Now that we have analyzed the different types of bandages according to their composition and function, it’s time to review the most common types of bandages and understand how to apply them. In this post we will discuss some generalities about the application of bandages and introduce some basic concepts that will serve as guidelines. In the next post, we will explain the different basic bandaging techniques.
Which side of a bandage is applied?
The bandage is always applied keeping the outer side of the bandage roll in contact with the previous layer and rolling over itself. This correct way of application is shown in the photo on the left below.
The reason why the outer side is always applied to the area to be bandaged is because this allows for greater control of the force or pressure during the application of the bandage. The health professional will be able to control the force applied at all times and the bandage will unfold in a constant and homogeneous manner over the applicable area. If done in the opposite way (keeping the inner side of the bandage roll in contact with the previous layer) the practitioner will have to pull the bandage away from the patient’s body in order to unroll the bandage and then apply it. This generates irregular pressure peaks, less control over the bandage application technique, greater discomfort for the professional applying the bandage and discomfort for the patient. In addition, the risks of iatrogenesis are increased by not maintaining constant pressure during the application, which can impede correct blood circulation and lymphatic drainage.
What is overlap when applying a bandage?
Bandage overlap is the amount of bandage width that is covered by the following layer after one revolution of a bandage has been applied. Thus, 0% overlap means that each new layer of the bandage does not cover any of the previous layer, and 100% overlap means that the next layer of the bandage completely covers the previous one. As we will see in the next post, a 100% overlap is the one used in circular bandages. The bandage as a whole must have a homogeneous thickness, allowing for mobility and comfort.
Below can be seen an example of overlapping at 25%, 50% and 75%.
Another important aspect of the overlap is that the greater the overlap with the same force, the greater the level of pressure. Therefore, the more turns of a bandage there are over one specific point, the more pressure is generated at that point. This will be discussed in greater depth later.
Is it necessary to first put a padding bandage before applying any type of bandaging?
Pressure-absorbing products (cottons, foam, felt, etc.) should always be to protect areas at risk of hyperpressure such as bony prominences or areas that compromise the movement of the joint, to smooth perimeters by avoiding areas with folds, or to fill concavities such as the malleolar area. There are few occasions when such protection is not required.
If, for example, immobilization is the goal, it is always advisable to apply padding bandages to protect the area before the immobilization bandage is applied. In addition, in immobilization bandaging it is even recommended to bandage the nearby joints to prevent further harm and to provide support. If a decongestive or post-surgical bandage is to be applied, it is essential to smooth the perimeter with padding or extrinsic compression systems (pads) that strengthen the pressure in certain areas.
Currently, there are bandages that incorporate padding in their design, as they are strictly for support or protection.
How to begin the bandaging process correctly
At the beginning of the bandaging process, the bandage must be fixed securely, placing the bandage at an oblique angle from the heel to the forefoot to give stability to the bandage making two initial turns , thereby avoiding greater pressure in distal areas.
Bandaging is begun from the distal end of the limb (further from the heart) to the proximal end (closer to the heart) in order to promote lymphatic drainage and prevent oedema. As we have seen, there are many points to bear in mind when applying a bandage. It is always advisable to have bandaging done by a professional, unless expressly told otherwise, as failure to do so could lead to injury or worsening of the affected area.
Produced by the Technical Department of Calvo Izquierdo S.L.
with the collaboration of Carmen Alba Moratilla
- Fundamentals of Nursing Kozier and Erb (LS 071151594827879)
- madrid.es/ficheros/SAMUR (https://www.madrid.es/ficheros/SAMUR/data/606_03.htm#:~:text=Vendaje%20circular%3A%20Se%20usa%20para,que%20tape%20completamente%20la%20anterior.)