Indications and rules for applying the Deso bandage for injuries of the shoulder and collarbone

The famous French surgeon of the 18th century, who took an active part in wars, developed a method of fixation for injuries to the upper limb. In his honor it was named the Deso bandage, which is used to apply the shoulder joint to this day.

Modern traumatology uses it in the classic version and various modifications designed to immobilize the shoulder joint and the entire arm. The Deso bandage is indispensable when you need to provide first aid for an injury; the application technique is simple. Taking into account the high incidence of injuries at work and at home, everyone needs to master it.

Author of the article / Site experts Shulepin Ivan Vladimirovich, traumatologist-orthopedist, highest qualification category

Total work experience over 25 years. In 1994 he graduated from the Moscow Institute of Medical and Social Rehabilitation, in 1997 he completed a residency in the specialty “Traumatology and Orthopedics” at the Central Research Institute of Traumatology and Orthopedics named after. N.N. Prifova.

Features of the Deso bandage

The advantage of fixation is the ability to immobilize the entire upper limb, fixing it to the body, eliminating any movement in all joints. At the same time, wearing a bandage does not lead to compression of the tissues of the arm and disruption of its blood circulation if it is applied correctly.

In addition, an important point is the ease of application and availability of materials.

A wide bandage - gauze or elastic from the first aid kit - is enough to quickly provide assistance to the victim.

DIY Deso bandage

Not wanting to buy a ready-made orthosis for fixing the shoulder joint because of its high cost, many patients are thinking about how to make a Deso bandage themselves. To do this, you need to purchase several rolls of a wide bandage (10–15 cm) and follow the bandaging technique indicated above.

After the Deso bandage for the shoulder joint is ready, you need to secure it at the intersections of the bandage with a needle and thread (you can also use a regular pin). The disadvantage of such a dressing lies in its short service life. After just a week of wearing the bandage will stretch and a new bandage will need to be made. In addition, during use, the bandage quickly gets dirty, which is why it loses the aesthetic aspect of the bandage.

When should a Deso bandage be applied?

The Deso bandage and its various variants can be used for both first aid and treatment.

Indications for transport immobilization for injuries are:

• shoulder dislocation;
• injuries of the shoulder joint - bruise, sprain and rupture of ligaments;
• collarbone fracture;
• humeral neck fracture;
• fracture of the forearm bones;
• damage to the elbow joint - bruises, sprains and ligament tears.

During treatment, fixation is used in the following cases:

• after surgery for a fracture of the collarbone, shoulder, ligament rupture;
• after closed or open reduction of shoulder dislocation;
• in the initial period of rehabilitation after injuries;
• with acute inflammatory process in the shoulder joint.

Deso bandage - how long to wear?

The length of immobilization required depends on the type of injury. In addition, it is necessary to take into account the speed of recovery, which has individual characteristics. Each body recovers differently, so there is no single established norm for wearing a bandage. How long to wear the Deso bandage in a particular case is determined by the doctor.

Generally speaking, if a shoulder is dislocated, the bandage can be worn from 1 week to 1 month. It is worth noting that young, mobile patients often require longer immobilization. In this way, specialists try to exclude possible re-injuries. In the absence of complications of closed fractures of the humerus, the Deso bandage for a clavicle fracture is worn for about 1 month.

When should you not apply a Deso bandage?

Despite all its advantages, the bandage cannot be applied to open injuries of the upper limb and shoulder girdle, when there is bleeding, measures to stop it and constant monitoring are necessary.

Also, in the case of complex fragment fractures and fracture-dislocations with pronounced displacement and deformation of the limb, it cannot be used, because to apply it you will have to straighten the arm and bend it at the elbow joint. This cannot be done when providing assistance; you must try to fix the limb in the position as it is, using the available means.

How to sleep with a Deso bandage?

Due to the fact that plaster casts limit mobility, are uncomfortable to wear, and are almost impossible to use at night, a soft Deso bandage is often applied. How long it needs to be worn during the day and whether it can be removed during the night is determined by the doctor. 24-hour immobilization of the upper limb is often required. In such cases, patients have to sleep on their back.

This position is the only possible: it eliminates pressure on the shoulder joint, which is possible if the patient lies on his side. Even on the healthy side of the body it is not always possible to sleep. This position of the body leads to a change in the angle of inclination of the shoulder girdle and can cause pain (with collarbone fractures). To prevent this from happening, doctors recommend resting strictly on your back.

Overlay Rules

All you need to prepare is: a bandage at least 20 cm wide, scissors, a pin or adhesive tape, a small roller made of soft fabric or cotton gauze. In order for the bandage to perform its fixation function as much as possible and not cause inconvenience and undesirable effects, the following rules must be observed:

1. Make the victim sit facing you, calm him down, and let him relax.
2. Before application, a roller is placed in the axillary area of ​​the injured arm, after which the arm is carefully brought to the body.
3. Bend the arm at the elbow joint at a right angle, the hand should be relaxed, and the healthy arm is moved to the side.
4. Wrap a bandage around the chest 2 times with the hand pressed to it above the level of the elbow. In this case, if the patient’s right arm is fixed, the bandage is placed around the chest from left to right.
5. Having made 2 turns on the back, the bandage is led from the front of the chest obliquely upward to the top of the shoulder joint of the affected arm, bends around it and lowers the bandage along the back surface of the shoulder.
6. Bending around the elbow area, the bandage is led obliquely upward into the axillary area of ​​the healthy side, from there it is transferred to the back and the previous move is repeated.
7. The end of the bandage cannot be tied; it is fixed to the main bandage with a pin or bandage.

When applied to the left hand, the algorithm of actions is the same with the difference that they begin to bandage in a different direction - from right to left.

How to properly apply a Deso bandage

Algorithm 15 Deso bandage

Algorithm 29

Deso bandage.

Introduction :

“I am providing first aid at the scene of an accident to a victim with a dislocated right collarbone. Anesthesia has already been performed. My task is to carry out transport immobilization of the right clavicle using the Deso bandage.”

Equipment:

bandages, scissors. To carry out the manipulation, you will need an assistant in the role of the patient.

Obtaining patient consent:

"Hello! My name is First Name and Patronymic. I am a nurse. In order to ensure immobility of the damaged area during transportation, it is necessary to apply a bandage. Do you agree? Sit comfortably. The body must be motionless. If my actions cause you pain, please let me know. Fine?"

Manipulation technique:

1. Take a wide bandage;
2. place a cotton pad in the armpit;
3. bend your arm at the elbow joint and bring it to your chest;
4. bandage the shoulder to the chest in a circular motion, starting from the “healthy side” (1st round);
5. direct the bandage from the healthy armpit to the shoulder girdle of the “sick” side, obliquely upward;
6. throw it back over the shoulder girdle and lower it down to the elbow joint (2nd round);
7. go around the elbow joint, supporting the forearm and hand, direct the bandage obliquely upward into the armpit of the “healthy side”;
8. pass it to the back surface of the chest (3rd round);
9. direct the bandage obliquely up the back onto the sore shoulder girdle;
10. throw it over it and move it down to the elbow joint;
11. go around the arm in the upper third of the forearm and direct the bandage to the back of the chest (4th round);
12. guide the bandage V

    the armpit of the “healthy side” along the back;

13. repeat four rounds several times until the hand is completely fixed;
14. secure the bandage using one of the following methods.

Completion:

"All. The bandage application is complete. The ambulance will arrive now and I will accompany you to the hospital. If you feel worse, please let me know. Fine?"

General rules for applying soft bandages

1. The part to be bandaged must be accessible (at the level of the bandage’s chest)
2. The patient is given a comfortable position
3. The bandaged part must be motionless
4. The limb is given a functionally advantageous position
5. Muscles should be as relaxed as possible
6. You should stand so that you can see the part being bandaged and the face of the person being bandaged.
7. Periodically (at least 3 times) you should ask the patient the question: “How do you feel?”

Bandaging technique

1. The bandage must be of the appropriate size (head, limbs -10 cm; fingers - 5 cm; torso - 10-14 cm)
2. Bandaging is carried out from the periphery to the center, from the lower sections to the upper.
3. The head of the bandage is taken in the right hand, end to left, without preliminary rolling.
4. Bandaging begins with a securing circular tour
5. The head of the bandage rolls without lifting over the bandaged surface, stretches evenly, each subsequent round (spiral bandage) should cover the previous one by half.
6. Bends are made in cone-shaped areas
7. Reverse movements, sudden movements, and “adjustment” movements should be avoided.
8. When applying the bandage is completed, the end of the bandage is secured with a knot, a pin, glue, an adhesive plaster, a tubular bandage, or stitching. Bonding should not be done over the wound. Criteria for the correct application of the bandage:

1. The bandage must perform its function
2. The bandage must stay firmly in place
3. The bandage should not cause pain
4. The bandage should not interfere with blood circulation
5. The bandage should have an aesthetic appearance.

Possible mistakes:

Gross mistakes:

1. Violation of bandaging rules points: 2; 3; 4; 6.
2. Violation of bandaging technique, points: 2; 8
3. The dressing does not meet the criteria for correctness, points: 1; 2; 3; 4.

Non-blunders:

1. Errors during bandage positioning among other interventions.
2. Inability to justify the need to apply a bandage to a patient.
3. Violation of the course of manipulation.

Criteria for evaluation:

Passed – no major mistakes, no more than two minor mistakes.

Did not pass - the presence of at least one gross error, more than two not serious errors.

If an error is detected, the teacher may ask you to repeat the corresponding stage of the manipulation; if the error is corrected, you pass; if not corrected, you fail.

Possible errors during application

When applying a bandage, you should not make the following mistakes:

• fixing the hand in the wrong position, this can lead to displacement of fragments and increased pain;
• bandage too tightly, you can squeeze the blood vessels, causing swelling of the hand;
• bandage is not tight enough, leaving the possibility of hand movements when transporting the patient;
• use strips of fabric, sheets, scarves and other materials instead of bandages; they will not provide normal fixation.

Ready-made Deso dressings - indications and application rules

Today, industrially produced ready-made Deso bandages - bandages of various models - are very popular. They are easy to use, provide quick, reliable and adjustable fixation using hooks, Velcro, and locks.

At their core, these are fixing bandages for the shoulder and forearm; they can be purchased at pharmacies or medical equipment and orthopedics stores, as well as in online stores. The price varies from 800 to 4000 rubles, depending on the type of model, materials, and rigidity of fixation. All types of such fixing bandages are selected according to size; in most cases they are marked by clothing size - S, L, M, XL and so on, or their corresponding numbers 1, 2, 3, 4.

Care of the bandage

If immobilization is imposed temporarily only to transport the victim to a medical facility, no care is required. You just need to make sure that the bandage does not move and the fixation does not weaken.

When wearing a bandage for a long time, you need to keep it clean so that the limb does not become infected with pathogenic microbes. If it gets dirty or wet, you need to reapply it, but at the same time make sure that during the process of removing and re-bandaging the hand remains in the same position.

Alternative bandages for fixing the shoulder joint

Other types of bandages are applied to the shoulder joint area:

• plaster version of the Deso bandage - fixed only in a hospital setting for the purpose of rigid and long-term immobilization for fractures;
• Velpeau bandage is an alternative to the classic Deso bandage with the difference that the arm is bent at the elbow joint at an acute angle, the hand of the injured arm is fixed at the level of the shoulder girdle of the healthy side, it swells less, the indications for application are the same;
• figure-of-eight bandage and Delbe rings - applied to both shoulder joints, ensuring shoulder abduction in case of a clavicle fracture;
• scarf bandage - used only for first aid, suspends the arm from the neck, excluding movements in the shoulder and elbow joints.
• spica - for bandaging the shoulder and joint in the presence of open injuries, fixing the dressing material on the wound.

During treatment for injuries and diseases, the optimal dressing option is determined by the doctor in each specific case. And for providing first aid for injuries, the Deso bandage is the best option.

Alternative options for the Deso bandage

Bandage fixing the shoulder joint (Dezo bandage)

Description:

• Made from three-layer breathable knitted material for maximum comfort during use
• consists of a coupling for optimal placement of the upper limb in a functionally advantageous position and a removable belt for reliable fixation of the upper limb to the body
• universal bandage, suitable for left and right hands
• does not cause allergic reactions or skin irritation
• color: gray

Functions:

• fixation of the upper limb in a physiologically correct position
• unloading of the muscular-ligamentous apparatus and joints of the upper limb

Indications for use:

• rehabilitation after injuries, plaster immobilization and surgical interventions on the shoulder joint and upper limb
• acute and chronic diseases of the shoulder joint and upper limb (arthritis, arthrosis, plexitis, tendonitis, subacromial syndrome, myositis, etc.)

Contraindications for use:

No absolute contraindications have been identified. Relative contraindications require consultation with a doctor:

• the need for customized joint orthosis
• malignant neoplasms in the area of ​​use of the bandage
• the presence of contact dermatitis, trophic ulcers and bedsores in the area where the bandage is used
• allergic reaction to the materials from which the product is made

Use the Deso bandage as directed and under the supervision of a physician.

Instructions for use:

• place the forearm in the clutch as shown in the figure
• the straps are thrown over the shoulder girdles, crossed on the back and secured to the muff
• the belt secures the affected limb to the body
• the degree of fixation is determined by the attending physician

If you have any questions about the use of the shoulder brace, please contact your healthcare provider. If pain, discomfort or other unpleasant sensations appear while using the brace on the shoulder joint, remove it and consult your doctor.

Care instructions:

• We recommend hand washing at 30°C, separately from other items, using detergent for delicate fabrics.
• do not rub or squeeze the product
• After washing, rinse the shoulder brace thoroughly
• Dry flat, away from heaters and direct sunlight
• do not iron, do not use solvents, bleaches or dry cleaning
• store the product in a dry place at room temperature
• Avoid exposure to moisture, high temperatures and direct sunlight

Sizing:

Compound:

• polyurethane foam - 60%
• nylon - 20%
• polyester - 20%