Aseptic wound dressing: safety rules. The procedure for applying an aseptic bandage consists of several stages Rules for applying a pressure bandage

BANDAGES- a remedy for the treatment of injuries and diseases, consisting in applying a dressing material to the affected focus and fixing it in the affected area or in immobilizing the affected area itself.

There are several varieties of antiseptic P.: dry (a dry antiseptic is poured onto the wound, and dry aseptic P. is applied on top); wet-drying (gauze napkins soaked in antiseptic solution are applied to the wound and covered with dry aseptic P.); P. using aerosols, P. using napkins, antiseptic preparations are included in the tissue molecules; P. of the longest bactericidal action (eg, "Livian", "Legrazol", etc.); Items that have anti-inflammatory, analgesic and antiseptic effects.

Hypertonic dressing promotes the outflow of wound exudate from the wound. Its suction effect is due to solutions impregnating tampons, the osmotic pressure of which is higher than the pressure in body fluids and wound discharge. Hypertensive P. is one of the methods of physical antisepsis; It is used for the treatment of purulent wounds with an abundant amount of discharge, as well as for sluggish epithelialization of the wound. After 6-12 hours. after imposition (depending on the amount of wound discharge) P. practically ceases to act. According to the overlay technique, hypertonic P. does not differ from wet-drying antiseptic P. As a hypertonic solution, 5-10% sodium chloride solution is most often used.

Hemostatic dressing is used in two versions. With venous and capillary bleeding, the so-called. pressing P., which is a dry aseptic P., on top of which a cotton ball is tightly bandaged. This P. was widely used in the 19th century; for squeezing the vessels then special pilots were made. If hemostatic P. is used to stop cough, small arterial, venous or mixed bleeding, then biol, antiseptic swab, hemostatic sponge or dry thrombin are used.

The oil-balsamic bandage is a medicinal P. with an ointment proposed by A. V. Vishnevsky and called by him an oil-balsamic antiseptic. It can be used to treat inflammation, burns, frostbite.

An occlusive (sealing) bandage provides isolation of the affected area of the body from water and air. The idea of these P. was realized for the first time in Lister's insulating bandage. In modern, surgery, the term "occlusive dressing" is understood as a method of dissociation with the help of P. of the pleural cavity and the external environment for chest injuries complicated by open pneumothorax (see). To ensure occlusion, a water- and air-tight material is applied directly to the wound and the surrounding skin (within a radius of 5-10 cm) (large gauze napkins soaked in vaseline oil, a wrapper from an individual dressing bag, a sterile plastic film, etc.), which tightly fixed with a gauze bandage. Occlusion can also be achieved by sealing the wound with wide strips of adhesive tape, applied like tiles; for greater reliability, especially with wet skin, dry aseptic P. is applied on top.

Fixed bandages are used to ensure complete or partial immobility of the affected part of the body (see Immobilization) or immobility with traction (see). These include tire (see Tires, splinting) and hardening P. Of the hardening P., gypsum is the most common (see Gypsum technique). Included in the surgical practice of P. with the use of synthetic materials (polivik, foamed polyurethane, etc.), which become plastic when heated in hot water and harden after being applied to the limb. Other hardening plasters (using starch, glue, celluloid, liquid glass, etc.) are of historical importance; they are sometimes resorted to by orthopedists in pediatric practice.

Seten's starch bandage is applied over a cotton pad using bandages soaked in starch paste; bandage the limb from the periphery to the center. To increase P.'s strength, strips of cardboard are placed between the layers of bandages. Starchy P. dries out slowly, and therefore there is a risk of secondary displacement during hardening; it is less durable than gypsum.

The adhesive bandage is prepared from cloth bandages coated with carpenter's glue. Before applying P., the bandages are dipped in hot water and applied to the limb over the gauze lining. It takes approx. 8 o'clock

A celluloid bandage is made by applying a solution of celluloid in acetone over the passages of a gauze bandage.

Shraut's liquid glass bandage is applied to the limb on a layer of cotton wool (batting, flannel), fixing it with a bandage (3-5 layers) soaked in liquid glass (saturated aqueous solution of sodium sulfite). P. hardens after 4 hours.

The elastic bandage is designed to provide uniform pressure on the tissues of the limb in order to prevent swelling due to stagnation of blood and lymph (see Lymphostasis). It is used for varicose veins (see), post-thrombophlebitis syndrome (see Phlebothrombosis), etc. Elastic P. can be made on a zinc-gelatin basis using Unna paste. Unna paste contains zinc oxide and gelatin (1 hour each), glycerin (6 hours) and distilled water (2 hours). The paste has a dense elastic consistency. Before use, it is heated in a water bath (not boiling) and applied with a wide brush to each layer of a gauze bandage applied to the limb. Usually P. is made of 4-5 layers. P.'s drying lasts 3-4 hours. Another type of elastic P. is the imposition of a knitted elastic or mesh elastic bandage. Bandaging with an elastic bandage is performed from the periphery to the center like a spiral bandage. Finished products such as elastic stockings, elastic knee pads, etc. are also used.

Complications associated with P.'s use are most often due to the irritating effect of some of them on the skin and technical errors in their application. So, adhesive plaster and colloid P. irritate the skin, adhesive plaster P. sticks to the hair so tightly that removing it is usually associated with pain; tight application of a bandage on a limb causes pain, blueness and swelling below the P. Incorrect application of hardening and hard P., which usually remain on the patient's body for a long time, can cause damage to the joints, bedsores in the area of bone protrusions, displacement of bone fragments during fracture, etc.

Bibliography: Atyasov N. I. and Reut N. I. Desmurgy technique for soft tissue injuries and bone fractures (Medical Atlas), Saransk, 1977; Billroth T. General surgical pathology and therapy in 50 lectures, trans. from German, St. Petersburg, 1884; Boyko N. I. Influence of various concentrations and combinations of dimexide (dimethyl sulfoxide) solutions on the course of the wound process, Klin, hir., No. 1, p. 64, 1979; Tauber A. S. Modern schools of surgery in the main states of Europe, book. 1, St. Petersburg, 1889; F r and d-l and n d M. O. Guide to orthopedics and traumatology. M., 1967; Biological actions of dimethyl sulfoxide, ed. by S. W. Jacob a. R. Herschler, N. Y., 1975; Lister J. On the antiseptic principle in the practice of surgery, Lancet, v. 2, p. 353, 1867.

F. Kh. Kutushev, A. S. Libov.

bandages

Bandages are applied to treat wounds and protect them from external influences, to immobilize (see), stop bleeding (pressure bandages), to combat saphenous veins and venous stasis, etc. There are soft and hard bandages, or fixed .

Soft bandage, kerchief, plaster, glue and other dressings are applied to hold the dressing on the wound, as well as for other purposes. Overlay methods - see Desmurgy.

Aseptic dry dressing consists of several layers of sterile gauze, covered with a wider layer of hygroscopic cotton wool or lignin. It is applied directly to the wound or over the tampons or drains introduced into it in order to drain the wound: the outflow of fluid (pus, lymph) into the bandage contributes to the drying of the surface layers of the wound. At the same time, due to the removal of microbes and toxins from the wound, conditions conducive to healing are created. A dry aseptic bandage also protects the wound from new infection. If the bandage gets wet through (all of it or only the upper layers) must be changed; in some cases, bandaging is performed - cotton wool is added and bandaged again.

Antiseptic dry dressing according to the method of application, it does not differ from dry aseptic, but is prepared from materials previously impregnated with antiseptic agents (mercuric chloride solution, iodoform, etc.) and then dried or sprinkled with powdered antiseptics (for example, streptocide) before applying the dressing. A dry antiseptic dressing is used mainly in first aid in order to influence the substances contained in them on the microbial flora of the wound. More commonly used wet drying dressing from gauze soaked in an antiseptic solution. An antiseptic solution can be injected into the bandage fractionally with a syringe or continuously drip through special drains, the ends of which are brought out through the bandage.

Hypertonic wet drying dressing prepared from materials (tampons, gauze, covering the wound), impregnated immediately before dressing with a 5-10% sodium chloride solution, 10-25% magnesium sulfate solution, 10-15% sugar solution and other substances. Such dressings cause an increased outflow of lymph from the tissues into the wound and into the dressing. Their imposition is indicated for infected wounds with poor discharge, for wounds containing many necrotic tissues.

Protective bandage consists of gauze thickly lubricated with sterile vaseline, vaseline oil, 0.5% synthomycin emulsion or other oily substances. It is used to treat granulating wounds cleared of necrotic tissues.

pressure bandage it is applied for the purpose of a temporary stop of bleeding (see). A tight ball of cotton wool is placed over the tampons inserted into the wound and gauze napkins and bandaged tightly.

Occlusive dressing used for open pneumothorax (see). Its main purpose is to prevent air from entering the pleural cavity through the chest wound. After abundant lubrication of the skin with vaseline around the wound, a piece of a torn rubber glove, oilcloth or other air-tight fabric is applied to it. The bandage should cover not only the wound, but also the skin around it. A large amount of cotton wool is applied over this fabric and bandaged tightly. When inhaled, the air-tight tissue sticks to the wound and seals it. It is also possible to tighten the edges of the wound with strips of a sticky plaster with the application of gauze, cotton wool and a bandage on top.

Elastic bandage - see Varicose veins.

Zinc-gelatin bandage - see Desmurgy.

Fixed (immobilizing) dressings superimposed to limit movement and ensure rest of any part of the body. Indicated for bruises, dislocations, fractures, wounds, inflammatory processes, tuberculosis of bones and joints. Fixed dressings are divided into tire (see Tires, splinting) and hardening. The latter include plaster casts (see Plaster technique), as well as the starch dressing, which is rarely used at the present time. For the manufacture of hardening dressings, other substances can also be used: a syrupy solution of gelatin, liquid glass (sodium silicate solution) and a solution of celluloid in acetone. These slowly hardening dressings are used (mainly the latter) for the production of corsets and splint-sleeve devices made from a plaster model.

starch dressing. Starch gauze bandages, after being immersed in boiling water and squeezed out, are applied over a cotton lining, often with cardboard splints. Such a bandage hardens within a day. A starch dressing can also be applied with a regular bandage, each layer of which is smeared with starch glue. It is prepared by mixing starch with a small amount of water to the consistency of thick sour cream, and brewed with boiling water while stirring.

See also Balsamic dressings.

According to the mechanical properties, soft bandages used to treat wounds are distinguished; rigid, or motionless, - for an immobilization (see); elastic - to combat the expansion of the saphenous veins and venous stasis; P. with traction (see traction). Soft P. is most widely used for wounds and other defects of the integument (burns, frostbite, various ulcers, etc.). They protect wounds from bacterial contamination and other environmental influences, serve to stop bleeding, influence the microflora already present in the wound, and the biophysical and chemical processes occurring in it. In the treatment of wounds, dry aseptic dressings, antiseptic (bactericidal), hypertonic, oil-balsamic, protective, hemostatic dressings are used.

Ways to keep dressings on the wound - see Desmurgy.

A dry aseptic dressing consists of 2-3 layers of sterile gauze (applied directly to the wound or to tampons inserted into the wound) and a layer of sterile absorbent cotton covering the gauze of various thicknesses (depending on the amount of discharge). In terms of area, the dressing should cover the wound and the surrounding skin at a distance of at least 4-5 cm from the edge of the wound in any direction. The cotton layer of P. should be 2-3 cm wider and longer than gauze. Absorbent cotton can be completely or partially (top layers) replaced with another highly absorbent sterile material (eg lignin). To increase the strength of P. and the convenience of bandaging, a layer of gray (non-hygroscopic) cotton wool is often applied over it. Aseptic P. is applied to the operating wounds sewn up tightly from one gauze in 5-6 layers without cotton wool. A dry aseptic bandage is applied to dry the wound. With wounds that heal by primary intention, drying promotes the rapid formation of a dry scab. With infected wounds, along with pus, a significant part of microorganisms and toxic substances enter the dressings. About 50% of the radioactive isotopes contained in it pass into dry cotton-gauze P., imposed on a fresh radioactively infected wound (V. I. Muravyov). Dry P. reliably protects the wound from contamination until it gets wet. A thoroughly soaked P. must either be immediately changed or bandaged, that is, after lubricating the soaked area of the bandage with tincture of iodine, fix another layer of sterile material over P., preferably non-hygroscopic.

An antiseptic (bactericidal) dry dressing does not differ in design from a dry aseptic one, but is prepared from materials impregnated with antiseptic agents, or is a dry aseptic dressing, the gauze layer of which is sprinkled with a powdered antiseptic (for example, streptocide).

The use of dry P. from antiseptic dressings is most justified in military field conditions, since they, even soaked in blood, continue to protect the wound from microbial invasion to a certain extent. Therefore, for the manufacture of individual dressing bags, an antiseptic dressing is preferred.

Wet drying antiseptic dressing consists of sterile gauze wipes moistened ex tempore with an antiseptic solution; they are applied to the wound in a lump and covered with dry aseptic P. The latter immediately absorbs liquid from napkins and gets wet; in order to prevent the patient's linen and bed from getting wet, P. is usually covered on top with a layer of sterile non-hygroscopic cotton wool that does not interfere with ventilation. If you cover wet P. with an airtight material (for example, oilcloth), you get a warming compress from an antiseptic solution, which can cause dermatitis and even skin burns, and sometimes tissue necrosis in the wound. Bactericidal P. at one time almost completely went out of use and only with the advent of modern antiseptics began to be widely used again. Currently, a wide variety of chemical and biological antibacterial drugs introduced into P. ex tempore are used.

The hypertonic dressing creates a difference in the osmotic pressure of the tissue fluid and the fluid contained in the wound and in P., and thereby causes an increased flow of lymph from the tissues into the wound cavity. Dry hypertensive P. is prepared from dry aseptic P., powdering 2-3 layers of gauze and the wound with powdered sugar. This type of P. is rarely used, usually a wet, drying hypertonic P. is made, which is impregnated with a hypertonic (5-10%) solution of salt, usually table salt, instead of an antiseptic solution. A solution of magnesium sulphate, which has analgesic properties, can also be used. Sometimes a 10-15% solution of sugar (beet) is also used, however, saline hypertonic solution is more beneficial, as it contributes to favorable changes in the electrolyte balance of tissues, pH of the environment and other indicators, therefore, it is a method of pathogenetic wound therapy.

Oil-balsamic dressings have an even greater influence on the pathogenesis of the wound process (see).

A protective bandage is used at the stage of wound granulation. It protects the delicate granulation tissue from drying out and from being irritated by gauze fibers and loops. This P. is devoid of suction capacity, but is used in that phase of the wound, when the pus accumulating under the P. is rich in antibodies and phagocytic cells and serves as a good medium for young connective tissue.

It is advisable to widely use vaseline protective P. (usual dry aseptic P., thickly lubricated from the gauze side with sterile vaseline ointment). It is simple and effective. At protective P. introduction into a wound of drainages, tampons and highly active antiseptics is usually excluded. Ointments of weak antiseptic action that do not irritate granulations (for example, A. V. Vishnevsky's oil-balsamic ointment, 0.5% synthomycin ointment, etc.) can be used for protective P., but they do not have significant advantages over pure petroleum jelly . A protective bandage is often applied for a long time, in these cases it should be covered with a layer of non-absorbent cotton wool on top.

An occlusive (hermetic) bandage is necessarily used for external open pneumothorax. It is based on a piece of hermetic tissue (oilcloth, rubber, leukoplast), applied directly to the wound and widely covering the skin around it. When inhaled, the oilcloth sticks to the wound and reliably seals it. When exhaling, air from the pleural cavity freely exits from under the P. Complex occlusive P., equipped with a valve of various designs, do not represent significant benefits.

Fixed dressings are divided into tire (see Tires, splinting) and hardening. The latter can be made using various substances. Gypsum P. - see Gypsum technique.

A starch bandage is made from factory-made starch bandages up to 4 m long. Before bandaging, the bandage is immersed in boiling water. After light squeezing, the bandages are cooled on plates. The limb is wrapped with a thin layer of gray cotton wool and bandaged with a warm starch bandage spirally (see Desmurgy). When ironing by hand, the tours of the bandage are glued and aligned. After applying three layers of starch bandage, put longitudinally cardboard tires and fix them with another 2-3 layers of starch bandage.

Approximately in a day P. hardens. The disadvantage of starch P. and previously used P. from liquid glass is slow hardening. It seems promising to use bandages moistened with a fast-curing adhesive such as BF-2.

Elastic and gelatinous (zinc-gelatinous) P. - see Varicose veins.

Radioactive dressings - see Alpha therapy.

Often, any wound that was received, not during the period of surgical intervention, is considered infected, since microbes may be present there anyway.

To prevent subsequent infection in the wound obtained in one way or another, it is recommended to apply a sterile or, in other words, aseptic dressing. At the same time, in order to gain access to a person’s wound, it is often necessary to cut rather than remove existing clothing. In no case should you wash the wound with ordinary water, since as a result of these actions, microorganisms located on the surface of the wound, together with water, can penetrate deeper. Immediately before such a procedure as the application of an aseptic dressing, it is necessary to carefully lubricate the skin near the wound with ordinary tincture of iodine. In addition, in a situation where it is an aseptic dressing that is applied, it is also recommended to use other medications instead of iodine, such as brilliant green, cologne, or ordinary alcohol. Next, the wound is covered with a special bandage that has sterile characteristics in several layers. Otherwise, in the absence of such a bandage, you can use a piece of cotton naturally in a clean version. After these actions, the tissue applied to the wound is recommended to be well fixed. Here you can use both a scarf and a regular bandage.

Dry antiseptic dressings today are actually made under the guise of layers of ordinary sterile gauze, which are covered in the upper part with hygroscopic cotton wool or lignin, which have a wider diameter. Today it is customary to apply modern aseptic dressings either on the human wound itself, or on top of the applied tampons, or on special drainage. In order to rid the wound of infections and toxins as effectively as possible to ensure rapid healing, it is in any case necessary to use a sterile dressing in order to prevent subsequent infection.

To date, there are a number of mandatory steps that must always be followed when applying sterile dressings. So, any aseptic dressing on the wound is applied taking into account the following recommendations. First of all, the specialist must thoroughly wash his own hands and put on special sterile rubber gloves. The patient should be in a comfortable position for him. The very same procedure regarding the imposition of a dressing of a sterile version is often carried out using a pair of tweezers. The skin must be lubricated with cleol. Good fixation of a sterile dressing is of great importance, since this product is primarily intended to cover the affected parts of the human body. No less important here is the procedure for disinfecting the instrument used.

It is also worth clarifying here that there are also differences between antiseptic and aseptic dressings. Therefore, in no case should you consider that this is the same product. After all, for example, an aseptic dressing is considered just a sterile dressing, but an antiseptic dressing is additionally also intended to protect against various infections entering the wound.

Protective bandages are used today to protect the wound from re-infection and the adverse effects of the external environment. Protective is considered to be an ordinary aseptic bandage, which in certain situations can be made with the presence of an additional cover under the guise of a waterproof polyethylene film. This type of dressing also includes dressings for wounds with the presence of a film-forming aerosol or a conventional bactericidal plaster. In addition, occlusive dressings are also considered to be protective, which are designed to hermetically seal the affected areas of the human body in order to prevent the penetration of air and, accordingly, water to the wound. Most often, such a dressing is used in the presence of a penetrating wound to such a part of the human body as the chest. In this situation, the application of a material that does not allow air or water to pass through is recommended first of all. Often such a product is impregnated with vaseline oil or other similar substances. Any such bandage should be well fixed, for example, with a simple bandage. In addition, in this situation, the use of a wide adhesive plaster is also allowed, which is applied under the guise of a tile for the purpose of subsequent maximum fixation of the product.

Thus, when applying an aseptic bandage in any situation, it is necessary not only to strictly observe the rules for implementing this procedure, but also to use additional medications.

What is bandaging (overlay 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 raw materials on the surface of the body (sometimes containing healing and other substances). He studies dressings, methods of applying them, as well as the rules for healing wounds, the medical section of desmurgy.

Classification

How are bandages applied? What is the overlay technique? By purpose, they distinguish:

hemostatic (pressure) dressings - stop bleeding by creating a certain pressure on the desired part of the body;
protective (aseptic) - prevent infection of the wound;
medicinal (usually partially impregnated with a mixture) - provide prolonged access of the drug to the wound;
bandages with stretching - straighten broken bones, for example, tibia;
immobilizing - immobilize the limb, mainly with fractures;
dressings that eliminate deformities - corrective;
sealing wounds (occlusive), for example, with chest injuries, are needed so that the victim can breathe.

There are the following types of bandages:

solid - with the use of solid materials (Kramer's tire and others);
soft - using soft raw materials (bandage, cotton wool, gauze and others);
hardening - plaster bandages.

"Deso"

What is the Deso bandage for? Its overlay technique is unsophisticated. With the help of it, the upper limbs are fixed in case of dislocations and fractures of the shoulder. To make this dressing, 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 - in the reverse order.

So, let's find out how the Deso bandage is made. Its overlay technique is as follows:

Seat the patient facing you, reassure, explain the course of the upcoming actions.
Roller wrapped with gauze, put in the armpit.
Bend your forearm at an angle of 90 ° at the elbow joint.
Press your forearm to your chest.
Perform a couple of fixing tours of the bandage on the chest, injured arm in the area of the shoulder, back and armpit from the side of the working arm.
Guide the bandage through the armpit of the active side along the frontal chest surface obliquely on the shoulder girdle of the diseased area.
Move down the back of the injured shoulder under the elbow.
Go around the elbow joint and, holding the forearm, direct the bandage obliquely into the armpit of the healthy side.
Move the bandage from the armpit along the back to the sore forearm.
Guide the bandage from the shoulder girdle along the frontal plane of the ailing shoulder under the elbow and around the forearm.
Guide the dressing along the back to the armpit of the healthy side.
Repeat the rounds of the bandage until the shoulder is firmly fixed.
Complete the bandage with a couple of fixing rounds on the chest, on the sore arm in the area of the shoulder, on the back.
Pin the end of the bandage with a pin.

By the way, if the bandage is applied for a long time, the bandage tours need to be stitched.

Bandage cap

Do you know what a headband is? Its overlay technique is easy to remember. This dressing can simultaneously perform the functions of fixation, stop bleeding, fix drugs 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 quality bandage, the medical worker should involve an assistant.

Cut off a meter tape from the head of the bandage and put it in the middle on the parietal region. Its ends should hang freely, like the strings of a baby's cap. During the procedure, they must be held by the victim himself or by the assistant of the health worker.

Around the entire skull, make a couple of fixing tours. Then lay out the cap itself. After the blocking round, reach the tie area, wrap the head of the bandage around it and bring it to the back of the head to the second strap. There, in the same way, wrap a bandage around it and put a tour on the cranial area from the side of the forehead.

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 of the skull is completely covered with a dressing cloth. It turns out a gauze cap, similar to a cap. The bandage is fixed as follows: tear the end of the bandage, secure with a knot and tie under the tie. Then tie the straps together.

Do you know that a cap bandage can stop the bleeding? The overlay technique in this case is somewhat different. Cut off the hair in the area of injury and check it for foreign matter. Disinfect the wound or its edges if possible. It must be remembered that an antiseptic (mainly alcohol) can contribute to the appearance of a painful shock. Therefore, proceed carefully. Then, on the open wound, apply two layers of a clean gauze napkin, then a squeezing pad from a bandage bag. Next, apply a bandage according to the above algorithm.

If you do not have a specific pad on hand, use a dressing bag or tightly folded items, preferably clean. The pressure pad should completely cover the wound, cover 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. At the time of sleep, it is not recommended to untie them, as the bandage can move out.

Bleeding

What is the technique for applying a pressure bandage? This type is used primarily to control minor bleeding and reduce extravasation in the joints and periarticular soft tissues. Apply a gauze-cotton roller to the wound and fix it tightly with a bandage without squeezing the vessels. Sometimes healthcare providers use elastic compression bandages for ligament injuries or venous insufficiency.

It is known that bleeding is capillary (bleeding on a large surface of the body), arterial and venous. Arterial blood gushes 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? In case of small external bleeding from a vein or from capillaries, apply a squeezing bandage without squeezing the limb. This method will not save if there is severe mixed or arterial bleeding. Clamp the artery with your finger above the wound (determine the point by pulsation) while the assistant prepares the tourniquet. Place a note under the tourniquet indicating the time of its application.

Finger injuries

How is the glove bandage made? Its application technique is quite simple. This bandage is used for injuries 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.

Seat the patient and stand facing him (control his condition). Anesthetize the bandaged area. Perform 2-3 circular rounds around the wrist, and then direct the bandage obliquely along the dorsum of the carpal surface to the nail of the thumb of the right hand, and of the left hand to the nail phalanx of the little finger (do not cover ½ of the nail phalanx with a bandage to observe the condition of the limb).

Then, with spiral turns from the nail to the base of the finger, close it, and cross the bandage on the back surface and point to the wrist (left to right). Perform a fixing tour around the wrist. Bandage the remaining fingers in the same way. Finish the bandage with circular rounds and tie off. It should be noted that the "Knight's Glove" bandage can be supplemented with a kerchief bandage.

Spike type

Many do not know the technique of applying a spike-shaped bandage. She, as a rule, fixes the shoulder joint in case of pathology of the shoulder and armpit. You should have on hand a bandage (width 12-16 cm), a sterile napkin, scissors, a kidney-shaped basin, a pin, tweezers.

Here you need to follow the steps in the following order:

Turn around to face the patient.
Draw two fixing circular circles around the shoulder on the ailing side.
Swipe the third round obliquely from the armpit to the back along the front of the shoulder.
The fourth turn continues the third.
With the fifth circle, circularly cover the shoulder (outer, inner surfaces, front and back) and bring it to the back, crossing with the fourth round.

"Mitten"

What is the "Mitten" bandage for? The application technique is quite simple. It is used for injuries and burns of the hand, frostbite. To make this bandage, you need to prepare a needle and syringe, wipes, a bandage (width 8-10 cm), a tray, an analgesic, balls, an antiseptic and gloves.

In this case, you need to do the following:

Sit the patient down and stand facing him to monitor his condition.
Anesthetize.
Perform 2-3 circular fixing turns around the wrist.
Bend the bandage 90° on the dorsal carpal surface.
Move the bandage along the back of the hand to the tops of the fingers, and then go to the palmar surface and reach the wrist.
Repeat the steps of the third step three to four times, simultaneously covering four fingers.
With a circular tour in the wrist area, secure the previous turns by bending the bandage 90 ° in advance.
Lead the bandage along the back to the tops of the fingers, wrapping it in spiral-shaped moves, following to the base of the fingers.
Return the bandage to the wrist through the back of the hand. Fasten the previous turns with a circular tour.
Put a spica bandage on your thumb.
Complete the bandage with circular tours around the wrist and tie.

By the way, so that the fingers do not stick together, you need to put gauze scarves between them. "Mitten" can be supplemented with a kerchief bandage to immobilize the limb.

Head bandage

And what is the technique of applying a bandage on the head? We considered the bandage cap above. It is known that several types of bandages are used for bandaging the skull, which have different purposes:

"Cap of Hippocrates". To apply this bandage, two bandages or a bandage with two heads are used. Take the head of the bandage in your right hand, make circular turns and fasten the bandaging tours, which, diverging or converging, should gradually close the cranial vault.
Bandaging the right eye, the bandage is moved from left to right, and the left - in the opposite direction. A bandage is fixed around the head in a circular circular motion, then lowered to the back of the head and held under the ear from the bandaged area obliquely and upwards, covering the damaged eye with it. The crooked move is grabbed in a circular way, then an oblique move is made again, but slightly higher than the previous one. Alternating oblique and circular turns, envelop the entire eye area.
Bandage for two eyes. The first fixing circular round is performed, and the next one is transferred down 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 the bottom up, covering the right eye. As a result, all the next turns of the bandage intersect in the region of the bridge of the nose, imperceptibly enveloping both eyes and going down. At the end of bandaging, the bandage is strengthened with a horizontal circular tour.
The Neapolitan baldric begins with annular coils around the head. Then the bandage is lowered from the ailing side to the area of the ear and mastoid process.
The bridle sling is mainly applied to close the chin area. First, a fixing circular tour is performed. The second coil is led obliquely to 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, a couple of turns are made around the head, and then from under the chin they are led obliquely to the back of the head or on the other side and, having transferred to horizontal turns, the bandage is fixed. In order to completely close the lower jaw after fixing horizontal strokes, you need to lower the head of the bandage crookedly down the back of the head and go to the neck along the anterior region of the chin. Further, rounding the neck, it is necessary to return. Then, lowering the turn of the bandage a little below the chin, it is lifted vertically, fixing the bandage around the head.

Occlusal view

The technique of applying an occlusive dressing is known only to health workers. Let's consider it in as much detail as possible. Occlusive dressings provide hermetic isolation of the injured area of the body, preventing its contact with air and water. For the manufacture of such a device, it is necessary to place a water- and air-tight material on the wound and the adjacent skin area with a radius of 5-10 cm, for example, rubberized fabric or a synthetic film, and fix it with an ordinary bandage. Instead of a bandage, you can use wide strips of adhesive tape.

It is known that a modern and reliable application of an occlusive dressing is especially important when the patient has a penetrating chest wound and pneumothorax has developed.

Each person should analyze the application of bandages. The technique for applying a sealing (occlusive) dressing is as follows:

If the wound is small, prepare 1% iodanat, tupfer and a dressing personal bag. Sit the victim down and treat the skin around the injury with an antiseptic. Then apply the rubber sheath of the private set to the wound with the sterile side, and place cotton-gauze packs on top of it. Next, you need to fix it all with a spike-shaped 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 iodanat 1%, tupfer, petroleum jelly, sterile wipes, a wide bandage, oilcloth and gauze-cotton swab. Give the victim a semi-sitting position and treat the skin around the wound with an antiseptic. Then apply a sterile napkin to the damage and lubricate the skin around it with petroleum jelly. Next, apply an oilcloth so that its edges protrude 10 cm beyond the wound. After that, apply a gauze-cotton swab that overlaps the film by 10 cm, and fix it with a bandage on the chest or a spike-shaped bandage.

Gypsum variety

It is difficult to fully learn the application of dressings. The overlay technique, of course, is useful to everyone. It is known that there are complete plaster bandages and incomplete ones. The latter include a bed and a splint.

These bandages can be unlined and lined with cotton gauze. The former are used in the treatment of fractures, and the latter in orthopedic practice. So, the technique of applying plaster bandages is performed as follows:

Before applying the bandage, seat or lay the patient down so that he does not have any discomfort when bandaging.
For a fixed limb or body part, use special stands, racks to give it a pose in which it will be after the procedure is completed. Cover all protrusions of the bones with gauze-cotton pads to prevent bedsores.
Lead the plaster bandage in a spiral, bandage without tension, rolling it over the body. Do not tear off the head of the bandage from the dressing surface so that wrinkles do not appear. Smooth each layer with the palm of your hand, model according to the outlines of the body. With this technique, the bandage becomes monolithic.
Above the fracture zone, on the folds, strengthen the bandage, which may include 6-12 layers, with additional bandage tours.
During bandaging, it is forbidden to change the position of the limb, as this leads to the appearance of folds, and they will squeeze the vessels and a bedsore will appear.
During the procedure, support the limb with the whole palm, and not with your fingers, so that dents do not appear on the bandage.
In the process of applying a cast, watch the patient's pain sensations and his facial expression.
Always leave the fingers of the lower and upper limbs open so that blood circulation can be judged by their appearance. If the fingers are cold to the touch, turn blue and swell, then venous congestion has occurred. In this case, the bandage must 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, spread the edges and temporarily strengthen with a soft bandage before applying a new bandage.
At the end, the edges of the bandage are cut, tucked out, and the resulting roller is smoothed with a mixture of plaster. After that, cover with a layer of gauze and again coat with gruel.
At the end, write the date of its application on the bandage.

It is known that it is forbidden to cover a wet bandage with a sheet before drying. It will dry out on the third day.

Rules

Therefore, the technique of applying bandage bandages is known to us. Among other things, you need to follow some rules of bandaging:

always stand facing the patient;
bandaging start with a fixing tour of the bandage;
apply the bandage from bottom to top (from the periphery to the center), from left to right, minus special bandages;
with each subsequent turn of the bandage, overlap the previous half or 2/3;
bandage with both hands;
applying a bandage to the cone-shaped parts of the body (shin, thigh, forearm), for a better fit, twist it every couple of turns of the bandage.

soft views

The technique of applying soft bandages is known to many. These bandages are divided into the following types: bandage, adhesive (colloidal, adhesive plaster, glue) and kerchief. They are created like this.

Adhesive bandages are used mainly for minor injuries and on the wound area, regardless of its location. If hair grows in the area, it should be shaved beforehand.

To make an adhesive bandage, you need a dressing raw material applied to the wound, attach a couple of strips of an adhesive plaster to healthy areas of the skin. Unfortunately, this design has an unreliable fixation (especially when wet), and maceration of the skin can occur under it.

Cleol is called resin - pine resin dissolved in a mixture of ether and alcohol. Cover the wound with a bandage, and lubricate the skin around it with a drug and let it dry a little. With gauze, close the bandage and skin areas treated with cleol. Firmly press the edges of the napkin to the skin, and cut off the excess gauze that has not stuck to the skin with scissors. What are the disadvantages of this bandage? It does not stick firmly enough, and the skin is contaminated with dried glue.

The collodion bandage differs from the previous one in that gauze is glued to the skin with collodion - a mixture of ether, alcohol and nitrocellulose.

Requirements

We have considered the types, technique of applying bandages. We have covered a broad topic. Of course, you now know how to help a person who has been injured. Narrow bandages (3-5-7 cm) are used for bandaging the toes, hands, heads, forearms, hands, lower legs - medium (10-12 cm), breast, thigh, chest - wide (14-18 cm).

If the bandage is applied correctly, it does not interfere with the patient, is neat, closes the damage, does not disturb the lymph and blood circulation, and is firmly attached to the body.

The technique of applying an aseptic dressing is quite simple, but in order to perform the dressing correctly, a number of important rules must be observed. It is very important to use high-quality dressing material in this case.

In order to protect the wound from possible contamination and the ingress of foreign particles into it, it is necessary to apply an aseptic bandage on 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 bandage.

In order to perform the dressing correctly, you must first treat the wound. To do this, in no case should it be washed with water. To treat and disinfect the damaged area, it is necessary to use special antiseptics or medical alcohol, a solution of brilliant green.

Aseptic bandage is a dressing consisting of a cotton-gauze pad and a bandage. It is better to purchase ready-made aseptic bandages 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 multilayer sterile gauze. The top layer consists of cotton wool or other sterile hygroscopic material. In order to fix the bandage, special gauze ties are provided.

To apply a bandage to the wound, you need to get it out of the sterile package, without touching the pad, which will be in contact with the damaged area. The bandage should be applied with the gauze side to the wound and bandaged tightly. Dry aseptic bandage 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 gets wet through, it must be replaced immediately.

There are many ways to apply bandages. If the wound simply needs to be protected from possible infection, then the usual aseptic bandage is quite suitable. If the formation of the wound is accompanied by a fracture or dislocation, it is necessary to apply a fixing bandage. With it, you can fix the limb in a stationary position. If the patient's arm is injured, then a scarf is often used to fix the limb, a sterile bandage should be applied to the wound under it. A scarf can be used to bandage a limb so that it remains immobile. This will avoid possible complications. If the kerchief is short, then it can be lengthened with bandages or other dressings.

Tight bandages are used to stop bleeding. In this case, you can use the usual dressing bag, and then press the bandage to the wound with a tourniquet. It is important to remember that the tourniquet must be removed immediately after the bleeding stops. Imposing 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 is 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 soaked through, but it is not possible to change it completely, you can apply a few more layers of bandage on top of it. You can also use another package designed for first aid. It is better that it does not consist of hygroscopic material, but of sterile gauze folded in several layers. It should be remembered that a soaked bandage can create a favorable environment for the development of pathogenic bacteria and their penetration into the wound, and this is completely unacceptable.

The imposition of an aseptic dressing requires a responsible approach. Before applying a bandage, it is necessary to treat the wound with antiseptics. Washing damaged areas with water is strictly prohibited.