Definition
A compression bandage is an individually applied elastic bandage that exerts external pressure on a body part and thus improves the return flow of blood and lymph fluid from the periphery to the heart. In contrast to fixed compression stockings, which have a similar mode of action and are used for similar indications, a compression bandage can be corrected by doctors or experienced nursing staff each time the bandage is changed and may be tightened or wound a little more tightly. This is particularly useful at the beginning of compression therapy, for example, when existing water retention (edema) must first be removed before the leg can regain its original shape. General information can be found here: Lymph drainage
Types of compression bandages
There are many different types of compression bandages. Distinctions can be made according to both the manufacturing companies and the wrapping technique. The materials offered by the various manufacturers differ only slightly, so that the question of which bandages 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 applied and safely wrapped, every 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 the skill of the person applying the compression bandage, as not everyone is equally proficient in every technique. Two of the most important wrapping techniques are described in detail below.
Applying a compression bandage
As a matter of principle, careful skin care and wound care is required before any compression bandage is applied if there are open wounds. At the beginning, a so-called stocking bandage is pulled over the area to be wrapped. It is later used for fixation and fastening, but also functions as skin and pressure protection.
A careful layer of padding is then applied. This padding can be done with special padding cotton or foam bandages. It is just as important for avoiding pressure points and the like as it is for improving the patient’s wearing comfort.
Even at this stage, meticulous attention should be paid to ensuring that there are no wrinkles and that the entire surface is evenly covered. Afterwards, the actual compression wrapping with elastic bandages begins according to the technique chosen. Finally, the stocking bandage is wrapped around the bottom and pulled up.
With all forms of compression bandages it is important that the end of the body part that is wrapped remains free. The toes, for example, must never be wrapped as it must be possible to check the blood circulation, sensitivity (i.e. the feeling) and motor function (i.e. mobility) at any time.
Furthermore, the joints that are enclosed by the compression bandage (usually the ankle) are always wrapped in the so-called functional position. In the case of the ankle, for example, this means wrapping with the foot at a 90 degree angle to the lower leg. This allows the patient to walk around freely later and is easy 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 become somewhat weaker “near the heart”. This provides optimum support for the drainage of blood and lymph fluid. The aim should be to exert a pressure strong enough to achieve the therapeutic intention, but not so strong as to cause damage or complications. However, the exact strength of traction is – just like the perfect technique – purely a matter of practice and experience.
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