The occurrence of trophic ulcers is typical, as a rule, for elderly patients over 65 years of age. They are formed mainly due to vascular disorders and affect the lower extremities. Treatment of trophic ulcers has the following goals:
- elimination of edema;
- healing ulcers and preventing dermatitis;
- prevention of relapse.
One of the treatment methods is special dressings for the treatment of trophic ulcers, the choice of which is influenced by the condition of the ulcer and the tissues surrounding it. Only a doctor can prescribe such dressings!
Dressings for trophic ulcers should prevent infection, clean the wound surface of necrotic tissue, absorb wound exudate and promote epithelization. It is important that the application of a wound-healing dressing for trophic ulcers is comfortable for the patient, in particular, that it does not stick to the wound.
What is a trophic ulcer
A trophic ulcer is a long-term non-healing tissue defect that occurs as a result of vascular damage to the superficial and deeper veins. These damages lead to disruption of lymph and blood flow and, as a consequence, insufficient tissue nutrition.
The formation of ulcers is preceded by the following symptoms: swelling, severe itching, change in skin color and thinning. The skin acquires a smooth, glossy surface, and stagnant lymph begins to appear on the surface in the form of drops. The condition is aggravated by chills and convulsions. The epidermis begins to peel off, and ulceration occurs in this place, causing severe pain at the slightest touch. The ulcerative surface quickly becomes infected, begins to fester, and inflammation penetrates deeper into the tissue.
Ulcers are difficult to treat, the likelihood of relapses is high, and after healing deep scars form in their place. Most often, ulcers occur in the lower third of the leg.
Breast ligation
The Velpeau bandage is applied to the mammary gland with the following features:
- It is preferable to use a wide bandage - at least 10 cm;
- when applying a Velpeau bandage to the right side, the nurse holds the head of the bandage in his right hand, and its turns are applied from left to right; when applied to the right side, vice versa;
- to secure the bandage, at the very beginning they wrap it around the chest under the mammary gland;
- when the bandage is brought to the mammary gland, it should cover its lower and inner parts, then it is applied to the opposite shoulder, and then along the back to the armpit;
- the next step is that the bandage should cover the lower and outer part of the gland, then the nurse makes a securing turn of the bandage;
- these steps are repeated until the breast is completely closed.
Types of dressings for trophic ulcers
The modern approach to treating ulcers with dressings involves maintaining a moist environment, which creates optimal conditions for wound healing. An ideal dressing should fulfill many requirements:
- prevention of infection;
- stimulation of granulation tissue formation;
- creating an environment favorable to healing;
- effective cleansing of the wound surface from necrotic tissue and exudate;
- protection of the wound from mechanical damage;
- the ability to easily remove the bandage so that it does not cause discomfort to the patient;
- vapor permeability;
- hypoallergenic.
To date, there are no universal dressings for the treatment of trophic ulcers that meet all these requirements, but the HARTMANN product range includes dressings that have shown their effectiveness in the treatment of different types of ulcers at different stages of healing.
In the treatment of venous trophic ulcers, atraumatic dressings with antimicrobial action, such as HydroClean Plus, which contain Ringer's solution, are effective.
Sponge absorbent dressings remove wound exudate well and maintain the necessary microclimate in the wound. Hydrogel dressings for trophic ulcers HydroTac with an absorbent gel layer have been developed for moderately exuding wounds.
Cleansing the wound and stimulating the processes of granulation and epithelization are provided by hydrocolloid healing dressings for trophic ulcers of the Hydrocoll series. Exuding and bleeding deep ulcers respond well to treatment with Sorbalgon alginate packing dressings. The use of ointment dressings for trophic ulcers, such as Branolind with Balsam of Peru, may also be recommended by a doctor.
Velpeau bandage: application technique
Before applying the bandage, the necessary instruments are prepared and preparatory work is carried out.
So, if the patient has open wounds, they must be treated with iodine, chlorhexidine or hydrogen peroxide. Next, gauze folded in four is applied to the wound, which is fixed at the edges with adhesive tape.
To apply the bandage you will need:
- regular or elastic bandage;
- cotton wool for making rollers.
In emergency situations, instead of a bandage, use a rag cut into long strips, and instead of a roller, use a 0.5 liter plastic bottle half filled with water.
The Velpeau bandage is applied to the patient according to the following algorithm:
- The patient is helped to take a comfortable position - facing the nurse, standing or sitting, with the spine straight.
- Velpo bandage application technique begins with the correct placement of the injured limb - the palm is on the healthy shoulder and clasps the collarbone.
- The patient's elbow is bent at an angle of 45°.
- A cotton swab is placed in the armpit.
- First of all, the hand is fixed in this position by 3-4 turns of the bandage around the chest of the affected limb. The goal of the health care worker at this stage is to pull the limb tightly to the body.
- In case of injuries to the right hand, rotations are carried out from left to right, for the left hand - from right to left.
- Spiral-shaped turns are passed through the chest and the injured arm, towards the elbow joint from above.
- Next, the bandage is passed diagonally across the back through the injured area, then it is thrown over the shoulder and grabs the elbow.
- After this, the bandage is lifted through the armpit of the healthy side, and subsequent turns are carried out through the damaged arm and chest.
- The next turns of the bandage should overlap the previous ones by half. Each vertical turn approaches the clavicular part.
To properly apply the Velpo bandage, an experienced doctor or nurse needs 1-2 turns.
If the technique is performed according to this algorithm, this is enough to securely fix the injured arm. If the healthcare worker does not have enough experience in applying this type of dressing, 3-4 turns should be made.
The Velpeau bandage is applied to the patient for a period of 2-3 days to several weeks. Caring for the bandage is simple - once every few days you need to remove the soiled elastic bandage strips and wash them; if the bandage is gauze, replace it with a new one.
Bandage for wounds of the scalp - cap
Indications
:
- Stop bleeding
- Fixation of dressing material
Technique
- The support bandage goes through the parietotemporal region and serves as the basis for applying the bandage; it should be slightly stretched;
- The main round of the bandage is fixed under the supporting round in the right temporal region, goes through the forehead to the opposite side, turns around the supporting round and exits through the occipital region to its original position;
- The bandage is overlapped around the supporting bandage and the new half-turn goes in front slightly higher than the previous one;
- The back round of the bandage is repeated. Gradually alternating with front and rear hemispheres, the entire scalp is covered;
- The supporting part of the bandage is tied with a knot in the chin area;
In what cases is it used?
Cross-shaped bandage on the foot
So, what is the Velpeau bandage for? Indications for its application are most often associated with the reduction of a dislocated shoulder joint. It is used somewhat less frequently for clavicular fractures, since in this case it is more advisable to use the dressing method developed by Deso. In this situation, the Velpeau bandage ensures immobility of the shoulder and is applied before the victim is admitted to the hospital. It prevents possible displacement of the bone (if we are talking about a fracture) or repeated loss of the joint from the bag. After the necessary examination and therapeutic manipulations, the Velpeau bandage is often replaced with other types of bandage. And the third area of application: postoperative recovery when the mammary gland is removed. In this case, the Velpeau bandage is worn by the patient for quite a long time - the time of permanent fixation is determined by the attending physician.
In what cases is it used?
If the shoulder is dislocated, apply a bandage.
So, what is the Velpeau bandage used for? Indications for its application are most often associated with the reduction of a dislocated shoulder joint. It is used somewhat less frequently for clavicular fractures, since in this case it is more advisable to use the dressing method developed by Deso. In this situation, the Velpeau bandage ensures immobility of the shoulder and is applied before the victim is admitted to the hospital. It prevents possible displacement of the bone (if we are talking about a fracture) or repeated loss of the joint from the bag. After the necessary examination and therapeutic manipulations, the Velpeau bandage is often replaced with other types of bandage. And the third area of application: postoperative recovery when the mammary gland is removed. In this case, the Velpeau bandage is worn by the patient for quite a long time - the time of permanent fixation is determined by the attending physician.
Indications for use
The Velpeau bandage is intended for fixing injured limbs at the stage of providing first aid to the victim. Mainly used to immobilize an injured arm. The bandage was developed in the 19th century by the French surgeon Alfred Velpeau. The use of a bandage significantly alleviated the condition of victims with injuries to the shoulder girdle.
In this regard, the Velpo bandage application algorithm will be considered further; it is applied for such indications as:
- Reduction of shoulder dislocation.
- Clavicle fracture.
- Removal of the mammary gland.
- Postoperative rehabilitation.
The use of a bandage for dislocations and fractures helps prevent the bone from shifting or the joint falling out of the bursa again. After the necessary treatment, the Velpo bandage is replaced with other types of bandage.
Features of care
A bandage applied in this way requires increased attention. The patient needs to ensure that it remains in place and does not slip, and if this happens, bandage the upper part of the wound without removing the dressing that has already been applied. It is equally important to keep the bandage clean. If a finger is damaged, a special finger cap is put on top of it, and if a hand is damaged, a clean mitten or sterile gloves are put on. If you follow these simple rules, the bandage will reliably protect the wound from infection and help the damaged joint to recover quickly.
Indications for use
As a rule, a soft Velpo dressing for a fracture is applied temporarily until the victim is admitted to the emergency room. It is intended for fixing the injured limb in a stationary state. This is necessary to prevent bone displacement during a fracture.
Also, this bandage can be applied in case of dislocation, so that the joint does not fall out again after reduction. Sometimes a bandage is prescribed for the rehabilitation period after breast removal. In this case, it is worn until the patient recovers completely.
Note. Typically, the Velpo bandage is worn for no more than 7 days, and then it is changed to a more comfortable bandage. This is explained by the fact that the bandage can interfere with normal blood circulation.
Installation and removal
Methods for applying plastic plaster depend directly on the type of dressing. For example, softcast, adhesive cast and primcast require the use of a special stocking during installation to provide a layer between the material and the skin. Turbocast is installed without additional devices, however, to apply it it is necessary to carry out a number of temperature procedures.
Unfortunately, there are no ways to remove plastic bandages at home, as this requires the use of a special saw.
The procedure for installing and removing an orthopedic device is absolutely painless.
Important! Only an experienced orthopedist or traumatologist can apply and remove plastic plaster. Do not try to do such manipulations yourself.
Overlay errors
If, when prescribing a Velpeau dressing, the application technique is violated, the following errors are possible:
- The wraps of the bandage are not tight enough - while wearing the bandage, the bandage will slip off. To avoid this, you should do additional rounds or reapply the bandage.
- While wearing a bandage, the patient can actively move the injured limb - because of this, the bandages leave their original position. In order to correct the situation, the bandages can be pinned with plastic clips, which are sold in hardware stores.
- Unlike other types of dressings, Velpo's ready-made dressing is not currently sold in pharmacies. Therefore, you should prepare the necessary materials - bandage and cotton wool.
- An alternative to this bandage is the Deso bandage, which is also often used for shoulder dislocations and clavicle fractures.
Advantages and disadvantages
The Velpeau bandage fully fulfills its tasks, fixes and supports the limb reliably. However, in most cases it is not a treatment and prevents you from straightening your arm if necessary. In addition, applying the Velpeau bandage is somewhat difficult to perform and is usually performed incorrectly by a non-professional.
However, shoulder injuries (both dislocations and fractures) occur quite often in everyday life. So in first aid courses, among other tricks, they usually tell and show how to properly apply a Velpeau bandage. As a rule, after the second or third repetition, students perform it quickly, clearly and without errors.