It should always be remembered that the compression The zinc paste bandage can be indicated as a substitute
bandage – regardless of the material and application for temporary bandages if the bandage is liable to manip-
technique – can only be fully effective when the patient is ulation or if dressing change on schedule is not always
engaged in physical movement. It is also important to possible.
note that only one type of bandage should be used at
once; for example low- and long-stretch bandages should Low-stretch bandages
never be combined in a single layer. Low-stretch bandages are characterized by relatively low
stretch, which causes the bandage to exert high compres-
Zinc paste bandages sion with a high working pressure and low resting pres-
After application, zinc paste bandages produce semi- sure. Since these pressure conditions are still sufficient to
rigid, unyielding bandages. Because of their non-elastic influence the deeper regions, the mode of action of such
nature, among all the bandaging materials these are the bandages corresponds to that of zinc paste bandages,
ones which can offer the greatest resistance to the work- although they do not have their high efficiency. On the
ing muscles and exert a working pressure so intense that other hand, low-stretch bandages have the advantage
it extends deep into the subfascial regions and rapidly compared to zinc paste bandages that they adapt better
reduces swelling. The correspondingly low resting pres- to changes in leg circumference. When a good applica-
The high working pressure of
sure assures a good aeration effect, so that blood circula- tion technique is used, this means that they can be left in
low-stretch bandages is still suffi-
tion in the nutritive vessels is promoted, especially during place for about three days, except in the acute, highly
cient to therapeutically influence
the deep venous regions,
stagnation due to lacking withdrawal of blood by the edematous stage.
although they do not offer the
deep veins.
high efficiency of zinc paste
Low-stretch bandages are suitable for all forms of chronic
bandages. Their particular advan-
The zinc paste bandage is therefore indispensable for rap- venous insufficiency and are the treatment of first choice
tage, however, is that they adapt
better to changes in leg circum-
idly reducing the leg swelling and removing stubborn for initiating or continuing treatment until the ulcer is
ference and are easier to change
edema especially on the back of the foot which resist completely decongested and epithelised.
if daily wound treatment is
treatment with temporary low-stretch bandages or per-
required.
manent plaster bandages. Since the bandage cannot Low-stretch bandages are available in a range of versions
adapt to changes in leg circumference after the edema made possible by textile technology. Their stretch can
has subsided, however, it has to be changed frequently in range from about 50 % to a maximum 90 % to achieve
this first phase of therapy. the required high working pressure and low resting pres-
sure. The type of yarns used and the design determine
Local ulcer care during the cleansing phase presents the typical use characteristics.
some difficulties. A daily change of bandage is often
required, and is more easily accomplished by using tem- If bandages derive their elasticity from over-twisted, i.e.
porary, low-stretch bandages. If appropriate, however, highly plied cotton chain-link threads, they are known as
rapid decongestion with the zinc paste bandage may textile elastic. The best known and most commonly used
have to be attempted; wound cleansing can then be com- bandage of this type is the classical “Ideal” type band-
menced. age, textile elastic bandage, but the Pütter bandage is
Compression therapy [68.69]
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