between each layer there should be a free space in the middle of the dressing.
7. Return dressing – involves applying a bandage to the stumps and tips.

An alternative to these bandaging techniques is the use of a spray bandage. This type of dressing is used to treat surface wounds, abrasions, and scratches in both easily and hard-to-reach places. A spray bandage is a preparation that is applied to a dry and cleansed wound. However, it should not be used on deep and exuding wounds, e.g. burns. It should also not be inhaled and applied to the face.

Types of bandages and their application

1. Elastic bandage – made of elastic fabric, usually containing synthetic fiber additives, e.g. polyamide or polyester. The set, in addition to the bandage itself, also includes a metal clasp, thanks to which it is easier to fix the end of the dressing in a fixed place. Its purpose is to stiffen and immobilize broken or dislocated limbs. It is available in various versions, e.g. 8 cm, 10 cm and 15 cm wide. The price of an elastic bandage ranges from PLN 3 to PLN 10.
2. Knitted bandage (knitted bandage supporting) – a dressing made of inelastic fabric, e.g. viscose or polyester. It is designed to wrap, immobilize and attach the body to the dressing. A knitted bandage can be used in first aid for wounds of various types. It is available in various widths, e.g. 4 cm, 6 cm, 8 cm, 10 cm, 12 cm and 15 cm.
3. Semi-elastic bandage – this is a knitted bandage with a slightly higher degree of elasticity. It is an intermediate type of bandage between a knitted bandage and an elastic bandage. It is used to support dressings on parts of the body that are difficult to bandage, e.g. joints. It is available in various widths, but usually in the following versions: 4 cm, 6 cm, 8 cm, 10 cm, 12 cm.
4. Cohesive bandage – dressings of this type do not require binding or fastening with a clasp – they stick to each other and do not stick to the skin or hair. They retain their self-adhesive properties even when removed and can be torn off without the use of scissors. They are used to dress heavily bleeding wounds, support dressings, also in places that are mobile and hard to reach.

Principles of proper bandaging

One of the first rules for proper bandaging is body position. The person applying the dressing should stand in front of the diseased part of the body. When the lower limb is the bandaged element, sit next to the patient. During the procedure, the patient should be provided with maximum comfort – they should find themselves in a comfortable lying or sitting position. The bandaged limb must have a stable support. For this purpose, you can use, for example, a chair, a dressing table top or a footrest.

Whether or not the procedure is performed correctly also depends on the type of bandage. It should be of a suitable width, the size of which must be similar to the bandaged limb. In this matter, the most problematic choice is the selection of a bandage, e.g. for the chest. In this case, you should take into account the narrowest point of the given part of the body through which the bandage will pass.

The number of bands needed for the procedure depends on various factors, such as body size and the extent of the wound. Usually for adults, 2 bandages per head and 1 to 2 bandages per hand are needed. Obese people will need more of them. More bandages are also needed when treating wounds on the upper limbs.

Applying the bandage starts with a circular wrapping above or below the injured part of the body. It is recommended to bandage the extremities from the parts farthest from the center of the body and work towards the closer ones. As a result, it will be possible to avoid the back outflow of the lymph and the formation of venous stagnation. Bandaging should not be started at the cut.

Once the first few wraps of the bandage have been applied, check that they do not shift and that they do not fit too tightly against the body part concerned. Improperly applied bandage should be removed and reapplied. You can tell if the operation has been performed correctly by the fact that the bandages are properly tightened. Both bandages should always be equal.

Bandaging the upper limbs

1. Thumb

We start with making a circular band on the wrist. Then move to the thumb up and make loops around it. The band should then be placed on the wrist – this is how we will perform the first earing. The second vote is the same as the first, but slightly lower than the first. After the third ear, which should start from an even lower position than the second, make a circular band around the wrist.

1. Thumbs up

We start with making a circular band on the wrist. Then we head towards the thumb and spread the bandage upwards. Make a loop around the thumb and guide the wristband back to the wrist. When the first earring is done, repeat the same operation twice – the next earring should be done a little lower, just like when bandaging the thumb. We end the procedure with a circular band ending around the wrist.

1. Hand

We start with making a circular band on the wrist. We pass the band through the middle of the joined fingers – to both sides. Then we tie it diagonally on the right and then on the left. Fasten the return bands with a circular loop through the middle of the joined fingers. We start polishing with the tips of the fingers to cover of the return band.

Bandaging the lower limbs

1. Track

We start by rolling out a tight bandage (8 cm) from the inside to the outside of the foot. The first three layers should lie so that the third covers the heel. Then we cover the lower edge of the heel with a bandage and wrap another layer of bandage with the upper edge of the heel. This will allow you to strengthen the lower and upper layers of the bandage. Then we wrap the bandage on the lower edge of the heel and wrap the upper edge of the heel with another layer. Finally, wrap the leg with a bandage several times.

1. Knee

We start with a circular loop around the knee. Make a diagonal band above the circular helix. We also start the tapered knee dressing with a circular wrap around the shin. Then we wrap the bandage around the thigh and make a circular wrapping at an angle to then go below the knee. At the last stage of applying the bandage, we also finish with a circular wrapping on the knee.

How to bandage the head?

Before we start bandaging the head, it is worth knowing that the scalp has a lot of blood supply. This means that the head wounds are bleeding profusely. For bandaging, you can use a triangular scarf or an elastic bandage – this bandage is called the “Hippocrates hat”. First, wrap the head with a bandage at the level of the forehead and temples. When the ends of the band are at the back of the head, hide one of them under the other and pull it all the way to the forehead.

When the end of the bandage is on the forehead, run it to the back of the head – to do this, run the bandage diagonally towards the back of the head. In order for the Hippocrates hat to cover the entire head, do this action several times. A properly made dressing does not change its shape and does not slide off the scalp. It must not be too tight so that it does not compress the wound.

Compression bandaging as a healing method

Desmurgy is a branch of surgery focused on the healing properties of bandaging. It is a science known for many years, which was developed by rehabilitators dealing with, for example, venous insufficiency and the treatment of venous thrombosis. Compression bandaging can be an effective method of treating, among others, lymphoedema. However, it should be said that the treatments she offers are not very convenient for patients.

Bandaging in venous insufficiency aims to reduce venous hypertension. The bandage must not be very stretchy. Knitwear must resist the veins. In this regard, compression bandages surpass even the most expensive compression stockings. The bandages cause the venous blood to be pushed upwards – as a result, the skin’s condition improves and heals faster. Their advantage is also high mobility.

Treating venous thrombosis with bandages speeds up the recovery process. External pressure reduces swelling and is especially helpful in the first phase of treatment. The bandage also protects the skin against chafing due to the fact that it contains cotton. It is also helpful for patients who are preparing for surgery.

The use of bandages during the treatment of lymphedema consists in applying several layers of them to the affected limb. Rehabilitators also use additional materials to protect the skin and pads that cushion the impact of the material on the skin. People interested in this technique should always use the services of experienced physiotherapists – it is not a method that can be fully mastered on the basis of information obtained during a several-day course.

What bandages are used for compression bandaging?

When treating venous and lymphatic diseases, it is recommended to use short stretch bandages with short stretch. Their flexibility does not exceed 70%. This means that when fully stretched, they can lengthen by 70% of their original length. When the bandage is on the limb, the resting pressure will be lower than during exertion.

Another type of bandage used during treatment is long stretch bandages. Typically, they are used more often than short-stretch bandages. Their flexibility exceeds 130%. This makes them extremely stretchy and exerts a higher resting pressure than during exercise. The bandage, no matter which of the mentioned models we are talking about, is always supposed to decrease from the distal to the proximal part of the limb.

Compression bandaging – indications

Compression bandaging supports the work of mechanisms responsible for proper lymphatic and venous circulation. It also facilitates lymphatic and venous outflow from the limb. It also increases blood flow through the veins from the deep system and reduces the pain experienced by the patient, which causes swelling and venous disorders. However, in order for the compression bandaging to be successful, it should be adapted to the individual needs of the patient.

Compression bandaging is recommended in the following cases:

1. prophylaxis of venous disorders,
2. past treatments, such as sclerotherapy,
3. varicose veins surgery,
4. lymphoedema,
5. varicose veins of the lower extremities,
6. conditions after fractures or sprains,
7. swelling of the legs during pregnancy.

Compression bandaging – contraindications

Although it is a non-invasive treatment method, it should not be used by people with the following conditions:

1. skin inflammation,
2. inflammation of the subcutaneous tissue or muscles,
3. atherosclerosis,
4. obliterating arteritis of the lower extremities,
5. allergy to yarns that are in the bandage.

Types of dressings – cover dressing

Covering dressings are placed over wounds to protect them against the leakage of blood and body fluids and against the penetration of external factors into them. They are used in head and eye injuries, abrasions, burns, open fractures and gastritis. The primary function of the dressing is to protect the wound and stop leakage of blood or body fluids.

Covering dressings are:

1. Wound plasters with a dressing – this is a traditional dressing for both minor cuts and deep wounds. The dressing protects the wound from dirt and can support the skin regeneration process. Moreover, in some situations it will be an element of life and health safety. These patches are made of various materials and each of them has a different air permeability. When buying this type of dressing, it is worth making sure that it adheres strongly to the skin and provides tight protection against external factors.
2. Hydrofiber dressing – it is a wound dressing with biofilm or suspected biofilm, i.e. a biological membrane consisting of bacteria surrounded by organic or inorganic substances. This dressing destroys the biofilm and prevents it from renewing itself. It also fights bacteria and pathogens in the wound. Its advantage is that it adapts to the shape of the wound and reduces free spaces in which bacteria often multiply. It can also be used for surgical, traumatic and oncological wounds.
3. Alginate dressing – it is a dressing for wounds with little exudate. It is used primarily in the treatment of chronic wounds, e.g. ulcers, bedsores and the diabetic foot. It consists of calcium alginate fibers. When wound discharge comes into contact with it, the fibers of the dressing turn into a gel that promotes wound healing. The dressing absorbs secretions quickly, is easy to tampon and sticks tightly to the damaged area.
4. Hydrocolloid dressing – available in the form of a gel, paste or patch. It can be used to heal wounds of various shapes, sizes and depths. It consists of an inner layer, covered with a medicinal substance, and an outer layer that forms a layer of polyurethane foam, ensuring gas exchange. The inner layer of the dressing turns into a soft gel that destroys dead skin and exudate. As a result, the wound cleans and heals faster. What’s more, it is constantly moist, so it causes less pain.
5. hydrogel dressing – used to treat burns of the XNUMXst, XNUMXnd and XNUMXrd degree (thermal, chemical, electrical), sunburn, ulcers, bedsores, abrasions, bruises and swelling. The dressing can be applied to any wound surface. It will absorb the exudate from it and keep it inside the dressing. The gel in the dressing supports the wound cleansing process and has a beneficial effect on enzymes and peptides. It also reduces wound dehydration and prevents the formation of necrotic tissue.
6. antiseptic gel – used to cleanse and heal skin wounds. It also works well in the treatment of infected and chronic burns, wounds with dry and fluid necrosis, and the treatment of chronic wounds. It is used to moisturize bandages and dressings due to the property of removing hardened wound layers. The antiseptic gel does not have a negative effect, e.g. on the graining process. Effectively supports the wound healing process. It is worth remembering that this is a medical device for external use only.
7. polyurethane dressing – it is a self-adhesive foam dressing. It is used to treat difficult-to-heal wounds and extremely moist wounds. The dressing contains several layers that intensively absorb moisture. It does not allow microorganisms to penetrate the wound and at the same time provides it with optimal moisture. As a result, it does not form a scab and thus the wound healing process takes less time. The structure of the dressing allows you to observe the wound while it is healing, without removing the plaster.
8. dressing with silver ions – this is a sterile dressing recommended for patients with a weakened immune system. It consists of a hydrophobic polyamide mesh covered with metallic silver. The mesh is impregnated with a triglyceride ointment. The dressing is thin and flexible – thanks to which it fits well under clothes or bedding. It can be used on necrotic wounds.
9. activated charcoal dressing – this dressing is a combination of an absorbent compress and an antimicrobial odor-absorbing dressing. It is used to treat infected and purulent wounds that emit unpleasant odors, such as pressure ulcers, anal fistulas and leg ulcers. The activated carbon content promotes the transfer of the ooze to the compress.

Types of dressings – sealing dressing

The most important element of the sealing dressing is the airtight foil. The dressing attaches to the skin so that there is no gap between it and the skin. The dressing protects the pulmonary cavity from getting air into it. It is applied in the event of any injuries penetrating the chest. At the edges of the dressing, tapes are taped to fix it to the skin.

Once the dressing has been applied, place the victim in a semi-sitting position. Unconscious people should be placed in a safe position, thanks to which the airways will be open – in this state, various secretions may flow from the mouth. Before the injured is in the safe position, remove all items from the pocket, e.g. phone, keys and other hard objects or remove his glasses. In this position, the lower limbs must be straightened.

Types of dressings – stabilizing and fixing dressing

This type of dressing is applied, for example, when a knife is stuck in a hand or another limb. The stabilizing and fixing dressing consists of sterile gauze, a bandage and two elements stabilizing the foreign body. The bandage wraps the stabilizing elements so that the unwanted object cannot move. Applying this type of dressings requires practice and is not always easy, if only because of the stress accompanying the injured person.

Types of dressings – foil dressing (wet)

It is a dressing used in the event of digestion, i.e. the displacement of organs outside the abdominal cavity. The most important element of the dressing is foil or moist gauze. Their purpose is to protect the damaged part of the body from drying out. This element must be put on at the same time so that it is stable and does not constrict organs. For this purpose, you can use a bandage, plaster or a triangular scarf.

Types of dressings – tourniquet

This type of dressing is used for amputation. Its task is to limit bleeding from the limb. It is put on approx. 4 cm from the damaged part of the body. The tourniquet must remain in the same condition from the moment it is put on and cannot be loosened or removed later. This type of dressing can be either a specially made bandage or a regular triangular scarf. When the haemorrhage is massive, a tourniquet can be used to stop it, but should only be used in this way in exceptional circumstances.

Hemorrhage – causes

A haemorrhage occurs when arteries or veins, which are large blood vessels, are damaged. It is worth mentioning that this is not the same as the bleeding that occurs during skin damage. Haemorrhage may occur, for example, in the course of diseases such as:

1. pulmonary tuberculosis,
2. rak,
3. varicose veins,
4. stomach ulcer,
5. duodenal disease,
6. hemophilia.

There are arterial, venous and capillary haemorrhages. An arterial haemorrhage is a heavy discharge of blood that cannot be easily stopped. It is the most dangerous of hemorrhages as it leads to shock and sometimes death. Venous haemorrhage causes blood to flow out at a constant rate but is not as dynamic as with arterial haemorrhage. Capillary hemorrhage occurs during superficial skin lesions. The blood then seeps through the skin, but flows much slower than in arterial and venous hemorrhages.

Haemorrhage – what to do?

If a haemorrhage occurs, stop the bleeding site as soon as possible. You can even do it with your hand, preferably with a glove. Then apply a pressure dressing and place the person in an anti-shock position – unless there are any contraindications for this. If there is a hemorrhage on a limb, lift it up

Stressing a hemorrhage is only one way to deal with it. When it turns out that internal hemorrhage has occurred, it will not always be possible to stop it without access to specialized tools. Then you should call for help as soon as possible and cover the bleeding area with ice. The casualty should be placed in the shock position or with a knee deflection when the haemorrhage has occurred in the abdominal cavity.