Gilchrist bandage is a special bandage used in shoulder and upper arm injuries to stabilize and immobilize the affected area. The bandage is used after shoulder surgery, for lateral fractures of the clavicle, acromioclavicular fractures, and minor injuries to the shoulder or AC joint. If complete immobilization is required, the dressing is not suitable.
What is a Gilchrist bandage?
A Gilchrist bandage is a special bandage used for injuries to the shoulder and upper arm to stabilize and immobilize the affected area. Injuries to the shoulder or upper arm often require immobilization of the affected arm. Immobilization is used for the affected tissues to recover and is also required, for example, for fractured limbs to allow the fracture to heal appropriately and prevent the fracture fragments from shifting. In the 19th century, the U.S. dermatologist Thomas C. Gilchrist developed a special bandage for immobilizing the shoulder and upper arm. This classic bandage variant is known today as the Gilchrist bandage. In the 21st century, the bandages are available as prefabricated constructions in various ready-made sizes. This means that patients of any stature can be fitted with a glichrist bandage. Making your own glichrist bandage is also within the realm of possibility and requires neither much material nor extensive medical knowledge. The shoulder and upper arm are firmly fixed by a Gilchrist bandage and can thus hardly leave the resting position. The accuracy of fit of the bandage is a decisive criterion. A suboptimal fit can sometimes compromise the purpose of the applied bandage.
Function, impact and goals
Gilchrist bandaging is used for certain injuries to the shoulder and upper arm. This type of bandage is used for loose immobilization or even moderate fixation of the shoulder joint. The indication for this type of immobilization is, for example, in patients with a re-established dislocation of the shoulder joint in the sense of a previously treated shoulder dislocation. Other indications for the bandage are minor injuries to the acromioclavicular joint, also known as the AC joint. In addition, the dressing can be used for humeral fractures, acromioclavicular fractures, or lateral clavicle fractures. In certain cases, the bandage is also the aftercare step of shoulder surgery, such as typically shoulder arthroplasty, and is intended to immobilize the operated area in this case as well. Prefabricated Gilchrist bandages in different sizes are used for the care of patients. The dressings are distributed to the appropriate hospital facilities, are reusable, and can be secured and removed using a hook-and-loop fastener. Pre-made Gilchrist dressings virtually eliminate the wrapping step. A ready-made bandage is constructed of a chest band of certain width and an upper fixation and lower arm fixation. The patient must bend the affected arm at a right angle at the elbow joint. Meanwhile, the hand is directed towards the navel and looks out of the applied bandage in this direction. Complete immobilization of the affected arm is not the goal of the Gilchrist bandage. Rather, the patient should use the hand of the affected side with some restrictions. The on-site portion of the bandage carries a sling that is placed around the patient’s neck. The strap around the chest holds the arm in a dorsal position, pulling it backward. If you want to make a Gilchrist bandage yourself, you use a long piece of tubular gauze, which is fitted with padding or dressing wadding and fixed with two to four safety pins. However, the homemade Gilchrist bandage can also be realized using tight elastic bandages and in this case is wrapped.
Risks, side effects and dangers
Gilchrist bandage is not suitable for severe immobilizations of the shoulder. If stronger to maximum immobilizations are to be achieved, a so-called desault bandage application. This dressing is used primarily in the setting of unstable proximal humerus fractures and was developed by Pierre-Joseph Desault for absolute immobilization of the shoulder joint and humerus.The bandage corresponds to elastic bandages or, in certain cases, a body hose bandage. A Desault bandage may be used for a maximum of three weeks. If further immobilization is required in the following weeks, the Gilchrist bandage can replace the stronger type of bandage from this point on. The Gilchrist bandage is also less suitable for fractures of the clavicle. Plaster rein bandages are more likely to be used for such fractures, especially on children. Backpack dressings for adults are also more suitable than a Gilchrist dressing for these fractures. Backpack bandages are based in their effectiveness on a shoulder bandage that fixes the collarbone. The shoulder is pulled backward in these bandages. Thus, the bandage ensures a straight back posture and the clavicle does not grow together in a shortened position. When patients apply a Gilchrist bandage instead of a backpack bandage for clavicle fractures, the result can be shortening of the clavicle. In most cases, such shortening must be opened and surgically fractured to return to the anatomic position. If, in turn, the desault bandage and thus absolute immobilization is omitted in a severe shoulder fracture, the result may be permanent stiffness or functional impairment of the shoulder joint. It is therefore imperative to seek medical advice before applying a Gilchrist bandage on one’s own. The bandage is by no means suitable for all injuries to the upper arm and shoulder, but can only be used sensibly and without complications for specific purposes. Despite the bandage, a patient may still experience pain, as the Gilchrist bandage does not achieve absolute immobilization of the injured structures.
