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also textile elastic and is made from a somewhat stronger
These rules must be followed if
right
fabric resembling the “Ideal” type bandage.
treatment is to be successful:
1) Compression treatment can
only be effective if the correct
Bandages are classified as permanently elastic if they
pressure gradient is applied. The
derive their elasticity from fully synthetic chain-link
pressure is highest at the ankle
threads. Crimped polyamides are mainly used for this pur-
and decreases continuously
towards the knee.
pose, and their degree of elasticity can be made suitably
wrong
1 2
2) The bandage must be held
low by texturising in order to meet the physical require-
properly in the hand ...
ments of a low-stretch bandage.
3) ... because only in this way
For correct bandage application,
can it be unwound on the leg. If
the bandage must always unroll
90˚
the roll of bandage is lifted from
General principles of bandaging technique
directly on the skin and may only
the skin, it cannot be guided
be pulled tight in the direction of
Compression therapy with bandages supports the joint
properly, constrictions inevitably
running.
muscle pump, but only reaches its full effectiveness in
develop and the continuous pres-
combination with active movement. Consequently, this
sure distribution is jeopardised.
Too weak compression at the
treatment should usually be carried out on an outpatient
ankle and strong compression
basis. Bed rest should also be avoided. Prolonged sitting, 3 4
90˚
around the calf, however, con-
however, is even more unfavourable than lying. The fol-
gests even more than a stocking
lowing principles should be observed when applying the bandage should be held in the hand such that the rolled-
garter.
4) To apply the bandage, the
bandage: up part of the bandage is uppermost and faces outwards.
ankle should be held at a right
▪ A good bandage should firmly enclose the leg all round, Only in this way can it be unrolled on the leg. If, on the
angle.
▪ be applied with a pressure gradient decreasing continu- other hand, the roll of bandage is lifted off the skin, it
ously from proximal to distal cannot be guided properly, strangulating constrictions
▪ and not press or pinch at any point. can form and the correct pressure gradient decreasing
from proximal to distal will be jeopardised.
Every bandage that meets these requirements is correct
and beneficial regardless of the technique used. A guid- To apply the bandage, the ankle is placed at a right angle
ing principle is that the bandage should adapt to the leg, and the lower leg is flexed at about 90°. Application of
and not the leg to the bandage. This is only achieved, the compression bandage begins at the metatarsopha-
however, if both edges of the bandage are always ten- langeal joints, taking care to include the heel. The skin of
sioned with equal force and the bandage is closely the toes becomes slightly cyanotic during this procedure.
moulded onto the leg. To achieve this, the bandage must During walking, however, it becomes anaemic with every
always unroll directly on the skin of the lower leg and step only to fill with blood again when relieved. The
should only be pulled tight in the direction of application. pump action of the bandage can thus be observed direct-
The gaps that are initially left open should be closed ly at this site.
later.
The pressure exerted by a bandage is higher the greater
Depending on the circumference of the leg, bandages its curvature. Bony prominences (ankles) or edges over
with a width of 8 cm or 10 cm are most suitable. The the shin bone and the Achilles tendon should be padded
Compression therapy [70.71]
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