Chapter 53 Bandages and Binders

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 53

Bandages and Binders

Chapter 53

Bandages and Binders


BandagesBandages• Purposes and therapeutic benefits

– *To support a limb or joint, a wound or incision

– *To support a wound or incision

– *To hold dressings, splint, cold pack or warm pack in place, or to hold a pad to absorb drainage

– *To immobilize a joint or limb or maintain a limb in a specific position

– *To provide compression, to promote venous return or prevent edema or prevent contractures

– To shape a stump before fitting a prosthesis

– *Wrapped around a clients limbs to provide muscle or joint support or to increase or support circulation


Wrapping of BandagesWrapping of Bandages

• Type of application

– Figure eight

– Spiral

– Spiral-reverse

– Circular

– Recurrent


Peripheral Neurovascular Assessment (PNA) Peripheral Neurovascular Assessment (PNA)

• Peripheral neurovascular assessment (PNA)

• Observations (CMS-ET)

– Color of toes or fingers

– Motion or mobility

– Sensitivity or sensation

– Edema and swelling

– Temperature


In Practice: The Client’s Circulation When Using BandagesIn Practice: The Client’s Circulation When Using Bandages

Refer to Data Gathering in Nursing 53-1

CMS-ET


Types of BandagesTypes of Bandages• Roller bandages

– All cotton elastic (ACE) bandage

• Usually provides support

• Hold a dressing in place

• Exert pressure over a bleeding point

• Kerlix-stretchy gauze

• Stretch-net bandages-tube gauze


Antiembolism stockingsAntiembolism stockings

– Thromboembolic disease (TED) stockings

– To promote adequate return circulation and prevent clots

– Remove the stockings at least once every 4-8 hours ad examine the leg carefully for redness, pitting edema, or skin discoloration

– Nursing procedure 53-1


Nursing Care Guideline 53-1Nursing Care Guideline 53-1

• Applying roller bandage

– Use correct size

– Elevate extremity to be wrapped just above the level of the clients body

– Overlap each layer about ½ the width of the previous strip

– Check the clients peripheral neurovascular status at least every 2 hours


The PCD MachineThe PCD Machine

• To provide alternating pressure to the legs

– Pneumatic compression device (PCD)

– Sequential compression device (SCD)

– Intermittent sequential compression device (ISCD)

• These machines support circulation and are used primarily for clients immediately after surgery and for those with circulatory disorders.


The PCD MachineThe PCD Machine


BindersBinders• Binder

– Wide, flat piece of fabric that is applied to support a specific body part or to hold a dressing in place.

– Arm sling

– T-binder

• Used to hold rectal or perineal dressings in place

– Breast binder

– Abdominal binder

• Flat piece of fabric that is secured around the trunk of the clients body to support the abdomen or dressings on the abdomen


Applying a binderApplying a binder

• Nursing care guidelines 53-3

– Apply firmly but not to tight

– Fasten the binder from the bottom up

– Rewrap binder every 2-4 hours and check the dressing


Hypoallergenic TapeHypoallergenic Tape

• Holds a client’s dressings in place

• Supports sprained ankles, fractured ribs, or fractured toes

• Allows ventilation and helps to prevent skin maceration (skin breakdown)


Montgomery StrapsMontgomery Straps

• May be used if frequent dressing changes are needed

• Helps prevent skin irritation


Montgomery StrapsMontgomery Straps

Chapter 53 Bandages and Binders

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