Elastic Bandages

Two Types of Compressive bandages?

1 .Static 2. Intermittent compression units

Purpose of Compression bandage?

1) Improve fluid balance and circulation:pressure in interstitial space versus in vessels -Maintaining/returning fluid to blood and lymphatic vessels = circulation vs accumulation 2) Modify scar-tissue formation: -Temperature-sensitive enzyme activity breaks-down collagen 3) incidence of -or- potential for DVT formation 4) Enable shaping of residual limb post-amputation 5) Facilitate healing of venous ulcers

2. What are 5 indications that you should use elastic bandages or garments?

1. Amputations 2. Orthopedic injuries (ankles, knees etc) 3. Muscular injuries (hamstring strains 4. Edema 5. Burns

Facts about Elastic Garments?

1. Increasing pressure distally and lower pressure moving proximally toward thigh and waist) 2.Used for Pts. On Long term bed rest 3. Available variety of sizes and styles 4. Holes in the end of toes for skin observations

What are 6 purposes of elastic bandaging?

1. Prevent/decrease edema through external pressure 2. Shaping an amputated limb in preparation for a prosthesis 3. Support of a body part 4. Restrict motion or immobilize a body part 5. Hold dressings in place 6. Prevent excessive scarring

Other contraindications for compression bandages?

1. Recent DVT, Thrombophlebitis, or pulmonary embolism 2. Obstructed lymphatic or venous return 3. Severe peripheral arterial disease and or ulcers due to arterial insufficiency 4. Acute local skin infection 5. Abnormally-low serum protein levels

What are 2 Contraindications for using elastic bandages or garments?

1. Severe PVD 2. Open wounds

Jobst garments indications?

1. Venous insufficiency 2 deg immobility **2. Post phlebitis **3. Venous stasis ( 30 - 40 mm Hg). 4. LE edema (15-20 mm HG) 5. Ulcers (20-30 mm Hg) 6 Varicose Veins 7. Orthostatic Hypotension

A Jobskin pressure garment can be worn up to ___ months following DC?

18 monhts

Each Jobskin garment last about ___ - ___ months?

2 -4 months

How many sets of Jobskin garments are ordered when prescribed to a pt.?

2 sets

What does a compressive bandage act like?

Acts a second skin so it's better for shaping new tissue

What are TED hose stockings are used for?

Anti-embolism stockings

Elastic garments are contraindicated for arterial or venous insufficiency?

Arterial insufficiency

The purpose of JOBST garments?

Assist the movement of venous blood and lymph from the extremity toward the heart.

Where do you wear your jobksin garment over?

Burn and donor sites

Jobskin garment is used for what type of pts?

Burn pts. For pressure

Biggest contraindication's for Compression bandages?

CHF (can't handle fluids entering the heart) Pulmnary edema (PE), and Kidney Failure (ICP)

Bandaging basic turns: used as an anchor-each turn covers the previous turn?

Circular

The application of a mechanical force that increases external pressure on the body or body part. Most ____ ___ will increase tissue temperature?

Compression Bandage

Static Compressive bandage what type of force?

Constant force applied to injury

What are the purpose of TED HOSE Anti-embolism stockings?

Decrease DVT by compressing superficial veins to facilitate venous return and decrease edema

What position should you try to avoid if you can when applying elastic bandages?

Dependent position during wrapping

T or F Ted HOSE Anti-embolism stockings Increase DVT by compressing superficial veins to facilitate venous return and decrease edema?

False Decrease DVT

T or F pressure increases as it move proximally when using the Jobst garment?

False It decreases as it moves proximally

T or F UNNA boots are wet slightly, then wrap into a semi rigid boot stays on for 5-8 days?

False stays on for 4-7 days

T or F you can go to Walmart and buy jobst garments?

False, they have to be pescribed very expensive

T or F Jobskin garments are worn continuously even when bathing?

False, worn all the time except for bathing

Bandaging basic turns: used to cover joints, good for immobilization and for edema control?

Figure Eight

Why would you not use a Intermittent compression pump on a person experiencing kidney failure?

May cause INCREASE stress on diseased or failing organ

Each time you reorder a Jobskin garment what must you do?

Measure every time you order a pressure garment

Open wounds are considered a contraindication for elastic bandaging, however they can be used for?

Open wounds - may however use over a dressing/ bandage to promote healing by Decreasing edema

Guidelines to applying elastic bandages?

Place body part in the position it will remain after bandage applied **If possible, avoid dependent positioning during wrapping/bandage application** 2. Anchor the bandage using one circular turn 3. Apply bandage evenly and firmly but not too tight 4. Avoid wrinkles - these will cause additional pressure 5. Leave fingers and toes exposed if possible to check circulation via capillary refill (squeeze toes **However - often must be fully closed with burn patients 6. Wrap from distal to proximal to aide in return of blood to heart 7. Pressure in bandage should be tighter distally and gradually decrease as you move proximal 8. Check fingers/toes after a few min to check circulation 9. Home Program: Best to apply bandage within 20' upon awakening as limb is likely least swollen from gravity.

Bandaging basic turns : used for uneven body parts such as head or residual limbs?

Recurrent

Why is severe PVD considered a contraindication for elastic bandaging?

Severe PVD - may further occlude blood

Why do TED HOSE stockings have holes in the toes?

Skin observation Capillary refill and foot ulcers)

Purpose and benefits of using Jobskin garment:

Smooth healing scar tissue (soft pliable - healing), Collagen fibers of the scar may twist resulting in excess scarring and contractures, Pressure from burn garment minimizes hypertrophy of scar, protects new skin from scraps, relieves itching, controls edema (assists venous return)

Bandaging basic turns: used to cover dressings of extremities; each ascending turn partially overlaps the previous turn?

Spiral

Bandaging basic turns: used for non-stretching bandage such as gauze-at completion of turn fold bandage back ?

Spiral Reverse

UNNA boot is considered static or intermittent compression unit?

Static

JOBST garments are used for?

Supporting Venous Gradient Pressure

T/F EXCEPT in PRICES: static compression may help control pain and decrease edema/ inflammation?

True

T/F Acute trauma or fracture is a precaution for compressive bandages?

True precaution

What type of chemical is used in UNNA BOOT?

Zing Oxide impregnated gauze

Venous stasis is a more ____ condition and must be _____ very closely?

more PERMINANT condition; must be WATCHED very closely.

Unna boot are used to treat?

venous stasis ulcers