1. Bandages and Binders

3. BANDAGES AND BINDERS
• A bandage is a piece of material used
either to support a medical device such
as a dressing or splint, or on its own to
provide support to or to restrict the
movement of a part of the body.
• When used with a dressing, the dressing
is applied directly on a wound, and a
bandage used to hold the dressing in
place.

4. Bandages and binders have many purposes and therapeutic benefits:
• Supporting a limb or joint
Supporting a wound or incision
Holding dressings in place
Holding a pad to absorb drainage
Holding a splint in place

5. Holding a cold pack or warm pack in place
Immobilization of a joint or limb
Maintaining a limb in a specific position
Providing compression , to promote venous return or prevent edema
Providing compression, to prevent contractures, as in a burn
To Shape A Stump Before Fitting A Prosthesis
Promoting Venous Return, AS Seen With Venous Insufficiency

6. The Three Major Types Of Bandages
Are:
• Roller Bandages, Tubular Bandages
and Triangular Bandages.
They are needy for:
• Covering Wounds,
• Applying Pressure Controlling
Bleeding, OR
• Supporting to Strain or Sprain.

7. There is a Specific Bandege Made for Each of These Tasks.
1. Roller Bandages Roller Bandages are Long Strips of Material.
Basically there are two types of Roller Bandages:
• An Elastic Roller Bandage is used to apply support to a Strain or
Sprain and is wrapped around the Joint Or Limb many times.
It should be applied firmly, but not tightly enough to reduce
circulation.
• Cotton or Linen Roller Bandages are used to cover gauze
Dressings. They come in many different widths and are held in place
tape, or pins clips.
They can also be used for Wound Compression if necessary, as they
are typically sterile

8. 2. Tubular bandages
Tubular bandages are used
on fingers and toes
because those areas are
difficult to bandage with
gauze .
They can also be used to
keep dressings in place on
parts of the body with lots
of movement, such as the
elbow or knee.

9. 3. Triangular bandages
Triangular bandages are made of
cotton or disposable paper.
They have a variety of uses:
• When opened up, they make
slings to support, elevate or
immobilize upper limbs. This may
be necessary with a broken bone
or a strain, or to protect a limb
after an operation.
• Folded narrowly, a triangular
bandage becomes a cold
compress that can help reduce
swelling.
They are used also foe applying
pressure to a wound to control
bleeding

10. Wrapping of Bandages
• TYPE OF APPLICATION: Figure
Eight
DESCRIPTION
Overlapping application alternating
with ascending and descending
wrapping with each pass of the
bandage crossing over previous
wrapping, as in a figure eight.
USES Stabilizes joints, such as wrist
or ankle, and helps maintain
immobilization.

11. • Spiral bandaging
Wrapping a limb in ascending
path, partially covering previous
wrapping while moving up the
limb.
Uses : Promotes venous
return. Effective when a bandage
needs to be applied around an
arm, leg, or wrist. May be used
to hold dressings in place.

12. Spiral Reverse
Similar to spiral, except the
bandage is folded back (distally)
halfway through each pass.
The appearance a basket weave is
produced.
Uses : May hold better on arms,
legs, thighs (extremities that are
wider at one end than the other-
cone shape) than spiral alone.
Promotes venous return.
Holds dressings in place.

13. Circular
Wrapping with continuous
application in the same place,
such as a wrist.
Uses :Stabilizes ankle, wrist,
fingers, and toes.
Binds amputation stump in
preparation for prosthesis
fitting.
Holds dressings on the head.

14. • Recurrent
Anchored at the top with
several spiral wraps, then
back and forth across the end
of the extremity or head.
Finish with spiral reverse or
figure eight.
Uses : Binds amputation
stump in preparation for
prosthesis fitting.
Holds dressings on the
head.

15. BASIC BANDAGING FORMS
Each bandaging technique consists of various basic forms of
bandaging.
The following five basic forms of bandaging can be used to apply
most types of bandages:
1. Circular Bandaging
Circular bandaging is used to hold dressings on body parts such as
arms, legs, chest or abdomen or for starting other bandaging
techiques.
For circular bandage we used strips of cloth or gauze roller bandage
or triangular bandage folded down to form strip of bandage (cravat).

16. In the circular bandaging technique the layers of bandage are
applied over the top of each other :.
• With the Roll On The Inner Aspect, Unroll The Bandage Either
toward you or literaly, holding the loose end until it is secured by
the first circle of the Bandage.
• Two or Three turns may be needed to cover an area
adequately hold the bandage in place with tape or clip.
Almost all bandaging techniques start and end with a few circular
bandaging turns.

17. 2. Spiral Bandaging
Spiral bandages are usually used for cylindrical parts of the
body. An elasticated bandage can also be used to apply spiral
bandaging to a tapered body part.
Despite the increasing diameter of the body part, the elasticity
will allow the bandage to fit closely to the skin.
With each spiral turn, part of the preceding turn is generally
covered by 1/3 of the width of the bandage.

18. 3. Figure-Of-Eight Bandaging
Figure-of-eight bandage involves two turns, with the strips of
bandage crossing each other at the side where the joint flexes or
extends.
It is usually used to bind a flexing joint or body part below and
above the joint.
The figure - of - eight bandage can be applied using a roller
bandage in two ways:
Following a circular turn around the middle of the joint, the
bandage should fan out upwards and downwards.

19. • The turns should cross at the side where the limb flexes.
• The figure-of-eight turns can also be applied from a starting
point located below or above the joint crease, working towards
the joint itself.
The cross-over points will be located at either the flexing or
extending side of the joint; the side where the turns do not cross
remains uncovered.

20. 4. Recurrent Bandaging
• Recurrent bandaging is used for blunt body parts consists partly
of recurrent turns. The bandage is applied repeatedly from one
side across the top to the other side of the blunt body part.
• To be able to fix the recurring turns well, not only the wound, but
the entire length of the blunt body part should be covered.
• Depending on the width of the bandage and the body part
successively turns either cover the preceding turn fully or
partially.

21. 5. Reverse Spiral Bandage
• Reverse spiral bandage is a spiral bandage where the bandage
is folded back on itself by 180° after each turn.
• This V-shaped fold allows the bandage to fit to the tapered
shape of the body part all the way along.
• This type of bandaging is required when using non-elasticated
bandages. The development of elasticated fixing bandages,
which are applied to tapered body parts using the spiral
technique, means that the reverse spiral technique is far less
commonly used nowadays.

22. APPLICATION ROLLER BANDAGES
Select the appropriate bandage material for the injury.
• Use gauze or a flex roller for bleeding injuries of the forearm, upper
arm, thigh, and lower leg
• Use a flexible roller bandage for bleeding injuries of the
hand,wrist,elbow,shoulder,knee,ankle,and foot.

23. -Use an elastic roller bandage for amputations, arterial bleeding
and sprains.
-It is best to use a bandage with some degree of stretch in the
weave. This will make the bandage easy to use and more likely to
stay in place for many hours.
-However, the correct application technique is essential to provide
comfort and adequate support for the affected part.

24. Select the appropriate width of bandage
• The width of the bandage to use is determined by the size of
the part to be covered.
• As a general guide, the following widths are recommended:
-Hand and fingers - 50 mm
-Lower arm, elbow, hand and foot - 75 mm.
-Upper arm, knee and lower leg - 100 mm.
-Large leg or trunk - 150 mm.

25. Prepare the patient for bandaging
• Position the body part to be bandaged in a normal resting
position (position of function),
• Ensure that the body part that is to be bandaged is clean and
dry.
Apply the anchor wrap.
- Lay the bandage end at an angle across the area to be
bandaged.
-Bring the bandage under the area, back to the starting point, and
make a second turn.
-Fold the uncovered triangle of the bandage end back over the
second turn.

26. - Cover the triangle with a third turn
,completing the anchor.
- Use a circular wrap to end other
bandage patterns, such as a
pressure bandage, or to cover small
dressings(A)
- Use a spiral wrap for a large
cylindrical area such as a forearm,
upper arm, calf, or thigh. The spiral
wrap is used to cover an area larger
than a circular wrap can cover (B).
-Use a spiral reverse wrap to cover
small to large conical areas, for
example, from ankle to knee.(C)

27. - Use a figure eight wrap to support or limit joint movement at
the hand, elbow, knee, ankle, or foot (D).
- Use a spica wrap (same as the figure eight wrap) to cover a
much larger area such as the hip or shoulder.
- Use a recurring wrap for anchoring a dressing on fingers, the
head, or on a stump (E).

28. Check the circulation after application of the bandage.
- Check the pulse distal to the injury.
- Blanch the fingernail or toenail, if applicable.
- Inspect the skin below the bandaging for discoloration.
- Ask the patient if any numbness, coldness, or tingling
sensations are felt in the bandaged part.
- Remove and reapply the bandage, if necessary.

29. Elevate the injured
extremities
• To reduce swelling
(edema) and
• control bleeding, if
appropriate.
Donut Bandage
The Donut Bandage is
used to put pressure
around an impaled object
without putting pressure on
the object itself.

30. BINDERS
A binder is a wide, flat piece of
fabric that is applied to support a
specific body part or to hold a
dressing in place.
Commonly used binders include
the arm sling and the T-binder, a
T-shaped strap.
Some binders are made of
elasticized material. Most use
hook-and-loop fasteners
(Velcro).

31. Applying A Binder
• Wash the hands before and after applying or adjusting a binder
Use Standard Precautions. If the client's skin is intact, gloves
are not necessary.
• Be sure the binder is a size appropriate for the
client. Rationale: Using an incorrect size will not be effective and
may cause damage.
• Apply the binder firmly enough to give support but not too tightly
Rationale: If the dressing is not applied firmly in place, bleeding
could occur, or the dressing's movement could irritate the area.

32. • If using a binder to hold a client's body part in place or a dressing in place,
be sure it is firm enough to be effective.
Rationale : A binder that is too tight might cause unnecessary discomfort or
constrict circulation.A binder that is too loose will not support or hold the
body part or dressing in place.
• Fasten the binder from the bottom up, to give upward support. Rationale:
Applying it from the top down will exert downward pressure and defeat the
purpose of the binder.
Make sure the binder has not slipped upward.
• Rationale: This could hinder breathing and impair gas exchange.

33. • Make sure the binder has not slipped down. Rationale: This would
loosen the binder and not give adequate support. . Rewrap the
binder every 2 to 4 hours and check the dressing.
Rationale: The client's movements tend to loosen the binder.
When rewrapping the binder , assess the client's skin and check the
dressing for amount and character of drainage .
Check the wound at the same time.

34. • 1) T-Binder
A T-binder gets its name from its
shape. Although not used frequently today, the
nurse may see a T-binder used in home care.
A T-binder can also be manufactured as a first
aid measure.
It is used to hold rectal or perineal dressings in
place. It may also be used to hold a perineal
pad in place for the incontinent or menstruating
female client. The top longer band is placed
around the client's waist and the perineal strap
is brought between the legs.
It is fastened with Velcro or may be pinned in
place in an emergency. (Be very careful not to
stick the client or yourself with the pins.)

35. 2) Abdominal Binder
An abdominal binder is a wide, flat piece of fabric that is secured
around the trunk of the client's body to support the abdomen or
dressings on the abdomen. Most frequently, the binder is secured
with Velcro. The abdominal binder is most often used after abdominal
surgery to hold large dressings in place. Rarely, it is used after
childbirth, particularly after cesarean delivery.
To apply the abdominal binder, place the center of the binder at the
level of the client's waistline on his or her back. Wrap the ends of the
binder snugly over the client's abdomen and secure it with the Velcro
straps. Remember , the binder is secured at the bottom first , working
upward . Rationale: This provides the most support.
Nursing Alert It is important to check the position of the binder
frequently particularly if the client is mobile. The binder could move up
and inhibit respiration or could slip down and lose its effectiveness.

36. 3) Tape
Instead of bandages and binders, strips of hypoallergenic tape
are sometimes used to hold a client's dressings in place. Tape
also may be used to give support, as for sprained ankles,
fractured ribs, or fractured toes. There are several kinds of tape
that allow ventilation and help to prevent skin maceration (skin
softening and breakdown due to moisture accumulation and lack
of circulation).
To provide more comfort, clip the client's hair close to the skin
(particularly on hairy body areas) before applying large tape

37. dressings because hairs stick to the tape and make removal
painful. Always remove tape in the direction of hair growth for
less discomfort. If tape is difficult to remove, carefully apply
acetone to the skin at the edge of the applied strip to loosen the
adhesion. Keep moistening the skin close to the adhesive as you
gently peel off the tape.
Nursing Alert
Be careful with acetone and other substances used to remove
tape adhesive. Never use these liquids near an open flame, the
client's eyes, or on an open wound! Be alert that some clients
may be allergic to tape or to acetone. Also, remember that
acetone will remove nail polish and paint from surfaces and may
damage other surfaces, such as latex or plastic.

38. • 4) Montgomery Straps Tape straps or
• Montgomery straps may be used if frequent dressing changes
are needed. These straps allow the dressing to be changed
without having to remove tape from the client's skin with each
change. This measure helps prevent skin irritation because the
tape remains in place when the dressings are
changed. General Nursing Care Of The Client With A Bandage
Or Binder • Wear gloves and follow Standard Precautions if the
client's skin is not intact. Rationale: It is important to help
prevent the spread of infection.