Types of dressings: technique and rules for applying them

Classification of dressings

Dressings are classified according to several parameters. According to the purpose of use, the following types of medical dressings are distinguished:

holding;
pressing;
immobilizing;
occlusive - to seal the wound from exposure to water and air;
aseptic;
medicinal - for supplying medicinal substances to the damaged surface;
corrective - to correct deformities.

Types of dressings vary depending on the material used:

soft;
hardening (gypsum and starch);
hard (tires).

Desmurgy: Deso

Desmurgy is a section of medical knowledge about the properties and types of dressings, including methods of applying medical dressings to different parts of the body.

Desmurgy provides recommendations on how to correctly apply certain dressing patterns. For Deso bandages, the scheme is also guided by the general principles of desmurgy.

Therefore, nurses must navigate desmurgy, because applying bandages is one of their immediate functions.

This will allow the nurse to quickly and correctly apply the dressing correctly, even in an emergency and under time pressure.

The Dezo bandage got its name from the inventor of the bandage bandage, which is used to immobilize limbs, Pierre Deso.

Today, this type of bandage is used everywhere in medical institutions, so health workers should know how to apply a Deso bandage step by step and be able to apply this knowledge step by step.

Basic rules for applying bandages

The ability to apply a simple bandage can be useful to everyone, so you should know the basic rules and techniques used when applying different types of bandages:

do not touch the wound with your hands;
use sterile dressing material;
carry out the dressing facing the victim in order to understand whether the manipulation does not cause unnecessary pain;
bandage from bottom to top and from the periphery to the center;
roll out the bandage without removing it from the body;
bandage the limb in a position comfortable for the victim: legs straight, arms slightly bent.

In this case, the bandage should be moderately tight so that it does not interfere with normal blood circulation and does not move out.

How to wear a Deso bandage?

The finished Deso bandage is placed on the shoulder joint over underwear. The injured arm is bent at a right angle, the forearm parallel to the floor. Above the elbow, the product is attached to the body horizontally using a belt. The bandage should not dangle or squeeze.

Patients are always interested in how long they will need to wear the bandage.

This depends on the severity and nature of the injury. Typically, when a shoulder is dislocated, it is worn for a week to a month. For uncomplicated closed fractures of the shoulder or clavicle, the bandage will have to be worn for about a month. The doctor should tell the patient whether the bandage can be removed at night.

Application techniques depending on the type of dressing used and the place of its application

The technique of applying bandages for different parts of the body is different and depends on what type of medical bandage is used.

For head injuries

What bandage is used to provide first aid for a head injury? There are several varieties:

the frenulum is applied to the parietal and occipital parts;
the cap and cap of Hippocrates cover the entire scalp;
a figure-of-eight monocular or binocular bandage is used for eye injuries;
A sling bandage is used for injuries to the facial part of the head.

For limb injuries

When applying bandages to limbs, it is especially important to adhere to the rule of bandaging in the direction from bottom to top. This technique will prevent the accumulation of venous blood in the unligated parts of the limb.

A reliable spica bandage is used to bandage the shoulder and hip joints. A figure-eight bandage is applied to the elbow and knee joints. The lower leg, shoulder, forearm and thigh are bandaged in a spiral or spicate manner.

Which bandage is used depends on the degree of load.

Pressure bandage and tourniquet

A pressure bandage is used for minor bleeding of a capillary or venous nature, as well as for violation of the integrity of small arteries. It can be left on the body until the victim is admitted to a medical facility.

A tourniquet is used for bleeding from large arteries. It should not remain on the body for more than 1 hour in the cold season and more than 2 hours in the warm months.

Immobilization splint

When applying an immobilizing splint bandage to the limbs, you should adhere to the basic rule - grab the joints above and below the injury site, except in cases of hip and shoulder fractures, when the entire limb is fixed at three points.

In areas of bony protrusions, the splint is lined with soft material to prevent the formation of bedsores and abrasions.

Indications

The Deso bandage is necessary to immobilize the arm from the shoulder to the finger phalanges when:

shoulder dislocation and to prevent relapses;
fracture of the humerus;
collarbone fracture;
scapula fracture;
ligament damage;
paralysis of the upper limbs;
arthritis, periarthritis and arthrosis;
secondary myositis, neuritis, paresis and plexitis;
during the recovery period after surgery on the upper limb and wearing a cast.

Can be used for simple fractures - when there is no risk of displacement and damage to soft tissues from bone fragments. Sometimes prescribed for bruises and cuts on the hands.

Compression bandages

They are widely used for diseases of the veins of the lower extremities. When applying such a bandage, it is important to follow the rule of gradually reducing the degree of compression from the foot to the knee. There should be no numbness in your fingers. The patient should feel the effect of a tight-fitting boot.

The self-fixing medium-stretch ones - PÜTTERBINDE® (“Pütterbint”) and the long-stretch Lastodur® straff (“Lastodur tight”) from HARTMANN are very convenient to use. They vary in size and degree of elasticity.

Indications for use of the Deso bandage

The Deso bandage is used for both first aid and treatment.

Thus, the Deso bandage is used to immobilize the injured area of the victim during transportation for various injuries:

shoulder dislocation;
damage to the shoulder joint;
fractures of the collarbone, forearm bones;
injuries of the elbow joint.

During treatment, fixation with a Deso bandage is used in the following cases:

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

Contraindications to the use of the Deso bandage:

open injuries of the upper limb and shoulder girdle with bleeding;
first aid for complex fragment fractures with severe displacement and deformation of the limb, because to apply a bandage you will have to straighten your arm and bend it at the elbow joint.

Occlusive dressings

They have unique properties: they accelerate the process of epithelization of wounds, improve tissue granulation even in the case of chronic ulcers, and protect the skin from environmental influences. They have found their use in military field surgery for penetrating lung wounds, as well as in dermatology, where they are used to enhance the effect of medicinal drugs.

If you need help choosing, our specialists will advise you online or by phone and tell you the name of the bandage you are looking for.

Signs and types of chest injuries

Content:

Signs and types of chest injuries
Why are bandages needed for chest injuries?
Rules for applying bandages for chest injuries
Types of bandages and dressings for the chest

The main classification of such lesions is the division into penetrating and non-penetrating wounds. Penetrating refers to injuries that affect the integrity of the pleura, while the internal tissues of the lungs and other organs in the chest may not be damaged. Chest wounds can also be through, tangential or blind. Through injuries are characterized by the presence of two holes - an entrance and an exit, through which a wounding object penetrates into the tissue and then exits. Tangential wounds pass close to bones or organs without affecting them. Blind wounds are a lesion in which the wounding object or part of it (bullet, fragments) remains in the wound.

Detection and differentiation of chest wounds are not difficult, especially if they are open: wounds are characterized by pain, deterioration of respiratory function, limited mobility, swelling, bleeding and damage to the skin (open injuries). Bleeding can be venous, arterial or parenchymal, while the first two are extremely dangerous for humans, as they can very quickly cause large blood loss and death of the affected person. Serous-bloody contents may also be discharged from the wound.

The most dangerous is considered to be a wound to the subclavian artery - with a wide wound, fatal bleeding occurs within a few minutes. If there is a blind or through wound, this is complicated by the formation of a pulsating hematoma, which can threaten a person’s life for a long time.

Non-penetrating types of wounds can be accompanied by extensive destruction of muscles and ligaments, as well as bone structures.

Contraindications

Open or comminuted fractures. It is possible that the displacement of fragments may increase due to the pressure of the bandage on the shoulder, which leads to damage to surrounding tissues and a worsening of the patient’s further condition.

Individual intolerance to dressing material.

Skin damage - acute stage of dermatitis and other skin diseases, open wounds, various skin infections.

Malignant tumors located in the immediate vicinity of the wound site.

Application of an orthosis: indications and choice

An orthosis is a device that provides immobility to a damaged joint or bone. Orthoses come in different types: bandages, plastic plaster, splints, special shoes (boots). They are used not only for fractures, but also for other injuries: sports injuries, arthrosis, dysplasia and arthritis. They are also worn during the rehabilitation period after operations. The orthosis is selected according to the doctor’s recommendation. It must match the type and severity of the fracture or injury. They are not available in emergency rooms or hospitals; the patient purchases the orthosis independently.

Orthoses instead of casts come in different types. Firstly, these are bandages made of polymer materials (Scotchcast), fiberglass (Cellacast), impregnated with polyurethane resins. They harden, but remain elastic, fixing damaged areas.

Secondly, this is a turbocast - a type of thermoplastic with a porous structure. It is five times lighter than gypsum, has plastic memory, which means that if necessary, it can be heated and restored to the desired shape. Wearing a turbocast is indicated for complex fractures as a replacement for plaster.

Wearing an orthosis for fractures or as a splint for the upper or lower extremities helps:

stimulate bone fusion;
stabilize joints;
reduce the load on the damaged area;
strengthen muscles, ligaments, tendons;
minimize swelling and pain.

Pros and cons of orthosis

The advantages of all types of orthoses are:

Light weight. They are much lighter than plaster casts.
Aesthetics: orthoses look neat, not bulky, and can be covered with clothing.
Strength. Modern materials are resistant to moisture, corrosion, mechanical stress, they do not tear, practically do not break, providing reliable protection for the damaged part of the body.
Moisture resistance. Plastic orthoses do not get wet, and fabric pads can be dried with a hairdryer. The fixing properties are not reduced.
Comfort. Wearing orthoses instead of a cast is much more comfortable. There is a lining under the plastic or fiberglass that provides a soft fit and free air exchange. The orthosis is fixed on the limb with straps; there are special pads for the bones. Everything is provided to ensure that the medical device does not chafe.
Removable, adjustable and re-fixable. The patient can remove and put on the orthosis himself without the help of others. This gives freedom of movement and activity is not limited.

The only disadvantage is the high cost. But taking into account the fact that recovery with orthoses is faster and rehabilitation is not required, as after wearing a cast, the price is justified.

Fracture of the collarbone in a newborn during childbirth

A clavicle fracture in a newborn, sustained during childbirth, is a partial or complete violation of the physiological integrity of the clavicular bone. This type of birth injury is one of the most common. This usually happens at the final stage of the birth process, when the baby is helped to be born using various physical influences (pulling the handle, using forceps or a vacuum). Causes of occurrence The shoulders of a newborn are the widest part of his body, therefore it is the clavicle bone that is subject to the greatest load, especially at the final stage of labor. A clavicle fracture can occur:

if the size of the mother’s pelvic bones does not correspond to the size of the child;
due to the use of auxiliary methods during childbirth (instrumental application of forceps or vacuum);
due to the rapid progress of labor (the birth canal and pelvic bones do not have time to open sufficiently);
if the baby was in a breech or transverse presentation until birth.

A fracture can also occur if the doctor was not very careful in his actions during obstetrics. Symptoms The clinical picture of such an injury directly depends on the type of fracture. So, if a partial fracture occurred (the upper part of the periosteum was not affected, but only the inner part was damaged), then the symptoms will not be noticeable immediately. Doctors may suspect such a fracture even a few days after birth. In this case, the child experiences:

absence or only partial impairment in the motor activity of the affected arm;
on days 2-3 a slight swelling may appear at the site of injury;
the area of soft tissue and skin above the fracture becomes bluish, and a hematoma occurs.

If the collarbone is broken, but both ends of the bone remain in their normal physiological position, then they speak of a fracture without displacement. The symptoms in this case will be more pronounced:

on the first day after birth, the child develops swelling and hematoma at the site of injury;
on palpation you can hear crackling and clicking sounds;
the child is restless, appetite becomes noticeably less;
Swaddling or other pressure on the injured arm causes sudden crying.

A displaced fracture is characterized by a condition where parts of the broken bone are in different planes from their normal location. This type of fracture is the most serious and causes the greatest concern on the part of the child:

the newborn refuses to breastfeed;
a violation of the motor activity of one of the hands is clearly recorded;
the soft tissues over the damaged area swell greatly;
the hematoma is pronounced;
any physical action with a sore arm is accompanied by sharp crying.

Treatment First, the newborn will have an x-ray to determine the presence and type of fracture. If the diagnosis is confirmed, then the baby’s sore arm is fixed to the body using a soft elastic bandage. In this case, a roll of cotton wool and a bandage is placed in the armpit. Wearing this bandage for a non-displaced fracture takes 7-10 days, and after surgery the wearing time increases to 25-30 days. In addition to fixing the limb to relieve symptoms of hematoma and tissue swelling, vitamin K is administered intramuscularly for 3 days. To relieve pain, it is possible to use local agents (ointments) with an analgesic and regenerating effect. Throughout the entire treatment period, the baby should not be turned over or placed on the side of the body on which the fracture is located. Usually the damaged bone heals after 20-25 days. And only with complex displaced fractures may surgical intervention be necessary. The recovery time increases to 1.5-2 months. Rehabilitation

At the final stage of treatment and upon its completion, additional procedures are recommended:
electrophoresis (by applying medications and exposure to low power current, regeneration and healing processes are accelerated);
massage (performed only after completion of treatment);
magnetic therapy;
therapeutic exercises (after consultation with a specialist, the mother herself is able to carry out physical therapy exercises).
The use of any additional methods of treatment and recovery is carried out only in consultation with a doctor.

Consequences The baby’s body is fragile, but accelerated metabolism and an active period of growth contribute to the rapid healing of the damaged bone. After a collarbone fracture, with adequate treatment, the baby will not have any cosmetic or physical defects.

Gypsum: pros and cons of use

Plaster casts have been used for a long time. They are very inexpensive, materials for them are available in every hospital or emergency room. At the same time, they quite reliably and rigidly fix the injured limb in a stationary position. This is where the benefits end. The disadvantages include:

bulkiness, heavy weight, unattractive appearance: the bandage gets dirty quickly;
inability to combine with clothes or shoes;
the material gets wet and, as a result, becomes deformed, which leads to a loose fit and poor-quality fixation;
motor activity is limited, the patient is uncomfortable moving;
the plaster cast rubs, the skin under it sweats and becomes irritated.

In addition, it is impossible to perform medical manipulations with a limb under a cast. During wearing, the plaster completely blocks movement; with prolonged treatment, the muscles atrophy. It is not removed during treatment.