Applying a sterile dressing to the wound. Aseptic wound dressing: what medications to use? Features of the occlusive dressing
Any type of burn leads to damage to the skin or tissue. The wound surface must be anesthetized and properly treated to prevent microorganisms from entering it. Dressings for burns with medications will help protect the wound and speed up regeneration.
Modern treatment of burn wounds involves the use of special dressings that disinfect, moisturize, and anesthetize the wound. Such dressings can have a different base: cotton fabric, plaster, hydroactive polymer and others. They may contain an antiseptic, analgesic, a regenerating drug or gel-forming substances that help maintain the required level of moisture in the damaged area.
All types of wound dressings have two sides. One of them is intended for contact with damaged skin and tissue, and therefore must be sterile. The other, the outer one, is devoid of a medicinal layer and serves for convenient fixation of the dressing material.
There is a certain algorithm that must be followed when using medicinal dressings:
- First, it is necessary to stop the action of the etiological or pathological factor. If there is clothing on the damaged surface, it is removed or cut, freeing the burned arm, leg, shoulder, lower leg, thigh from further exposure to boiling water, hot oil or chemicals. The stuck part of the fabric must not be torn off. It is cut off as much as possible with scissors, and the rest is left in the wound to avoid further injury.
- Now you need to cool the damaged area to relieve pain, relieve swelling and prevent further tissue damage. Such an event makes sense for the first half hour after an injury. To cool, place the affected part of the body under running cold water or immerse it for 20 minutes. The water temperature should not be lower than 15 o C. At the same time, you can use a painkiller.
- The bandage is applied to the damaged area in such a way that the burn surface is completely covered, but does not extend beyond the wound more than 2 cm around the perimeter.
After the dressing has been cut out according to the area of the burn, the protective layer of the bandage is removed and applied to the body. For fixation, you can use a bandage or plaster.
When localizing, a bandage is applied to each finger separately, and then the hand and forearm are suspended on a piece of fabric.
A bandage is not applied to the face, and the wound is treated openly with a chlorhexidine solution and covered with ointment preparations.
Dressing of the burned area is carried out according to the instructions of the dressing used. As a rule, for burn wounds, the bandage must be replaced every 2-3 days. When providing first aid to a victim, it is not recommended to use anti-burn ointments, as they may affect the correct determination of the degree of injury.
Types of dressings
There are several types of dressings. Let's look at some of them with detailed descriptions.
| View | Characteristic |
| Aseptic | An aseptic dressing is used to provide emergency care for burns. The dressing material used is a sterile bandage, an ironed diaper or cotton cloth, or a clean bag. The material can be dry or moistened with an antiseptic (alcohol tincture of calendula or propolis, vodka, potassium permanganate solution). The main goal is to close the wound surface from infection before sending the victim to a medical facility. |
| Mazevaya | You can make it yourself or buy it ready-made at the pharmacy. To prepare it at home, the remedy is applied to gauze or a bandage, and then applied to the wound and secured. Most often, and are used for these purposes. Store-bought ointment dressings are a layer of medication on a mesh base with protection from external influences. The most famous and widespread is the Voskopran series of ointment dressings. Levomekol, Dioxidin, Methyluracil ointment, Povidone-iodine can be used as medicine. |
| Wet | Wet-dry dressings are designed for protection, pain relief and treatment of 2nd and 3rd degree burns. For wounds with a purulent inflammatory process, a base is applied with antiseptic solutions of furatsilin, boric acid or chlorhexidine. If there is a scab in a grade 3 wound, a wet-dry type of dressing with an antiseptic is also used to ensure a drying effect on the wound surface. Ready-made gel dressings for burns, Gelepran with miramistin and lidocaine, have moisturizing, antiseptic and analgesic properties. |
| Hydrogel | Hydrogel bandages for burns are a modern means for treating and protecting the wound surface. One of three forms of this dressing can be purchased at the pharmacy:
The advantage of such a remedy is pain relief, maintaining the required level of humidity in the wound, protection against infection, providing cooling and cleansing the burned area from necrosis products. Contraindication: this remedy should not be used on wounds with strong exudate. |
Banolind dressings
Branolind burn dressing is a modern remedy for the treatment of burns and other wounds. It has a cotton mesh base. Branolind is an ointment dressing whose active ingredient is Peruvian balsam. Therapeutic impregnation has the following ingredients:
- Branolind ointment;
- glycerol;
- petrolatum;
- cetomacrogol;
- purified fat.
At the pharmacy you can purchase a package of Branolind with 10 or 30 pcs. mesh bandages. It is also possible to buy the mesh individually. This remedy has proven to be an excellent way to protect against infection, accelerate regeneration, and relieve inflammation. Branolind is widely used in surgery after skin grafting to accelerate cell growth and trouble-free tissue engraftment.
The advantage is that it is hypoallergenic. The wound-healing components of the ointment do not irritate even sensitive skin.
Based on consumer reviews, Branolind copes well with non-healing wounds of any nature. Pregnancy and lactation are not contraindications for use. It can also be used by children and adolescents.
How to avoid complications and further care
The main complication of burns is the development of burn disease. It occurs when more than 5-10% of the area of all skin is affected. The complication is caused by a complex of disturbances in the functioning of various systems and organs. These include hypovolemia, intoxication, circulatory disorders, tachycardia, etc.
It is important to timely admit a patient with an extensive burn to a specialized burn department. In a state of shock, specialists carry out a number of therapeutic measures to the patient to eliminate pain, normalize breathing, and prevent cardiovascular and renal failure.
Another complication of a burn can be sepsis. To avoid infection of the wound, regularly treat the affected area with antiseptic agents, perform dressings and monitor the healing process.
To avoid burns, you should follow safety rules and also protect children from possible sources of burn injuries.
The technique of applying an aseptic dressing is quite simple, but in order to perform the dressing correctly, you must follow a number of important rules. It is very important to use high-quality dressing material in this case.
In order to protect the wound from possible contamination and foreign particles entering it, it is necessary to apply an aseptic dressing to it as soon as possible.
The rules for applying a primary aseptic dressing are described in books on first aid. It is also necessary to remember that there are different types of fixation of an aseptic dressing.
In order to perform the dressing correctly, you must first treat the wound. To do this, under no circumstances should you rinse it with water. To treat and disinfect the damaged area, you must use special antiseptics or medical alcohol, a solution of brilliant green.
An aseptic dressing is a dressing consisting of a cotton-gauze pad and a bandage. It is better to purchase ready-made aseptic dressings at the pharmacy, which are sold in sterile packages. The bottom layer of the pad, which must be applied directly to the wound, is a multi-layer sterile gauze. The top layer consists of cotton wool or other sterile absorbent material. In order to secure the bandage, special gauze ties are provided.
To apply a bandage to a wound, you need to remove it from the sterile packaging without touching the pad that will come into contact with the damaged area. The bandage should be applied with the gauze side to the wound and bandaged tightly. A dry aseptic dressing is designed to dry the wound. The blood released from it is absorbed by the hygroscopic material. If the wound does not bleed, you can apply a bandage, which is a regular sterile bandage folded in several layers. It is important to remember that as soon as the dressing material gets wet through, it must be urgently replaced.
There are many ways to apply bandages. If the wound simply needs to be protected from possible infection, then a regular aseptic dressing is quite suitable. If the formation of a wound is accompanied by a fracture or dislocation, it is necessary to apply a fixing bandage. Using it, you can fix the limb in a stationary position. If a patient's arm is injured, a scarf is often used to fix the limb; a sterile bandage should be placed under it on the wound. A scarf can be used to bandage a limb so that it remains motionless. This will avoid possible complications. If the scarf is short, it can be lengthened with bandages or other dressings.
To stop bleeding, use tight bandages. In this case, you can use a regular dressing bag, and then press the bandage to the wound using a tourniquet. It is important to remember that the tourniquet must be removed immediately after the bleeding has stopped. Applying it for a long time can be dangerous.
It should be remembered that the size of the aseptic dressing must correspond to the size of the wound. To ensure tightness around the edges, the bandage is sometimes glued with Creole. The bandage should not only cover the wound completely, but a supply of sterile tissue should be needed on each side. It is enough to leave a margin of about 3 centimeters. If a bandage is applied to a postoperative wound and it is necessary to remove the drainage tube, then an incision can be made in it.
If the bandage is wet through, but it is not possible to completely change it, you can apply several more layers of bandage on top of it. You can also use another package designed for first aid. It is better that it consists not of hygroscopic material, but of sterile gauze folded in several layers. It should be remembered that a bandage that is soaked through can create a favorable environment for the development of pathogenic bacteria and their penetration into the wound, and this is completely unacceptable.
Applying an aseptic dressing requires a responsible approach. Before applying a bandage, it is necessary to treat the wound using antiseptics. It is strictly prohibited to wash damaged areas with water.
Use: orthopedics and traumatology. Improving regeneration processes by stabilizing the pressure on soft tissue in the osteotomy area. The essence of the invention: the aseptic dressing contains a gasket 1, made in the form of a tape made of elastic material, under which a liquid-absorbing material 2 is laid. The ends of the gasket 1 are equipped with fixing elements 3 in the form of hooks or burdock fasteners. 1 ill.
SOK)3 SOVG1SKIKH
SOCIALISTS fF.; SKIH
REPUBLIC(s)5 A 61 F 13/00
STATE PATENT
USSR DEPARTMENT (USSR STATE PATENT) DESCRIPTION OF THE INVENTION
"Restorative traumatology and orthopedics" (72) A.B.Poïkkov (56) Timofeev N.S., Khenina A.N., Timofeev
N.N., Guide for junior medical personnel of the operating and dressing unit, - L,: Medicine, 1983, p. 223.
Patent CLUA N. 3750666, cl. A 61 1
„„5Ц„„1803083 A1 (54) ASEPTIC DRESSING (57) Use: orthopedics and traumatology. Improving regeneration processes by stabilizing the pressure on soft tissue in the osteotomy area. The essence of the invention: the aseptic dressing contains a gasket 1, made in the form of a tape made of elastic material, under which a liquid-absorbing material 2 is laid.
The ends of the gasket 1 are equipped with fixing elements 3 in the form of hooks or fasteners
"burdock". 1 ill.
Compiled by T. Kovalenko
Techred M. Morgenthal Corrector T, Vashkovich
Editor T. Ivanova
Order 1016 Circulation Subscription
VNIIPI of the State Committee for Inventions and Discoveries under the State Committee for Science and Technology of the USSR
113035, Moscow, Zh-35, Raushskaya embankment, 4/5
Production and publishing plant "Patent", r. Uzhgorod, Gagarin st., 101
The invention relates to medicine, namely to orthopedics and traumatology.
The purpose of the invention is to improve regeneration processes by stabilizing the pressure on soft tissue in the osteotomy area.
The drawing shows an aseptic bandage applied to the wound and secured to the rods of the compression-distraction apparatus.
The aseptic dressing contains a retaining pad 1 made in the form of an elastic band. Under the pad 1 there is a material 2 that absorbs liquid.
The ends of the gasket 1 are equipped with fixing elements 3. The fixing elements 3 can be made in the form of hooks. The clamps 3 are hooked onto the rods 4 of the compression-distraction apparatus 5.
An aseptic dressing is used as follows.
After osteosynthesis of the limb segment and osteotomy, the wound is sutured in the generally accepted way. 2-3 sterile napkins 2 are applied to the skin, which are pressed with a gasket 1, namely: one end of the gasket 1 is strengthened with fasteners-hooks 3, for example, on one rod 4, and the other end , after pre-tensioning the gasket 1 on the opposite rod 4 of the apparatus 5. The length of the gasket 1 is adjusted by moving the fixing elements in the form of hooks 3, so that in the free state it is several centimeters less than the distance between the rods 4 of the apparatus
The use of the proposed aseptic dressing makes it easy, almost instantaneous. create and maintain constant over time the necessary pressure force on soft tissues in the osteotomy area. What allows you to prevent
10 formation of postoperative hematoma and prevents suppuration in the postoperative wound. In addition, the proposed aseptic dressing saves 1-2 meters of sterile gauze bandages on each
15 operated patients. Reduces the time of dressing the patient. The use of an aseptic dressing during surgery allows for urgent clamping in case of accidental damage to blood vessels.
20 the vessel through the soft tissues for the required time and stop the bleeding, thereby preventing blood loss.
Formula of invention
Aseptic dressing containing
25 liquid-absorbing material and a retaining pad with fixation elements located on top of it, with the exception that, in order to improve the regenerative processes by stabilizing the pressure on soft tissues in the osteotomy zone, there is a retaining pad in it made in the form of an elastic band. and the fixation elements are in the form of hooks located at its ends.
Providing first aid to victims with wounds, fractures, dislocations, ligament damage, bruises, burns, etc. becomes almost impossible without timely and correct application of a bandage. After all, thanks to dressing, additional infection of the wound is prevented, bleeding is stopped, fractures are fixed, and even a therapeutic effect on the wound begins.
Medical dressings and their types
The branch of medicine that studies the rules for applying bandages and tourniquets, their types and methods of application is called desmurgy (from the Greek desmos - leash, bandage and ergon - execution, business).
According to the definition, a bandage is a method of treating injuries and wounds, which consists of using:
- dressing material that is applied directly to the wound;
- the outer part of the bandage that secures the dressing material.
For various reasons, the role of dressing material can be:
- special dressing packages;
- napkins;
- cotton swabs;
- gauze balls.
Description | Varieties |
|
Protective or soft | Consist of material that is applied to the wound and a securing bandage Used in most cases: for burns, bruises, open wounds |
|
Immobilization or solid | Consists of dressing material and splint Used for transporting the victim, in the treatment of damage to bones and their elastic joints |
|
Primary care for trauma
The process of applying a bandage is called ligation. Its purpose is to close the wound:
- to prevent further infection;
- to stop bleeding;
- to have a healing effect.
General rules for applying bandages to wounds and injuries:
- Wash your hands thoroughly with soap; if this is not possible, you should at least treat them with special antiseptic agents.
- If the site of injury is an open wound, then carefully treat the skin around it with an alcohol solution, hydrogen peroxide or iodine.
- Place the victim (patient) in a position convenient for him (sitting, lying), while providing free access to the damaged area.
- Stand in front of the patient's face to observe his reaction.
- Start bandaging with an “open” bandage from left to right, from the periphery of the limbs towards the torso, that is, from bottom to top, using two hands.
- The arm should be bandaged with the elbow bent, and the leg straightened.
- The first two or three turns (round) should be fastening; for this, the bandage is tightly wrapped around the narrowest undamaged place.
- Next, you should bandage with even tension, without folds.
- Each turn of the rope covers the previous one by about a third of the width.
- When the injured area is large, one bandage may not be enough, then the beginning of the second is placed at the end of the first, strengthening this moment with a circular twist.
- Finish the dressing by making two or three wraps of the bandage.
- As an additional fixation, you can cut the end of the bandage into two parts, cross them together, circle them around the bandage and tie them with a strong knot.
Main types of bandages
Before learning the rules for applying bandages, you should familiarize yourself with the types of tourniquets and options for their use.
Classification of bandages:
1. By appearance:
- aseptic dry;
- antiseptic dry;
- hypertonic wet drying;
- pressing;
- occlusal.
2. By application method:
- circular or spiral;
- eight-shaped or cross-shaped;
- serpentine or creeping;
- spicate;
- tortoiseshell bandage: diverging and converging.
3. By localization:
- on the head;
- on the upper limb;
- on the lower limb;
- on the stomach and pelvis;
- on the chest;
- on the neck.
Rules for applying soft dressings
Bandage dressings are relevant in most cases of injury. They prevent secondary infection of the wound and minimize the adverse effects of the environment.
The rules for applying a soft bandage are as follows:
1. The patient is placed in a comfortable position:
- for injuries to the head, neck, chest, upper limbs - sedentary;
- for injuries of the abdomen, pelvic region, upper thighs - recumbent.
2. Select a bandage according to the type of injury.
3. Carry out the bandaging process using the basic rules for applying bandages.
If you have made a dressing, following the rules for applying sterile dressings, then the compress will meet the following criteria:
- completely cover the damaged area;
- do not interfere with normal blood and lymph circulation;
- be comfortable for the patient.
Rule for applying a bandage |
|
Circular bandage | It is applied to the wrist area, lower leg, forehead and so on. The bandage is applied spirally, both with and without kinks. It is better to carry out dressing with kinks on those that have a canonical shape |
Creeping bandage | Applied for the purpose of preliminary fixation of the dressing material on the injured area |
Cross bandage | Can be applied in places with complex configurations As the dressing progresses, the bandage should make a figure eight. For example, a cruciate bandage on the chest is performed as follows: move 1 - make several circular turns through the chest; move 2 - the bandage is passed diagonally through the chest from the right axillary region to the left forearm; move 3 - make a turn through the back onto the right forearm across, from where the bandage is again drawn along the chest towards the left armpit, while crossing the previous layer; moves 4 and 5 - the bandage is again passed through the back towards the right armpit, making a figure-of-eight step; securing move - the bandage is wrapped around the chest and fixed |
Spica bandage | It is a type of eight. Its application, for example, to the shoulder joint is performed according to the following scheme: move 1 - the bandage is passed through the chest from the healthy armpit to the opposite shoulder; move 2 - with a bandage they go around the shoulder in front, along the outside, behind, through the armpit and lift it obliquely onto the shoulder, so as to cross the previous layer; move 3 - the bandage is passed through the back back to the healthy armpit; moves 4 and 5 - repeating moves from the first to the third, ensuring that each new layer of bandage is applied slightly higher than the previous one, forming a “spikelet” pattern at the intersection |
Turtle headband | Used to bandage joint areas
Sliding tortoiseshell headband:
|
Head bandaging
There are several types of headbands:
1. “cap”;
2. simple;
3. “bridle”;
4. “Hippocrates’ cap”;
5. one eye;
6. on both eyes;
7. Neapolitan (on the ear).
Name | When superimposed |
For injuries to the frontal and occipital parts of the head |
|
For minor injuries to the occipital, parietal, frontal parts of the head |
|
"Bridle" | For injuries to the frontal part of the skull, face and lower jaw |
"Hippocrates' Cap" | There is damage to the parietal part |
One eye | In case of injury to one eye |
For both eyes | When both eyes are injured |
Neapolitan | For ear injury |
The basis of the rule for applying headbands is that, regardless of the type, the dressing is carried out with bandages of average width - 10 cm.
Since it is very important to provide timely treatment for any injury, for general head injury it is recommended to apply the simplest version of the bandage - a “cap”.
Rules for applying the “bonnet” bandage:
1. A piece about a meter long is cut from the bandage, which will be used as a tie.
2. Its middle part is applied to the crown.
3. The ends of the tie are held with both hands; this can be done either by an assistant or by the patient himself, if he is in a conscious state.
4. Apply a fixing layer of bandage around the head, reaching the tie.
5. Begin to wrap the bandage around the tie and further over the head.
6. Having reached the opposite end of the tie, the bandage is wrapped again and passed around the skull slightly above the first layer.
7. Using repeated actions, completely cover the scalp with a bandage.
8. When making the last round, the end of the bandage is tied to one of the straps.
9. The straps are tied under the chin.
Rule for applying a bandage |
|
Pass the bandage around the head twice. The next step forward is to make a bend and begin to apply the bandage obliquely (from the forehead to the back of the head), slightly higher from the circular layer. Another bend is made at the back of the head and the bandage is applied from the other side of the head. The moves are secured, after which the procedure is repeated, changing the direction of the bandage. The technique is repeated until the crown is completely covered, while not forgetting to fix every two oblique strokes of the bandage |
|
"Bridle" | Make two turns around the head. Next, the bandage is lowered under the lower jaw, passing it under the right ear. Raise it back to the crown through the left ear, respectively. Three such vertical turns are made, after which the bandage is passed from under the right ear to the front of the neck, obliquely through the back of the head and around the head, thus fixing the previous layers. The next step is to lower it again from the right side under the lower jaw, trying to completely cover it horizontally. The bandage is then passed to the back of the head, repeating this step. Repeat the move through the neck again, after which you finally secure the bandage around the head. |
One eye | The bandage begins with two reinforcing layers of bandage, which in case of injury to the right eye is carried out from left to right, the left - from right to left. After this, the bandage is lowered from the side of the injury along the back of the head, placed under the ear, covered the eye obliquely through the cheek and secured in a circular motion. The step is repeated several times, each new layer of bandage covering the previous one by about half. |
Dressings for bleeding
Bleeding is the loss of blood when the integrity of blood vessels is disrupted.
Type of bleeding | Description | Rule for applying a bandage |
Arterial | The blood is bright red and flows in a strong pulsating stream. | Firmly compress the area above the wound with your hand, a tourniquet or a cloth twist. Type of bandage applied - pressure |
Venous | The blood turns dark cherry color and flows evenly | Raise the damaged part of the body higher, apply sterile gauze to the wound and bandage it tightly, that is, make a pressure bandage The tourniquet is applied from below the wound! |
Capillary | Blood is released evenly from the entire wound | Apply a sterile dressing, after which the bleeding should quickly stop |
Mixed | Combines the features of previous types | Apply a pressure bandage |
Parenchymal (internal) | Capillary bleeding from internal organs | Apply a dressing using a plastic bag with ice. |
General rules for applying bandages for bleeding from a limb:
- Place the bandage under the limb, slightly above the wound site.
- Apply an ice pack (ideally).
- Stretch the tourniquet very much.
- Tie the ends.
The main rule for applying a bandage is to place the tourniquet on top of clothing or specially placed fabric (gauze, towel, scarf, etc.).
With the correct actions, the bleeding should stop, and the area under the tourniquet should turn pale. Be sure to place a note under the bandage with the date and time (hours and minutes) of the dressing. After first aid is provided, no more than 1.5-2 hours should pass before the victim is taken to the hospital, otherwise the injured limb cannot be saved.
Rules for applying a pressure bandage
Pressure bandages should be applied to reduce all types of external bleeding in areas of bruises, as well as to reduce the amount of swelling.
Rules for applying a pressure bandage:
- The skin adjacent to the wound (about two to four cm) is treated with an antiseptic.
- If there are foreign objects in the wound, they should be carefully removed immediately.
- As a dressing material, use a ready-made dressing bag or a sterile cotton-gauze roll; if this is not available, then a bandage, a clean handkerchief, or napkins will do.
- The dressing is fixed on the wound with a bandage, scarf, or scarf.
- Try to make the bandage tight, but not over-tightening the damaged area.
A well-applied pressure bandage should stop bleeding. But if it has managed to become saturated with blood, then there is no need to remove it before arriving at the hospital. It should simply be tightly bandaged on top, after placing another gauze bag under the new bandage.
Features of the occlusive dressing
An occlusive dressing is applied to provide an airtight seal around the damaged area to prevent contact with water and air. Used for penetrating wounds.
Rules for applying an occlusive dressing:
- Place the victim in a sitting position.
- Treat the skin adjacent to the wound with an antiseptic (hydrogen peroxide, chlorhexidine, alcohol).
- An antiseptic wipe is applied to the wound and adjacent area of the body with a radius of five to ten cm.
- The next layer is a water- and air-tight material (necessarily with the sterile side), for example, a plastic bag, cling film, rubberized fabric, oilcloth.
- The third layer consists of a cotton-gauze pad, which plays the role of constipation.
- All layers are tightly fixed with a wide bandage.
When applying a bandage, remember that each new layer of dressing material should be 5-10 cm larger than the previous one.
Of course, if there is such an opportunity, then it is best to use IPP - which is a bandage with two cotton-gauze pads attached. One of them is fixed, and the other moves freely along it.
Applying an aseptic dressing
An aseptic dressing is used in cases where there is an open wound and it is necessary to prevent contamination and foreign particles from entering it. To do this, it is necessary not only to correctly apply the dressing material, which must be sterile, but also to securely fix it.
Rules for applying an aseptic dressing:
- Treat wounds with special antiseptic agents, but under no circumstances use water for this purpose.
- Apply gauze directly to the injury, 5 cm larger than the wound, pre-rolled in several layers.
- Apply a layer (easily peelable) on top, which is two to three centimeters larger than gauze.
- Secure the dressing tightly with a bandage or medical adhesive plaster.
Ideally, it is better to use special dry aseptic dressings. They consist of a layer of hygroscopic material that absorbs blood very well and dries the wound.
To better protect the wound from dirt and infection, additionally stick a cotton-gauze bandage on all sides to the skin using an adhesive plaster. And after that, secure everything with a bandage.
When the bandage is completely saturated with blood, it must be carefully replaced with a new one: completely or just the top layer. If this is not possible, for example, due to the lack of another set of sterile dressing material, then you can bandage the wound, having previously lubricated the wet bandage with iodine tincture.
Application of splint dressings
When providing first aid for fractures, the main thing is to ensure immobility of the injury site, as a result of which pain is reduced and the displacement of bone fragments is prevented in the future.
The main signs of a fracture:
- Severe pain at the site of injury that does not stop for several hours.
- Painful shock.
- With a closed fracture - swelling, edema, tissue deformation at the site of injury.
- With an open fracture, there is a wound from which bone fragments protrude.
- Limited or no movement at all.
Basic rules for applying bandages for limb fractures:
- The bandage should be of an immobilization type.
- In the absence of special tires, you can use improvised things: a stick, a cane, small boards, a ruler, and so on.
- Ensure the victim's immobility.
- To fix the fracture, use two splints wrapped in soft cloth or cotton wool.
- Apply splints on the sides of the fracture; they should cover the joints below and above the damage.
- If the fracture is accompanied by an open wound and heavy bleeding, then:
- A tourniquet is applied above the fracture and wound;
- a bandage is applied to the wound;
- Two splints are placed on the sides of the injured limb.
If you apply any type of bandage incorrectly, then instead of providing first aid, you can cause irreparable harm to the health of the victim, which can lead to death.
What is bandaging (bandaging technique)? Who should study desmurgy? You will find answers to these and other questions in the article.
A bandage is a hard or soft device that fixes dressing materials (sometimes containing medicinal and other substances) on the surface of the body. He studies bandages, methods of applying them, as well as the rules of healing wounds in the medical section of desmurgy.
Classification
How are bandages applied? What is the overlay technique? By purpose they are distinguished:
- hemostatic (pressure) bandages - stop bleeding by creating a certain pressure on the desired area of the body;
- protective (aseptic) - prevent wound infection;
- medicinal (usually partially impregnated with the mixture) - provide prolonged access of the medication to the wound;
- stretching bandages - straighten broken bones, for example tibia;
- immobilizing - immobilize a limb, mainly for fractures;
- bandages that eliminate deformities - corrective;
- sealing wounds (occlusive), for example, in case of chest injuries, are needed so that the victim can breathe.
The following types of dressings exist:
- hard - using hard materials (Kramer splint and others);
- soft - using soft raw materials (bandage, cotton wool, gauze and others);
- hardening - plaster bandages.
"Dezo"
What is the Deso bandage used for? The technique of applying it is simple. It is used to fix the upper limbs during shoulder dislocations and fractures. To make this bandage you need the following tools:
- pin;
- bandage (width 20 cm).
It should be noted that the right hand is bandaged from left to right, and the left hand in the reverse order.
So, let's find out how the Deso bandage is made. The technique for applying it is as follows:
- Make the patient sit facing you, reassure him, and explain the course of the upcoming actions.
- Place a roller wrapped in gauze into the armpit.
- Bend your forearm at an angle of 90° at the elbow joint.
- Press your forearm to your chest.
- Perform a couple of fastening rounds of the bandage on the chest, the injured arm in the shoulder area, the back and the armpit on the side of the working arm.
- Place the bandage through the armpit of the able-bodied side along the frontal thoracic surface obliquely onto the shoulder girdle of the painful area.
- Go down the back of your injured shoulder, under your elbow.
- Bend the elbow joint and, holding the forearm, direct the bandage obliquely into the armpit of the healthy side.
- Move the bandage from your armpit down your back to your sore forearm.
- Move the bandage from the shoulder girdle along the frontal plane of the painful shoulder under the elbow and around the forearm.
- Direct the dressing down the back into the armpit of the healthy side.
- Repeat the rounds of the bandage until the shoulder is thoroughly fixed.
- Complete the bandage with a couple of fastening rounds on the chest, sore arm in the shoulder area, and back.
- Pin the end of the sling with a pin.
By the way, if the bandage is applied for a long time, the bandage needs to be stitched.
Sling-bonnet
Do you know what a headband is? The technique of applying it is easy to remember. This bandage can simultaneously perform the functions of fixation, stop bleeding, secure medications and prevent infection from entering the damaged surface. In fact, it is universal.
How is it applied? If the patient is conscious, one person can bandage him. If the victim has lost consciousness, in order to make a high-quality bandage, the medical worker must involve an assistant.
Cut a meter-long tape from the head of the bandage and place it in the middle on the parietal area. The ends should hang freely, like the ties of a baby's cap. During the procedure, they must be held by the victim himself or a medical assistant.
Make a couple of securing rounds around the entire skull. Then lay out the cap itself. After the blocking round, reach the area of the tie, wrap the head of the bandage around it and bring it to the back of the head to the second strap. There, too, wrap a bandage around it and apply it to the cranial area from the forehead.
The movements should be repeated, and each next round should overlap the previous one by about a third. With the help of such moves, the entire scalp area is completely covered with dressing tissue. It turns out to be a gauze cap, similar to a cap. The bandage is fixed like this: tear the end of the bandage, secure it with a knot and tie it under the tie. Then tie the straps together.
Do you know that a cap bandage can stop bleeding? The application technique in this case is somewhat different. Trim the hair in the area of the injury and check it for foreign matter. If possible, disinfect the wound or its edges. It must be remembered that an antiseptic (mainly alcohol) can contribute to the appearance of painful shock. Therefore, carry out the procedure carefully. Then apply a clean gauze napkin in two layers to the open wound, followed by a squeezing pad from a bandage bag. Next, apply the bandage according to the above algorithm.
If you don't have a specific pad on hand, use a dressing bag or tightly rolled things, preferably clean. The pressure pad should completely cover the wound, overlap the edges and not deform. Otherwise, it will push through the edges of the wound and increase its size.
During breakfast, lunch and dinner, the straps of the headband can be relaxed. It is not recommended to untie them while sleeping, as the sling may move out.
Bleeding
What is the technique for applying a pressure bandage? This type is used primarily to stop minor bleeding and reduce extravasation in joints and periarticular soft tissues. Apply a gauze-cotton pad to the wound and secure it tightly with a bandage without squeezing the blood vessels. Sometimes health care providers use elastic compression bandages for ligament damage or venous insufficiency.
It is known that bleeding can be capillary (blood discharge over a large surface of the body), arterial and venous. Arterial blood gushes out and has a scarlet color, and venous blood pours out in an even stream, dark.
What is the technique for applying a pressure bandage in these circumstances? For minor external bleeding from a vein or capillaries, apply a compressive sling without squeezing the limb. This method will not help if there is severe mixed or arterial bleeding. Pinch the artery with your finger above the wound (identify the point by pulsation) while an assistant prepares a tourniquet. Place a note under the tourniquet indicating the time it will be applied.
Finger injuries
How is the “Glove” bandage created? The technique of applying it is quite simple. This sling is used for wounds of the fingers. To apply it, you need to have a needle and syringe, a narrow bandage (4-6 cm), balls, a tray, gloves, an antiseptic and an analgesic.
Make the patient sit down and face him (monitor his condition). Numb the area to be bandaged. Perform 2-3 circular rounds around the wrist, and then direct the bandage obliquely along the dorsal surface of the hand to the thumbnail of the right hand, and with the left hand to the nail phalanx of the little finger (do not cover ½ of the nail phalanx with the bandage to observe the condition of the limb).
Then close it with spiral turns from the nail to the base of the finger, and cross the bandage on the back surface and direct it to the wrist (from left to right). Perform a tightening tour around the wrist. Bandage the remaining fingers in the same way. Complete the bandage with circular rounds and tie. It should be noted that the “Knight’s Glove” bandage can be supplemented with a scarf.
Spica type
Many people are unfamiliar with the technique of applying a spica bandage. As a rule, it is used to fix the shoulder joint in case of pathology of the shoulder and axilla. You should have on hand a bandage (12-16 cm wide), a sterile napkin, scissors, a kidney-shaped basin, a pin, and tweezers.
Here you need to perform the actions in the following sequence:
- Turn to face the patient.
- Draw two securing circles around the shoulder on the affected side.
- The third round is carried out obliquely from the armpit to the back along the front of the shoulder.
- The fourth round continues the third.
- With the fifth circle, cover the shoulder circularly (outer, inner surfaces, front and back) and bring it to the back, crossing it with the fourth round.
"Mitten"
Why is the “Mitten” bandage necessary? The technique of applying it is completely simple. It is used for injuries and burns of the hand, frostbite. To make this sling, you need to prepare a needle and syringe, napkins, bandage (8-10 cm wide), tray, analgesic, balls, antiseptic and gloves.
In this case, you need to follow these steps:
- Have the patient sit down and face him to monitor his condition.
- Pain relief.
- Perform 2-3 circular securing turns in the wrist area.
- Bend the bandage 90° on the dorsum of the hand.
- Run the bandage along the back of the hand to the tops of the fingers, and then move to the palmar surface and reach the wrist.
- Repeat step three three to four times, covering four fingers in unison.
- Using a circular motion in the wrist area, secure the previous turns, bending the bandage 90° in advance.
- Guide the bandage along the back to the tops of the fingers, wrapping it in spiral-shaped strokes, following to the base of the fingers.
- Return the bandage to your wrist through the back of your hand. Secure the previous turns with a circular tour.
- Apply a spica bandage to your thumb.
- Complete the sling with circular turns around the wrist and tie.
By the way, to prevent your fingers from sticking together, you need to put gauze scarves between them. The “mitten” can be supplemented with a scarf sling to immobilize the limb.
Head bandaging
What is the technique of applying a headband? We discussed the cap sling above. It is known that several types of bandages that have different purposes are used to bandage the skull:
- "Hippocrates' cap." To apply this sling, use two bandages or a bandage with two heads. Take the head of the bandage in your right hand, make circular turns and fasten the bandage rounds, which, diverging or converging, should gradually cover the cranial vault.
- When bandaging the right eye, the bandage is moved from left to right, and the left one in the opposite direction. Fix the bandage around the head in a circular motion, then lower it to the back of the head and pass under the ear from the bandaged area obliquely and upward, covering the damaged eye with it. The curved move is grabbed in a circular manner, then an oblique move is made again, but slightly higher than the previous one. Alternating oblique and circular turns, they envelop the entire eye area.
- Bandage for two eyes. The first fixing circular round is performed, and the next one is moved down along the crown and forehead. Then a curved coil is made from top to bottom, enveloping the left eye. Next, the bandage is moved around the back of the head and again a curved move is made from bottom to top, covering the right eye. As a result, all subsequent turns of the bandage intersect in the area of the bridge of the nose, imperceptibly enveloping both eyes and going down. At the end of bandaging, the sling is strengthened with a horizontal circular tour.
- The Neapolitan sling begins with ring turns around the head. Next, the bandage is lowered from the affected side to the area of the ear and mastoid process.
- The Bridle sling is mainly applied to cover the chin area. First, a fixing circular tour is performed. The second turn is led obliquely to the area of the back of the head on the neck and under the jaw is transformed into a vertical position. Moving the bandage in front of the ears, make a couple of turns around the head, and then from under the chin they bring it obliquely to the back of the head or along the other side and, turning it into horizontal turns, secure the bandage. In order to completely close the lower jaw after securing horizontal moves, you need to lower the head of the bandage crookedly down the back of the head and move to the neck along the front area of the chin. Next, going around the neck, you need to return. Then, lowering the turn of the bandage slightly below the chin, it is raised vertically, securing the bandage around the head.
Occlusal view
The technique of applying an occlusive dressing is known only to healthcare workers. Let's consider it in as much detail as possible. Occlusive dressings provide airtight isolation of the injured area of the body, preventing its contact with air and water. To make such a device, you need to place a water- and air-tight material, for example, rubberized fabric or synthetic film, on the wound and the adjacent area of skin with a radius of 5-10 cm, and secure it with a regular bandage. Instead of a bandage, you can use wide strips of adhesive tape.
It is known that modern and reliable application of an occlusive sling is especially important when the patient has a penetrating chest wound and pneumothorax has developed.
Each person should review the application of bandages. The technique for applying a sealing (occlusive) bandage is as follows:
- If the wound is small, prepare 1% iodanate, a tuff and a personal dressing bag. Sit the victim down and treat the skin around the injury with an antiseptic. Then place the rubber sheath of the private set on the wound with the sterile side, and place cotton-gauze bags on top of it. Next, you need to secure it all with a spica bandage (if the injury is at the level of the shoulder joint) or a spiral bandage on the chest (if the injury is below the level of the shoulder joint).
- If the wound is extensive, prepare 1% iodanate, tuffer, Vaseline, sterile wipes, a wide bandage, oilcloth and a gauze-cotton swab. Place the victim in a semi-sitting position and treat the skin around the wound with an antiseptic. Then apply a sterile napkin to the injury and lubricate the skin around it with Vaseline. Next, apply the oilcloth so that its edges protrude 10 cm beyond the wound. Then apply a gauze-cotton swab, covering the film by 10 cm, and secure with a bandage on the chest or a spica sling.
Gypsum variety
It is difficult to fully understand bandaging. The overlay technique, of course, is useful to everyone. It is known that there are complete plaster casts and incomplete ones. The latter include a crib and a splint.
These slings can be unlined or with a cotton-gauze lining. The former are used in the treatment of fractures, and the latter in orthopedic practice. So, the technique of applying plaster casts is performed as follows:
- Before applying the bandage, sit or lie down the patient so that he does not experience any discomfort when bandaging.
- For the limb or body part being fixed, use special stands or racks to give it the position in which it will be after the procedure is completed. Cover all bone protrusions with gauze and cotton pads to prevent bedsores.
- Guide the plaster bandage in a spiral, bandage without tension, rolling it over the body. Do not tear the head of the bandage from the surface to be bandaged to prevent wrinkles from appearing. Smooth each layer with your palm and model it according to the contours of the body. With this technique, the bandage becomes monolithic.
- Above the fracture zone, on the folds, strengthen the bandage, which can include 6-12 layers, with additional rounds of bandage.
- During bandaging, it is forbidden to change the position of the limb, as this leads to the appearance of folds, and they will compress the vessels and a bedsore will appear.
- During the procedure, support the limb with your entire palm, not your fingers, to prevent indentations in the bandage.
- While applying the cast, monitor the patient's pain and facial expression.
- Always leave the fingers of the lower and upper limbs open so that blood circulation can be judged by their appearance. If your fingers are cold to the touch, turn blue and swell, then venous congestion has occurred. In this case, the bandage needs to be cut and possibly replaced. If the patient complains of terrible pain, and the fingers become cold and white, then the arteries are compressed. Therefore, immediately cut the bandage lengthwise, separate the edges and temporarily secure it with a soft bandage until a new bandage is applied.
- Finally, the edges of the bandage are trimmed, folded outward, and the resulting roll is smoothed with a mixture of plaster. Then cover with a layer of gauze and coat with the paste again.
- Finally, write on the bandage the date it was applied.
It is known that it is forbidden to cover a wet bandage with a sheet until it dries. It will dry out on the third day.
Rules
Therefore, we know the technique of applying bandages. Among other things, you need to follow some bandaging rules:
- always face the patient;
- start bandaging with a securing bandage;
- Apply the bandage from bottom to top (from the periphery to the center), from left to right, minus special dressings;
- with each subsequent turn of the bandage, overlap the previous one by half or 2/3;
- bandage with both hands;
- when applying a bandage to cone-shaped parts of the body (shin, thigh, forearm), for a better fit, twist it every couple of turns of the bandage.
Soft types
The technique of applying soft bandages is known to many. These slings are divided into the following types: bandage, adhesive (colloid, adhesive plaster, cleol) and kerchief. They are created like this.
Adhesive dressings are used mainly for minor injuries and on the wound area, regardless of its location. If hair grows in the area, it is shaved off beforehand.
To make an adhesive plaster bandage, you need the dressing raw material applied to the wound and attached with a couple of strips of adhesive plaster to healthy areas of the skin. Unfortunately, this design has an unreliable fixation (especially when wet), and maceration of the skin under it may occur.
Cleol is the name given to resin - pine resin dissolved in a mixture of ether and alcohol. Cover the wound with a bandage, lubricate the skin around it with the medicine and let it dry a little. Cover the bandage and skin areas treated with cleol with gauze. Press the edges of the napkin tightly to the skin, and trim off any excess gauze that has not adhered to it with scissors. What disadvantages does this bandage have? It does not stick firmly enough, and the skin becomes contaminated with dried cleol.
The collodium dressing differs from the previous one in that the gauze is glued to the skin with collodion - a mixture of ether, alcohol and nitrocellulose.
Requirements
We reviewed the types and techniques of applying bandages. We have studied a broad topic. Of course, you now know how to help a person who has been injured. To bandage the toes and hands, narrow bandages (3-5-7 cm) are used; for the head, forearms, hands, and lower legs - medium (10-12 cm), for the mammary gland, thighs, and chest - wide (14-18 cm).
If the bandage is applied correctly, it does not interfere with the patient, is neat, covers the injury, does not interfere with lymph and blood circulation, and adheres firmly to the body.
