Compression bandage
definition
A compression bandage is a individually applied elastic bandage, which exerts pressure from the outside on a part of the body and thus improves the return flow of blood and lymph fluid from the periphery to the heart.
In contrast to solid compression stockings, which have a similar mode of action and are used for similar indications, a Compression bandage Corrected by doctors or experienced nursing staff each time the bandage is changed and may be wrapped tighter or wider. This is particularly useful at the beginning of compression therapy if, for example, existing water retention (Edema) must first be transported away before the leg regains its original shape.
General information can be found at: Lymphatic drainage
Types of compression bandages
Many different types of compression bandages exist. Distinctions can be made both according to the manufacturer and according to the winding technology.
The materials offered by the various manufacturers differ only insignificantly, so that the question of which sanitary napkins should be used, for example, is often a matter of taste. The different wrapping techniques for applying a compression bandage also differ only slightly.
Well laid out and securely wrapped, each type leads to the desired result. The decision for one or the other technique should ultimately depend on the comfort of the patient (which bandage feels most comfortable?) And on the skill of the person changing the diaper, as not everyone is equally good at every technique. Two of the most important winding techniques are described in more detail below.
Applying a compression bandage
Basically there is a before every application of a compression bandage careful skin care and wound careif there are open wounds.
At the beginning you draw a so-called Stocking bandage over the area to be wound. It is used later for fixation and fastening, but also functions as skin and pressure protection. Then comes a careful one Padding. This padding can be done with special padding or foam bandages. It is just as important to avoid pressure points and the like as it is to improve the comfort for the patient. Here you should be meticulous to ensure that there are no wrinkles and that the entire surface is covered evenly.
In connection the actual compression wrap begins with elastic bandages according to the technique that you have chosen. Finally, the stocking bandage is turned over and pulled up. It is important with all forms of compression bandages that the end of the body part that is being wrapped remains free. For example, the Toes never get wrapped up, since the blood circulation, the sensitivity (i.e. the feeling) and the motor skills (i.e. the mobility) must be checked at any time.
In addition, the joints that are enclosed by the compression bandage (usually the ankle) are always in the so-called Functional position wrapped up. In the case of the ankle, this means, for example, wrapping the foot at a 90 degree angle to the lower leg. This later enables the patient to walk around freely and is gentle on both muscles and joints. The pressure exerted by the compression bandage should always be strongest on the foot (or “far from the heart”) and then be somewhat weaker “close to the heart”. In this way, the outflow of blood and lymph fluid can be optimally supported. The aim should be to apply pressure that is strong enough to achieve the therapeutic intention, but not so strong that it causes damage and complications. The exact tensile strength, like the perfect technique, is purely a matter of practice and experience.
Compression bandage according to Sigg
When putting on a compression bandage according to Sigg, you start with a liner and careful padding as described above.
The first of the two compression bandages required is then applied to the outer edge of the arch of the foot. The toes remain free, while the rest of the foot always from the outside in towards the bottom up is wrapped. The area of the heel, which must also be carefully bandaged, is particularly important. There should be no wrinkles or creases at any time. These wraps around the foot, heel and ankle are continued until the first pad has been completely used up. It can be easily fixed with two strips of plaster.
Only then do you put the second compression bandage on, this time above the ankle, because the foot area has already been wrapped sufficiently. One begins with the application of the compression bandage according to Sigg an der Outside of the lower leg far below with initially a ring-shaped wrapping. The next round leads slightly offset from the outside inwards, pointing towards the knee. This winding is followed by one that also points slightly diagonally from the outside inwards towards the foot. This creates a Crossing of the wound webs. Now alternating wrapping diagonally towards the knee and diagonally towards the foot to just below the hollow of the knee. After a final straight wrapping, which is intended to stabilize the compression bandage, the ends of the second compression bandage are also fixed with plaster strips before the tubular bandage is pulled over the entire lower leg and fixed. The overlapping wrapping creates the so-called corn-ear pattern typical of the Sigg compression bandage.
Compression bandage according to Pütter
The Pütter compression bandage is wrapped a little differently than the Sigg corn ear bandage described above. So after the underwear and cotton padding, the Application of the first compression bandage on the inner side of the back of the foot the bandage will from the inside to the outside settled.
After the foot including the heel has been well wrapped, the Pütter technique goes directly to the lower leg. Round after round, the compression bandage evenly encloses the lower leg - always from the inside to the outside and from the foot to the knee. When wrapping with the first bandage, the Pütter bandage may still leave gaps on the lower leg; they are then covered with the second bandage. The last round of the first compression bandage should run straight and below the hollow of the knee and be fixed there.
The Wrapping of the second compression bandage now begins again on the back of the foot - but this time on the outer side. Analogous to the first bandage, slowly wrap the second bandage around the foot, heel and lower leg upwards. Since the direction is now from the outside to the inside, both pads automatically cross each other.Any remaining gaps can now be closed so that a uniform, even compression bandage is created. After the second bandage has been fixed, the pull-up tube for the Pütter compression bandage is folded up and fastened below the knee.
Compression bandage for the arm
The arm can also be supplied with a compression bandage according to the principles described above. This happens particularly often with disorders of the lymphatic drainage in the arm area. Such a disorder can occur, for example, after surgical removal of the axillary lymph nodes in patients with Breast cancer occur. But also Arm vein thrombosis are not uncommon and a primary indication for compression therapy. After an initial familiarization phase, specially adapted compression sleeves can be prescribed for the arm, which are more practical to put on and take off in everyday life.
Compression bandage for the leg
Indications
Compression bandages on the leg are used for numerous clinical pictures. The most important indication for therapy with the help of a compression bandage is chronic venous insufficiency, in which the blood can no longer drain properly from the legs. Even with leg vein thrombosis (see also: Thrombosis in the leg), Varicose veins and pronounced lymphedema is the compression therapy method of choice.
Contraindications
On the other hand, it may not be used, for example, with advanced peripheral arterial occlusive diseases (PAD) or a very weak heart (decompensated heart failure). A heart attack or weeping wounds also rule out a compression bandage.
Compression bandage for thrombosis
If a blood clot closes a vein, this results in a thrombosis. The skin is reddened, very warm and tense, and it may also become discolored. Water retention can occur.
In addition to drug treatment for such an event, below is a Compression therapy with compression bandages or compression stockings is recommended. The pressure built up from outside narrows the vessels, which increases the speed of blood flow. Combining such a compression bandage with sufficient exercise and short periods of standing and sitting can effectively prevent future thrombotic events.
For more information, see: Thrombosis prophylaxis, thrombosis prophylaxis measure
