Plaster bandage deso on the shoulder joint. Bandage Deso. Overlay technique. Rehabilitation and possible consequences

The Dezo bandage (orthosis) was invented in the 18th century by the famous French surgeon Pierre Joseph Dezo, who pioneered the bandaging technique.

Deso bandage - is a fixator for the upper limbs, which is used for dislocation of the arms or shoulder, as well as for a fracture, bruise or sprain. It helps to achieve the maximum fixing effect, allowing you to fix the limb in a fixed position with a few turns of the elastic bandage. The so-called immobilizing bandage provides comfortable conditions for the recovery of the anatomical segment after an injury.

Indications for use

The Dezo fixing bandage is used to fix the limb in case of injuries and damage to the collarbone. It is a semi-rigid fixative and is sometimes used with gypsum mortar. The application of the Dezo fixative is necessary in the following cases:

fractures of the humerus and clavicle;
dislocation of the humerus and shoulder joint;
recovery from the above injuries;
rehabilitation after operations in the shoulder area.

Description and functions

The retainer is made of airtight knitted three-layer material, which has the greatest immobilizing effect and maximum comfort when wearing it. The product consists of a special clutch for placing the injured limb in a comfortable position and a mobile belt for firmly attaching the hand to the body. The latch has a universal character, as it is suitable for both right and left hands. The bandage is a hypoallergenic product that does not cause itching and skin irritation.

The latch has the following functions:

immobilization after injuries and injuries of the upper limbs in the correct position;
unloads the ligamentous and muscular apparatus, which facilitates the condition of the joints.

Overlay technique

Dezo dressing needs a special overlay technique and is performed in the following sequence:

The patient is seated face to face.
A roll of gauze or a piece of cotton wool is placed in the axillary region.
The arm is pressed to the chest and bent at an angle of 90 degrees.
They perform several wrapping rounds in the chest area, while not forgetting about the diseased limb.
The bandage is removed from a healthy armpit and lifted obliquely towards the opposite shoulder.
Lower the bandage along the back of the arm and grab the sore elbow, hold the bandage under it.
They return to the armpit area, carry out one round along the back obliquely up to the opposite shoulder girdle.
From the shoulder, the bandage is released down the front surface of the arm, passing it under the elbow joint, returning to the intact armpit.
Repeat the original sequence, making three or four fixing moves with a bandage along the line of the triangle.
At the end, the remaining edge is firmly fixed with adhesive tape or a pin so that it does not hang out.
If the bandage is applied for a long time, then it is stitched through several layers.

This is where the bandage ends, however, it is not enough for a full and strong fixation. So that it does not weaken due to insufficiently strong material during the transportation of the patient to the medical facility, three additional rounds are carried out, achieving a tight and lasting effect.

Applying a bandage to the right or left limb allows its tight fixation relative to the body, but without taking the shoulder back. If there is a need for long-term use of the bandage, then the use of additional parts for shoulder abduction is allowed.

How to care

With temporary use of the bandage, no measures are taken to care for it. For example, if it is applied for a while as a splint (during transportation to the hospital), then it is removed there. If it is worn instead of plaster for a long time, then it needs care.

In this case, some nuances are required:

bandages are changed after they are heavily soiled;
in case of deformation of the bandages, when they are not able to perform the functions of a tight fixator, I completely change them, while keeping the hand in the desired position;
when individual sections are weakened, there is no need to completely replace the bandage, sagging sections can be tightened and fixed again;
if the pharmacy fixative is dirty, then it is washed by hand in water at room temperature;
at the same time I do not use chemical bleaches or solvents;
dry cleaning is contraindicated;
after washing, the product should be rinsed thoroughly;
it is strictly forbidden to rub and squeeze;
it is recommended to dry the product in a straightened position away from heaters and ultraviolet rays;
do not iron the product, store in a dry place;
Avoid water and direct sunlight.

How long to use

Terms of use vary depending on the type of injury. When providing first aid, the time of wearing the retainer depends on the timing of the delivery of the victim to a medical facility. If necessary, a reliable and durable fixation is worn for about 3-4 weeks. In addition, patients over the age of 40 do not wear a brace for as long as younger people. This is due to the high physical activity of young people, whose activity leads to repeated dislocations. During the same time, a bandage is worn for fractures of the collarbone and shoulder. In these cases, the use of a simple bandage bandage is not enough. However, it is used when the imposition of a plaster or splint is impossible for some reason.

Who is able to bandage Dezo

When providing first aid, the bandage is applied by people from the environment of the victim. As a result, the bandage is not always applied correctly. In a medical institution, the procedure is performed by junior medical personnel under the supervision and control of a traumatologist. In order to make a bandage, it is not necessary to have a special medical education. To do this, it is enough to have simple dexterity and skill, and most importantly, to repeat the sequence of actions exactly. In order to repeat the Dezo fixator, you need to take a wide bandage that will firmly and securely fix the limb.

The most common mistakes when applying a bandage

What can be done wrong when performing dressing? Errors can be as follows:

the hand may be in the wrong position, which leads to displacement of bone fragments;
unreliable and weak immobilization;
when carrying out too tight revolutions, the limb is compressed, which leads to the intensity of pain, there may also be a violation of the blood supply in the squeezed hand;
too weakly imposed revolutions lead to slipping of the bandage from the body and lead to a change in its position;
uneven pressure on the limb: in some areas the bandage is applied too tightly, in others too weakly;
the latch is made of inappropriate material, this happens during first aid, when improvised means act as a bandage: towels, sheets, shirts, pieces of cloth. Such fixators most often do not cope with their direct duty, fall off and do not have an immobilizing effect.

The immobilizing bandage is only effective when performed correctly. If there is no experience in applying medical dressings, it is better not to do this at all. Let the limb remain in the position that it took after the injury.

Deso bandage alternative

Alternative bandages include:

Delbe Rings

This method of applying the retainer implies the presence of two rings, which are made of belts, wide pieces of fabric or bandage. They are carried over the shoulders of the patient, and behind the back they are fixed in such a way that they spread the shoulders of the victim to the sides.

Eight bandage

This is a variation of the Delbe fixator. For the bandage, an elastic wide bandage is used, which is applied behind the back in the form of the number eight.

scarf

The easiest bandage to perform. In order to complete it, a piece of square-shaped fabric is required, which on one side must have at least one meter. The dressing is designed to prevent sagging of the injured limb, as a result of which bone fragments can move.

Fixator Velpo

This fixator is also a variant of the Deso bandage. When it is performed, the limb is fixed at an acute angle, and not at a right angle, as is customary in the classical version. The palm of the injured hand is pressed against a healthy forearm and thus attached to the body.

In case of fractures of the shoulder, collarbone or shoulder dislocation, fixing bandages are usually applied. The Dezo bandage for the shoulder joint fixes the upper limb in a stationary state, reducing the load on the joints. With the exact execution of the sequence of stages of applying such an orthosis, the recovery period is significantly reduced. You can make the bandage yourself or buy ready-made.

Deso bandage: indications for use

This method of dressing and fixing the shoulder joint after an injury was invented by the famous 18th century surgeon Pierre Joseph Dezo.

The fixing bandage on the shoulder joint is intended for semi-rigid immobilization of the arm after injury. It is used after an injury, a fracture of the shoulder or collarbone of a non-severe nature, during the rehabilitation and postoperative periods. The injured arm is connected to the body and secured with several rounds of a special bandage. The orthosis consists of a tape, a belt, a fixing pin and a cotton-gauze roller.

Indications for use

Bandages Dezo are used in the following cases:

simple injuries of the shoulder region;
or forearm;
fractures of a non-severe nature in the collarbone;
immobilization of the injured area after surgery.

Ready-made bandages Deso on the shoulder joint

In the pharmacy you can buy a ready-made orthosis for a child.

Ready-made Deso orthoses can be purchased at pharmacies and specialty medical stores. In their manufacture are used:

latex;
polyester;
cotton.

The bandage includes a belt wrapping around the body, two fixators - shoulder and forearm, and a tape supporting the shoulder belt. The bandage uses non-allergenic fabric sewn in several layers. The underside of the bandage is covered with a cotton fabric. Adhesive tape is used for fastening. There are 2 main types of modifications of such a device (Deso 1 and Deso 2), for children a children's orthosis is provided.

How to put on a ready-made bandage?

Putting on the fixing device is quite simple:

The patient is dressed in cotton clothing.
A belt is fastened in the abdomen area, designed to fasten the upper limb.
A latch for the forearm is fastened with a belt clasp.
The tape intended for the shoulder girdle is pulled from the non-injured area and fastened with Velcro.
The fixator is attached to the injured shoulder joint.

How to apply a bandage bandage?

The bandage is applied in several steps.

Dezo's bandage on the damaged humerus is done in stages. The patient is seated on a chair, the injured limb is bent at the elbow joint. A cotton-gauze pad is placed in the axillary area. The hand is connected to the body by applying 3 bandage circular tours:

The bandage is removed from the area between the shoulder joint and the chest along the front to the injured forearm, and then vertically down to the elbow. Then it is pulled along the chest area to a healthy armpit, then the coil is repeated.
The head of the bandage is removed under the arm of the workable part and stretched to the patient's shoulder girdle.
The bandage is pulled under the armpit of an uninjured shoulder, leading along the chest to the damaged shoulder girdle. Then it stretches down the back of the shoulder, capturing the elbow joint. A bandage is wrapped around the forearm and again stretched to a healthy armpit. Then the bandage tape will again be introduced to the damaged shoulder girdle. From it, along the front part under the elbow joint, it is directed to the armpit of the working side. All turns are repeated until complete fixation of the injured shoulder.

If bandage triangles have formed on the chest surface and on the back, then the Dezo bandage on the shoulder joint is applied correctly.

The Dezo bandage immobilizes the upper limb. Fixes the shoulder and forearm bent at the elbow to the body, creates physiological traction. Covers all the necessary musculoskeletal system. Helps relieve stress. It prevents displacements, which reduces the risk of complications and speeds up recovery after injuries.

Named after the inventor Pierre Dezo, one of the best French surgeons of the 18th century. Now it is used in an improved form - the technique of application and the materials used have changed, due to which the effectiveness of treatment has increased.

Indications

The Deso bandage is necessary to immobilize the arm from the shoulder to the finger phalanges in case of:

dislocation of the shoulder and for the prevention of relapse;
fracture of the humerus;
clavicle fracture;
scapula fracture;
ligament injuries;
paralysis of the upper limbs;
arthritis, periarthritis and arthrosis;
secondary myositis, neuritis, paresis and plexitis;
in the recovery period after operations on the upper limb and wearing a cast.

It can be used for simple fractures - when there is no risk of displacement and damage to soft tissues by bone fragments. Sometimes it is prescribed for bruises and cuts of the hands.

Types of bandages Deso

Bandage bandages Deso

Deso's classic bandage is bandage. It covers the sore shoulder and torso with several rounds of bandage, goes around the back and elbow from below, rises obliquely upwards, under the healthy armpit, spreads over to the sore shoulder and falls again. Fastened with pins or plaster. If you have to wear it for a long time, the tours of the bandage are stitched so that they do not slip off and stretch less. Sometimes Dezo's bandage is made of plaster.

Disadvantages of the Deso bandage

A bandage that is too tight cuts off circulation and causes pain. Too weak - does not perform its functions. Improper fixation can lead to malunion of the bones. In addition, the bandage requires systematic care. If it becomes dirty or displaced, a replacement is required: you need to remove the old bandage and apply a new one, without strictly changing the position of the sore arm.

Ready bandages Deso

Ready-made Deso dressings are easier to use, convenient for patients and doctors. They are bandages - connected into a single structure and. Made of hypoallergenic materials that allow air to pass through - do not cause irritation, provide full circulation. Attached with Velcro. They do not require an exact selection - they are produced in universal sizes, adjustable individually.

Rules for wearing a bandage Deso

How to choose and wear correctly?

A ready-made bandage of the Deso type on the shoulder joint is worn over underwear according to the principle of a T-shirt. At the same time, the patient's arm is bent at a right angle, the forearm is parallel to the floor. Above the elbow, the product is attached to the body horizontally with a belt. The device should not hang out or squeeze.

A suitable size is selected by a traumatologist or orthopedic surgeon. He puts the bandage on the patient for the first time and teaches the necessary technique.

How much to wear and how to sleep?

The duration of wearing the Dezo bandage depends on the nature of the injuries. With a dislocation of the shoulder, it is worn from a week to a month. Younger and more active patients require longer immobilization to prevent secondary injury. With uncomplicated closed fractures of the shoulder or collarbone, the product is worn for about a month.

How much to wear during the day and whether it is possible to take it off at night, the doctor indicates. When worn around the clock - the most common option - they sleep on their backs.

How to care?

Deso ready-made shoulder bandages come in non-staining colors so they require little maintenance while they are being worn. After the end of the treatment, the product is washed at a temperature of 30 ° C in manual mode without spinning. Dry naturally.

Algorithm 29

Bandage Deso.

ATintroductory word:“I am providing first aid, at the scene, to a victim with a dislocation of the right collarbone. Anesthesia has already been given. My task is to carry out transport immobilization of the right clavicle using the Deso bandage.”

Equipment: bandages, scissors. To carry out the manipulation, an assistant will be needed in the role of the patient.

Obtaining patient consent:"Hello! My name is First Name. I am a nurse. In order to ensure the immobility of the damaged area during transportation, it is necessary to apply a bandage. Do you agree? Sit comfortably. The body must be motionless. If my actions cause you pain, please let me know. Good?"

manipulation technique:

Take a wide bandage;

put a cotton pad in the armpit;

bend the arm at the elbow joint and bring it to the chest;

bandage the shoulder to the chest in a circular motion, starting from the “healthy side” (1st round);

direct the bandage from a healthy armpit to the shoulder girdle of the "sick" side, obliquely upwards;

throw it over the shoulder girdle back and lower it down to the elbow joint (2nd round);

go around the elbow joint, supporting the forearm and hand, direct the bandage obliquely upwards into the armpit of the “healthy side”;

pass it to the back of the chest (3rd round);

direct the bandage obliquely up the back to the sore shoulder girdle;

throw over it and swipe down to the elbow joint;

go around the arm in the upper third of the forearm and direct the bandage to the back of the chest (4th round);

guide the bandage in armpit of the "healthy side" on the back;

repeat four rounds several times until the arm is completely fixed;

secure the bandage in one of the ways.

Completion:"All. The bandaging is completed. An ambulance will come and I will accompany you to the hospital. If you get worse, please let me know. Good?"

General rules for applying soft bandages

The part to be bandaged must be accessible (at the level of the bandager's chest)

The patient is placed in a comfortable position

The bandaged part must be motionless

Limbs are given a functionally advantageous position

Muscles should be as relaxed as possible

You should stand so that you can see the bandaged part and the face of the bandaged.

Periodically (at least 3 times) the patient should be asked the question: “How do you feel”?

bandaging technique

The bandage should be of the appropriate size (head, limbs -10 cm; fingers - 5 cm; torso - 10-14 cm)

Bandaging is carried out from the periphery to the center, from the lower to the upper sections.

The head of the bandage is taken in the right hand and end in the left, without preliminary rolling.

Bandaging begins with a fixing circular tour

The head of the bandage rolls without separation along the bandaged surface, evenly stretches, each subsequent round (spiral bandage) should cover the previous one by half.

Bends are made on cone-shaped sections

Reverse movements, abrupt movements, as well as “fitting” movements should be avoided.

At the end of the dressing, the end of the bandage is fixed with a knot, pin, glue, adhesive plaster, tubular bandage, stitching. Fixing cannot be carried out over the wound. Criteria for the correctness of the applied bandage:

The bandage must fulfill its function

The bandage must be firmly attached

Bandage should not cause pain

The bandage should not interfere with blood circulation

The bandage should have an aesthetic appearance.

Possible mistakes:

Gross mistakes:

Violation of the rules of bandaging paragraphs: 2; 3; four; 6.

Violation of bandaging technique, points: 2; eight

The dressing does not meet the criteria for correctness, points: 1; 2; 3; four.

Not blunders:

Mistakes during dressing positioning among other interventions.

Not the ability to justify the need to apply a bandage to the patient.

Violation of the course of manipulation.

Criteria for evaluation:

Passed - the absence of blunders, the presence of no more than two not blunders.

Failed - the presence of at least one gross error, more than two not gross errors.

If an error is found, the teacher may ask to repeat the corresponding stage of the manipulation, if the error is corrected - passed, if not corrected - did not pass.

Indications for the Dezo bandage: immobilization of the upper limb to the chest in case of fractures of the clavicle, as well as after reduction of the dislocation of the shoulder.
When applying a bandage to the upper limb, a physiological position is attached.

First, the shoulder is fixed to the body, then the wrist joint is held, and finally the elbow joint of the injured side. The joints of a healthy upper limb remain free, and the patient can make any movements with a healthy hand.
Equipment: bandage 20 cm wide, cotton-gauze roller, scissors, pin or adhesive plaster.
Note: The fixing tour of the bandage is always carried out to the sore arm around the body, tightly pressing the shoulder to the chest. When a bandage is applied to the left arm, the bandage moves from left to right, and when bandaging the right arm, from right to left, the arm is bent at the elbow joint at a right angle, the elbow is retracted somewhat back, and the shoulder is lifted up during the bandaging process.

1. Dezo bandage is applied after preliminary insertion of a cotton wool roll wrapped with gauze into the armpit. After carefully bend the injured limb in the elbow joint, lead and press to the chest.

2. Make two fixing tours of the bandage on the chest, the diseased arm in the shoulder area, back and armpit from the side of the healthy limb.

3. Lead the bandage through the armpit of the healthy side along the front surface of the chest obliquely on the shoulder girdle of the diseased side.

4. Lower the bandage down the back of the affected shoulder under the elbow.

5. Go around the elbow joint and, supporting the forearm, direct the bandage obliquely into the armpit of the healthy side. Lead a bandage from the armpit along the back to the sore shoulder girdle.

6. Lead a bandage from the shoulder girdle along the front surface of the diseased shoulder under the elbow and go around the forearm. Direct the bandage along the back to the armpit of the healthy side. Repeat the rounds of the bandage until the shoulder is completely fixed.

7. Finish the bandage with two fixing rounds on the chest, on the sore arm in the area of the shoulder, back. Pin the end of the bandage with a pin. If the bandage is applied for a long time, the tours of the bandage should be stitched.