How to choose the right elastic bandage and how to bandage the ankle joint

When using, you need to know how to properly bandage your leg with an elastic bandage:

• You need to tie an elastic bandage on your leg while lying down immediately after waking up;
• You need to bandage your leg from the ankle up, grabbing the heel;
• each subsequent turn of the bandage should overlap the previous one by 30–50%; for better fixation, the heel should be bandaged in a figure eight;
• The bandage should be applied evenly, gradually loosening it. The bandage should not be overtightened so as not to disrupt blood microcirculation;
• The bandage should be removed during sleep, unless there are additional instructions in this regard.

Types of elastic bandages

Products differ in two main parameters: purpose and degree of elongation.

By purpose there are:

• compression - widely used in phlebology for the treatment and prevention of vein diseases;
• fixing bandages that prevent or compensate for the consequences of sprains and dislocations;
• fixing postoperative dressings.

According to the degree of extensibility, bandages are:

• short stretchable with an elasticity coefficient of no more than 70%;
• medium-tensile - the elongation coefficient is 70–140%;
• Highly stretchable, so-called motion bands, provide the most gentle compression. The stretch ratio is more than 140%.

Based on their shape, bandages are divided into tubular and tape.

Bandage sizes

Elastic tape bandages have a width from 6 to 20 cm and a length from 4 to 7 m.

Recommendations for choosing a suitable bandage should be obtained from your doctor and strictly followed.

Preparing for treatment

For bandaging

Low stretch bandages. Low-stretch wrap options range from the ultra-simple (short 100% cotton stretch wraps) to the more complex with a nylon/lycra blend in the outer layer and a foam inner layer that has multi-directional elasticity and adjustable compression that "doesn't migrate." Modern bandages have reusable Velcro and/or self-adhesive properties that help keep the bandages in place with little slippage. Most fabrics are cool, comfortable and breathable, hypoallergenic, hard-wearing and durable. Lotion to moisturize the skin and maintain its health. Well-moisturized skin prevents small cracks from forming and prevents bacteria from entering and causing infection. It can also prevent skin irritation from unaccustomed use of bandages. Tubular stocking. Additionally protects the skin and provides a comfortable, breathable base for wrapping. Felt cotton fabric, foam rubber, or foam sheets to add a layer of padding that evenly distributes the compression of the outer wraps.

Compression jersey

Compression clothing is selected by the attending physician. Important factors to consider are:

• compression class,
• appearance,
• material,
• finished product or to order,
• design,
• skin condition.

Elastic compression is recommended to maintain the results achieved by decongestant therapy. In the case of compression hosiery, compression is the force exerted by the product to compress the limbs and promote blood and lymph circulation. Compression is measured at specified points and expressed in millimeters of mercury. The highest value is at the ankle, called point B in medical parlance. The compression gradients indicated on the packages are measured at point B. Medical compression stockings are available in different compression grades:

• Class I: 20-30 mmHg.
• Class II: 30-40 mmHg.
• Class III: 40-50 mmHg.
• Class IV: 50-60 mmHg.

The gradient gradually decreases from point B to the edge of the garment. Sleeves are generally class I or II, gloves and mittens class I, stockings class II or III. Fibers used in elastic compression garments are typically latex or synthetic rubber, nylon, polyester, cotton, or a blend of these. Fabrics can be thick or thin, depending on the fibers used and the compression class (the higher the class, the thicker the garment). Most garments containing latex are knitted from a thread consisting of a latex core wrapped in nylon or cotton, this is important for those with latex allergies. There are three types of knitwear: round knitted, flat knitted and embroidered. Round knit fabrics are seamless but tend to bunch at the top. This creates a tourniquet effect, impeding the flow of fluid from the limb. Flat knits are often made from a rough, textured fabric that can provide a mini-massage to the skin, helping to improve fluid absorption and transport. Sewn, consist of several layers. In order for the clothes to stick better to the body, use a silicone tape inside the upper edge or several longitudinal (not circular) strips of transparent glue.

Indications and contraindications

You need to know what an elastic bandage is for:

• in case of varicose veins of the lower extremities;
• to bandage the foot with an elastic bandage in case of sprained ligaments and tendons;
• to maintain the correct position and maintain the integrity of the joints;
• for the purpose of treating degenerative-dystrophic diseases of the joints;
• for rehabilitation in the postoperative period;
• as a prophylaxis against thrombosis.

Contraindications to the use of compression elastic bandages include:

• late stage heart failure;
• infectious diseases of the extremities in the acute stage;
• diabetic foot syndrome;
• vascular diseases accompanied by obliteration - fusion or closure of blood vessels with connective tissue as a result of an inflammatory process or tumor growth.

Splint or plaster - which is better?

This question is asked by many patients, because even treatment, and especially recovery, should be carried out comfortably. Its main advantage is that it is modeled strictly along the contour of the lower limb. For high-quality fixation, it must cover at least 2/3 of the volume of the leg.

As for the plaster cast, before it is applied to the limb, it is diligently leveled so that there are no folds or unevenness. However, after drying and hardening, the bandage often leads to tissue necrosis. Therefore, it is additionally fixed using a circular method using an elastic bandage.

Pros and cons of using

Like any therapeutic agent, elastic bandages have advantages and disadvantages.

Advantages:

• Ease of use;
• reusable;
• versatility - can be applied to any part of the body;
• reliable fixation.

Flaws:

• a feeling of itching and peeling of the skin under the bandage;
• the need for qualified assistance in applying a bandage to elderly patients or patients with limited mobility;
• feeling of discomfort in the warm season;
• difficulties in choosing clothes and shoes.

Plastic fixtures

A splint is also a name given to a ready-made orthopedic device that is simply attached to the leg. It is intended both for the treatment of pathologies and elimination of the consequences of injuries, and for the prevention of tissue destruction. For example, hip splints are used to diagnose hip joint immaturity in young children. Wearing them promotes the correct formation of articulation. Splints are used for fractures of a toe, ankle, or knee joint. They are more convenient than gypsum analogues, easier to remove and clean. The name “splint” is rarely used for external devices in medicine, but in everyday life it is very common. What can this term mean:

• bandage. The simplest way to fix the leg, slightly limiting its mobility. This is a thick elastic bandage secured with straps or Velcro. A splint made of hypoallergenic materials allows air to pass through well, warms and creates a massage effect;

Semi-rigid ankle brace.

• orthosis A complex rigid structure that protects injured parts of the leg (fingers, foot, ankle or knee joint). The design of the splint has metal or plastic inserts for better fixation. An orthopedic device prevents the impact of excessive loads on injured or pathologically affected areas of the lower limb;

Dynamic ankle orthosis.

• splint. Made in the form of a capsule into which the injured leg is placed. The design of such a splint has no hinges, and its frame is made of polymer materials, less often metal. The surface of the splint is made of cotton or synthetic, which is highly breathable. To secure the splint to the leg and provide the necessary degree of fixation, a complex system of fastenings is used.

Plastic thin splint for fixing the joint.

To immobilize the limb, splints are used to provide mechanical support. It is equipped with a hollow solid frame, which is complemented by wooden, metal or plastic elements. Parts in contact with the skin are made of natural hypoallergenic materials.

Overlay technique

Depending on where the bandage is applied, a strict sequence of actions must be followed.

Ankle bandage

How to bandage your leg with an elastic bandage in the ankle area:

1. The ankle should be wrapped with an elastic bandage, starting with two turns around the ankle.
2. Then make two turns, starting from the back of the foot;
3. Next, wrap the bandage around the ankle again.
4. Repeat the required number of times until the entire ankle is secured with an elastic bandage.
5. The bandage is secured under the ankle.

Wrist band

When bandaging your wrist:

1. The bandage is fixed in one turn around the wrist.
2. Stretch it from the back of the hand between the thumb and index finger, then return through the palm to the wrist.
3. After this, the bandage is pulled through the palm and returned to the wrist.
4. Repeat the required number of rounds of the bandage until the joint is completely fixed.
5. Attach a bandage to your wrist.

Knee (or elbow) bandage

When applying the bandage, the knee or elbow should be in a comfortable flexed position.

1. Wrap the bandage two turns below the joint.
2. From the back of the arm or leg, the bandage is pulled above the joint and made two turns.
3. Perform overlapping turns above and below the joint until it is completely closed.
4. Secure the end of the bandage in a convenient place below or above the joint.

General recommendations

1. You need to wind the elastic bandage, overlapping each next turn with the previous one by no less than a third of the width and no more than half.
2. The tension of the bandage should be loosened as you move from the narrow part to the wide part.
3. The bandage should not have gaps or folds.
4. It is convenient to use self-fixing bandages.

Elastic ankle bandage

To fix the joint in the correct position, as well as to quickly restore sprained ligaments, an elastic bandage when the ankle is sprained.

Compression medical bandage "Intex" is a woven elastic tape that, when applied correctly, provides distributed pressure on the surface of the leg. Bandages vary in length and width . A wide elastic ankle bandage is rarely used. As a rule, for sprains, a tight bandage of low elongation (less than 50% of the length), 8-10 cm wide and 2.5 - 3 m long is used.

Before applying an elastic bandage to the ankle , you need to make sure that the injury is not combined with a soft tissue rupture or fracture. In case of serious damage, there is increased mobility in the joint, acute pain, and rapidly developing bluish swelling. For an accurate diagnosis, it is recommended to consult a doctor.

Rules for applying a fixing bandage from an elastic bandage 1. Make 3-4 rounds (that is, turns) of the bandage around the ankle. 2. Then the bandage is placed on the inside of the foot, and 2-3 rounds of the bandage are made around the foot. 3. The bandage is placed on the outside of the foot and wrapped around the shin, and then placed again on the inside of the foot. 4. The cycle, including steps 2 and 3, is repeated until the entire bandage has been applied. 5. The end of the bandage is fixed on the shin using a clip.

Since the bandage is intended to secure the ankle, the low-stretch elastic bandage does not need to be stretched. postoperative wraps are often used , designed to stabilize the ankle as well as reduce postoperative swelling. For this purpose, use a soft elastic bandage "Intex" of high elongation (up to 150% of the length), 8-10 cm wide and 2.5 - 3 m long.

Rules for applying a compression bandage made from an elastic bandage: 1. Bandaging should begin in the morning, immediately after sleep. If this is not possible, you should elevate the ankle on a pillow for 20-30 minutes before bandaging to reduce swelling. 2. It is necessary to bandage the leg, starting from the toes. 3. At the beginning of bandaging, you should tighten the tape, and as you move towards the lower leg, loosen the tension. 4. Each round of the bandage should overlap the previous one by at least a third. 5. Since there are a large number of blood vessels in the heel area, the heel area should also be covered with a bandage. 6. Stop bandaging three fingers above the shin area, and secure the end of the bandage there with a clip.

An elastic bandage of high extensibility is applied correctly if, at the end of bandaging, the toes acquire a slight bluish tint, which goes away while walking.

How long to wear

The wearing time of the bandage may vary depending on the purpose of its application. It is necessary to clearly understand how long you can wear an elastic bandage in each specific case, so as not to aggravate the situation.

1. It is recommended to wear the bandage on the ankle, elbow, knee, wrist, and shoulder for 5–6 hours a day, always removing it at night.
2. A postoperative dressing is applied an hour before surgery, then left for a day, including overnight. The exact time of wearing such a bandage is determined by the doctor.
3. For varicose veins, the bandage is worn no more than 6–7 hours a day.
4. The duration of wearing the bandage during surgery on large vessels is determined by the doctor. It can take up to 2–3 weeks.

How can you tell if the bandage is applied incorrectly?

There are several signs that the bandaging was incorrect and should be redone. These are the following signs:

1. Blueness of the toes that does not go away even after moving the toes. Indicates that the bandage is very tight and venous blood flow is impaired.
2. The toes and the foot itself are cold and pale. A symptom of deterioration in arterial blood circulation.
3. The leg goes numb and throbs under the bandage. If such sensations do not go away within half an hour, then the bandage is too tight.
4. The leg walks and the bandage falls off. This indicates insufficient immobilization of the ankle. The bandage was not tightened properly or the bandaging technique itself was incorrect.

The presence of at least one of the symptoms requires urgent removal of the bandage.

After this, it is recommended to take a lying position, put your leg on a pillow and massage it a little, this will help normalize blood circulation. After this, the ankle can be re-bandaged according to the instructions and do not forget about the force of compression of the joint with the bandage.

Plaster and plaster bandages

The most classic example of a fixing material is gypsum. This powder, mixed with liquid, is applied in a circular manner to the injured area, hardens and takes shape, making the limb immobile.

Medical plaster bandage is a more advanced form of fixation, which consists of strips of gauze impregnated with plaster mass. The plaster is evenly distributed over the gauze and secured with a special bacteriostatic agent. To apply, the plaster bandage is pre-moistened and only then applied to the injured area, where it is smoothed and hardened. Additionally, such a retainer can be secured with an elastic or gauze bandage.

Plaster and plaster bandages are most often used in trauma departments for bone fractures, soft tissue injuries, joint diseases, etc.