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PubMed2002

Addition of a propyl gallate-based procoagulant to a fibrin bandage improves hemostatic performance in a swine arterial bleeding model.

Fibrin bandages manufactured by Nycomed Austria (TC-S) were modified by the addition of Hemostyptin (HS), a proprietary platelet-activating reagent containing propyl gallate. HS was added as an additional layer to TC-S fibrin bandages and the bandages were tested for hemostatic efficacy in a swine femoral artery bleeding model. Injuries were treated with a TC-S+HS bandage preparation using HS lyophilized onto a bandage surface that was then attached to the fibrin dressing. This preparation qualitatively and quantitatively exhibited more robust blood clotting at the surgical site than the control bandages. TC-S+HS bandages were more effective than control bandages with a difference in blood loss of 251.8+/-66.5 g for TC-S bandage alone, n=12 vs. 121+/-40.7 g, n=13 for the TC-S+HS bandage, P=0.05. Bleeding times were shortened for animals treated with the HS fortified bandages and residual platelets counts in these animals were higher.

Animals↗

PubMed1997

[Temperature changes of the cornea by applying an eye bandage].

BACKGROUND: The corneal temperature is not often measured, but it may be useful to evaluate the temperature-changing effect of the application of eye bandages. The reason for applying an eye bandage is to calm an inflamed eye and to provide mechanical protection. Everyone knows that some patients have more complaints after an eye bandage has been applied. This phenomenon might be caused by the inflamed eye being warmed up by bandage application. MATERIALS AND METHODS: In 40 apparently healthy subjects 24 +/- 1.93 years of age we examined the temperature changes caused by two different types of eye bandage. The measurements were done with a Jeol infrared camera. Twenty probands received a monocular bandage consisting of a perforated plastic cap and another 20 subjects a monocular mull bandage with a perforated plastic cap. RESULTS: The mean corneal apex temperature was 32.05 +/- 0.74 degrees C. Both bandages caused the corneal temperature to go up considerably. The perforated plastic cap increased the mean apex temperature by 0.58 +/- 0.48 degree K and the combined mull bandage by 1.15 +/- 0.57 degrees K (P < 0.05). CONCLUSIONS: Application of an eye bandage increases the corneal temperature significantly. This is known to change enzyme activities and to cause prostaglandin liberation and pain. A change in the bacterial spectrum may result. Cooling as a universal principle in antiphlogistic therapy might be a supplementary therapy in treating sterile, but inflamed eyes.

Adult↗

PubMed2006

Compression therapy: effects of posture and application techniques on initial pressures delivered by bandages of different physical properties.

OBJECTIVE: To define the pressures and gradients achieved by different bandages when applied by alternative bandaging techniques. METHODS: An experienced bandager applied six bandages to the same leg of a volunteer using three application techniques. Pressure measurements were taken at the ankle, gaiter, calf and upper calf in three postures. RESULTS: All bandages gave consistent pressures with all standard deviations falling below 7 mmHg. The percentage increase in pressure from resting leg to standing was inversely related to bandage elasticity. Pressures were similar at the upper calf among the bandages for each application technique in each posture (differences <10 mmHg). Small differences in pressure among the bandages (4-15 mmHg) occurred at the ankle for the resting leg with a reduction in pressure between 6 and 63% at the upper calf compared to the ankle. These differences in ankle pressure were more marked on sitting (differences 15-18 mmHg) and standing (differences 15-27 mmHg), which resulted in substantial differences in gradients. CONCLUSIONS: Striking variations in pressures and gradients were observed between bandages of different physical properties applied using alternative application techniques. In order to achieve clinical benefits without tissue damage, it is essential that the therapist appreciates how a bandage will react with a specific application technique.

Adult↗

PubMed1997

Single-layer and multilayer bandaging in the treatment of venous leg ulcers.

This study compares levels of compression achieved in the application of both multilayer compression bandage systems and single-layer bandages by practitioners who are experienced with levels achieved by those who are inexperienced. Nineteen practitioners experienced in compression bandaging (13 nurses, six doctors) and 18 inexperienced (12 nurses, six doctors) participated in the study. Both experienced and inexperienced practitioners achieved a pressure of 40 mmHg more consistently when applying multilayer compression bandage systems than in the application of single-layer bandages. Compression bandaging experience does not result in significantly better sub-bandage pressure when using a multilayer system. Inexperienced practitioners are more likely to apply dangerously high levels of pressure with single-layer bandages than with a multilayer system. Single-layer compression bandages should be applied only by those health-care professionals with extensive experience of applying compression bandages.

Bandages↗

PubMed2006

Measuring sub-bandage pressure: comparing the use of pressure monitors and pulse oximeters.

OBJECTIVE: To test the use of low-cost sub-bandage pressure monitors and pulse oximeters as part of a quality-control measure for graduated compression bandaging in leg ulcer clinics. METHOD: Twenty-five healthy volunteers (mean age 40 years) providing 50 limbs were bandaged with a four-layer compression bandaging system. The ankle systolic pressure (ASP) was measured using a pulse oximeter (Nellcor NBP-40) before applying the graduated compression bandages. Interface pressure was measured by placing pressure sensors on the skin at three points (2cm above the medial malleolus; the widest part of the calf; and a point midway between them) in the supine and standing positions. The ASP was measured again with the pulse oximeter after the bandage had been applied, and the effect of the bandage on the ASP was recorded. The actual pressure created by the bandage was compared with the required pressure profile. RESULTS: Interface pressures varied with change of position and movement. With the operator blinded to the pressure monitors while applying the bandages, the target pressure of 35-40mmHg at the ankle was achieved in only 36% of limbs ([mean +/- 95% confidence interval]; 32.3 +/- 1.6mmHg [supine]; 38.4 +/- 2.4mmHg [standing position]). With the help of the pressure monitors, the target pressure was achieved in 78% of the limbs. There was no correlation between the pressure monitors and pulse oximeter pressures, demonstrating that the pulse oximeter is not a useful tool for measuring sub-bandage pressures. CONCLUSION: The results suggest a tool (interface pressure monitors) that is easy to operate should be available as part of quality assurance for treatment, training of care providers and education.

Adult↗

PubMed2003

Effects of topical application of antimicrobials and bandaging on healing and granulation tissue formation in wounds of the distal aspect of the limbs in horses.

OBJECTIVE: To determine whether povidone iodine ointment or 2 forms of silver sulfadiazine applied topically to wounds of the distal aspect of the limbs in horses affect the rate of second intention healing and to evaluate the additional influence of bandaging with these antimicrobials on granulation tissue formation. ANIMALS: 6 healthy adult horses. PROCEDURE: Six standardized 2.5-cm2 skin wounds/horse were distributed between the dorsomedial surfaces of the metacarpi and metatarsi. One of the following 6 treatments was applied to each wound: 1% silver sulfadiazine cream with bandage, 1% silver sulfadiazine slow-release matrix with bandage, 1% silver sulfadiazine slow-release matrix without bandage, povidone-iodine ointment with bandage, untreated control with bandage, and untreated control without bandage. Wound area, granulation tissue area, and perimeter were measured by use of planimetry software applied to digital images. Exuberant granulation tissue was excised when present. Days until healing, rate of healing parameter, rate of contraction, and epithelialization were compared among wound treatment groups. RESULTS: Healing parameters and mean days to healing did not differ significantly among any of the wound treatment groups. Percentage wound contraction and rate of epithelialization were similar among wound treatments. All bandaged wounds produced exuberant granulation tissue, which was surgically excised; none of the unbandaged wounds produced exuberant granulation tissue. CONCLUSIONS AND CLINICAL RELEVANCE: When exuberant granulation tissue is removed, rates of epithelialization and wound contraction were not different among wound treatment groups, whether bandaged or unbandaged. Topical application of 1% silver sulfadiazine slow-release matrix on unbandaged wounds induced the same result as medications applied beneath bandages, but without exuberant granulation tissue formation.

Administration, Topical↗

PubMed2007

Immediate hemodynamic effect of the additional use of the SCD EXPRESS Compression System in patients with venous ulcers treated with the four-layer compression bandaging system.

OBJECTIVES: To test the hypothesis that the SCD EXPRESS intermittent pneumatic compression applied in combination with a four-layer bandage in patients with venous ulcers increases popliteal vein volume flow and velocity. DESIGN: Twenty limbs of 18 patients with venous leg ulcers were studied, median age 76 years. The Total Volume Flow (TVF) and the Peak Systolic Velocity (PSV) were recorded in the popliteal vein using duplex ultrasonography. Measurements were made (i) without bandage, (ii) with four layer bandage and (iii) following the application of the SCD Compression System on top of a four-layer bandage for at least 15 minutes. RESULTS: The median VCSS was 17 (range, 12-22) while the median VSDS for reflux was 4.5 (range, 1-7.5). The median TVF was 71 mL/min (inter-quartile range 57-101) without bandage, 112 (IQR 89-148) with four-layer bandage and 291 (IQR 241-392) with the addition of the SCD System (P<.001, Wilcoxon signed ranks test). The median PSV was 8.4 cm/sec (IQR 6.8-14) without bandage, 13 (9.0-19) with four-layer bandage and 27 (21-31) with the addition of the SCD System (P<.001, Wilcoxon signed ranks test). Both TVF and PSV increased slightly with the addition of the four-layer bandage. However, with the addition of the SCD System these parameters increased three fold. CONCLUSIONS: The SCD EXPRESS Compression System accelerates venous flow in the legs of patients with venous ulcers already treated with a four-layer bandage. The combination of four-layer compression with the SCD System on healing venous ulcers needs to be tested by a clinical effectiveness study.

Aged↗

PubMed2000

Comparison of equine amnion and a nonadherent wound dressing material for bandaging pinch-grafted wounds in ponies.

OBJECTIVE: To evaluate healing of pinch-grafted wounds on the distal aspect of the limbs of ponies bandaged with equine amnion or a standard nonadherent wound dressing material. ANIMALS: 6 ponies. PROCEDURE: A 2.5x2.5-cm full-thickness section of skin was removed from the dorsal aspect of each limb at the midpoint of the metacarpus or metatarsus. Six days later, wounds were grafted with partial-thickness pinch grafts. Half the wounds were bandaged with amnion, and the other half were bandaged with a nonadherent dressing. Bandages were changed every 3 days until wound healing was complete. At each bandage change, numbers of grafts lost were recorded, and wounds were measured. RESULTS: Percentage of grafts lost from wounds bandaged with amnion was not significantly different from percentage lost from wounds bandaged with the nonadherent dressing. Median healing time for wounds bandaged with amnion (30 days) was significantly less than median healing time for wounds bandaged with the nonadherent dressing (39 days). All wounds were healed by day 45. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that amnion can be used for bandaging pinch-grafted wounds on the distal aspect of the limbs of ponies.

Amnion↗

PubMed1991

Radiographic assessment of splinting bandages.

The physical attenuation of X-rays by a variety of splinting bandages was measured and compared with the subjective opinion of nine radiologists. The radiolucency of the bandages and their interference with the interpretation of bony detail on radiographs (using a radiographic knee phantom) was assessed. Plaster-of-Paris (POP) bandages produced the greatest attenuation of X-rays and the greatest interference with interpretation of bony detail. All the polyurethane resin impregnated fabric bandages produced less attenuation than POP, but variations occurred due to the fabric type and knit of the bandage. The lowest attenuation occurred in those bandages using cotton, polyester or polypropylene fabric, and in all but one instance these caused least interference in radiographic interpretation. The exception was the polyester bandage, where the coarse knit of the fabric produced a large difference in X-ray beam absorption between the air spaces and the bandage. The distracting mesh pattern on the radiograph interfered with radiographic visualization. The glass fibre bandages caused intermediate attenuation, being better than POP but not as radiolucent as the non-glass fabrics.

Bandages↗

PubMedDate not supplied

The effect of pressure bandaging on complications and comfort in patients undergoing coronary angiography: a multicenter randomized trial.

OBJECTIVES: To determine the effectiveness of pressure bandaging in reducing bleeding and bruising in patients undergoing coronary angiography and to investigate the contribution that pressure bandages make to patient discomfort after angiography. DESIGN: A prospective multicenter, randomized study. SETTING: Three university hospitals in Melbourne, Australia. PATIENTS: One thousand seventy-five patients undergoing coronary angiography were randomized to receive a pressure bandage (N = 556) or no bandage (N = 519) after manual compression of the right femoral artery puncture site. RESULTS: Patients without pressure bandages had a higher incidence of bleeding (P < 0.05) and bled earlier (mean 2.4 hours; SD 3.6 hours) after catheter removal (P < 0.001) than patients with bandages (mean 5.3 hours; SD 3.8 hours). The incidence of bleeding in patients without pressure bandages was 6.7%. The incidence and extent of bruising was the same for both groups. Patients with pressure bandages experienced a higher incidence of back (P < 0.05), groin (P < 0.001), and leg pain (P < 0.001), nausea (P < 0.05) and urinary difficulty (P < 0.01). CONCLUSIONS: In view of the associated increase in patient discomfort and the delay in time of onset of bleeding, pressure bandages should not be used routinely in the management of patients after coronary angiography, especially in the context of early discharge from the hospital.

Adult↗

PubMed2026

Efficacy of an Adhesive Hydrocolloid Bandage on Wound Healing: Findings of a 28-Day, Single-Centre, Randomised, Controlled Study.

This single-centre, randomised, controlled study assessed the wound healing efficacy of adhesive bandages in eligible healthy adults (N = 36) aged 25-55 with Fitzpatrick skin types II and III using a model of laser-induced wounds. Here, we report data for wounds that were randomised to treatment with either a hydrocolloid bandage for multi-day use (BAND-AID Adhesive Bandage Hydroseal), standard of care (SoC) (BAND-AID Adhesive Bandage Tru-Stay Sheer) or an uncovered control. Primary endpoints included the time to complete healing and a composite wound healing score. Hydrocolloid bandage-treated wounds healed twice as fast as the uncovered control or SoC-treated wounds. Median time (days) to complete healing was significantly faster for the hydrocolloid bandage-treated wounds (6.9) versus SoC (11.9) and uncovered control (11.8). Hydrocolloid bandage-treated wounds had significantly better composite wound healing scores versus SoC and versus uncovered control over 2 weeks. At Day 28, cosmesis was better with hydrocolloid bandage treatment (0.3) versus SoC (0.6) and uncovered control (2.1) (change from baseline in a composite scar score; higher score = worse outcome). Multi-day wound occlusion with a hydrocolloid bandage promoted faster healing and improved cosmesis compared with daily SoC dressings or uncovered control.

Humans↗

PubMed2006

Class-3c compression bandaging for venous ulcers: comparison of spiral and figure-of-eight techniques.

AIM: This paper reports a study to compare the differences in compression produced on a limb using a spiral and a figure-of-eight bandaging technique. BACKGROUND: Chronic leg ulcers are a major health problem in Western countries. Compression bandaging is the accepted treatment for venous leg ulcers. The spiral and the figure-of-eight techniques are traditional methods of applying compression bandages. But their performance in terms of pressure profiles is unknown. Despite a lack of evidence about technique, class-3c compression bandages are not currently recommended for application in a figure-of-eight as this is thought to produce dangerously high pressure. METHODS: A cross-over experimental design was used with a sample of 26 nurse bandagers. Consistency of performance was tested. Bandage stretch and overlap were measured and analysed by standard deviation to ensure that the techniques were consistent and repeatable. Pressure probes were then applied to the medial, posterior and lateral aspects of the lower limb of a healthy volunteer. The class-3c compression bandage was applied using both techniques and the pressure profiles around the leg were measured under the bandage. The results of each technique were compared using independent sample t-tests. The data were collected in 1999. RESULTS: The figure-of-eight technique provided statistically significantly higher compression at lower areas of the leg than the spiral technique. Mean pressure difference was 20.3 mmHg at the ankle, 22.2 mmHg at the gaiter, 9.4 mmHg at the calf. The pressure differences decrease towards the knee with both techniques and decrease more steeply with the figure-of-eight technique. CONCLUSION: The spiral technique was a safe and comfortable method of bandage application. The figure-of-eight also provided graduated compression but with some high areas of pressure, notably overlying the Achilles tendon. However, before firm practice recommendations are made, replication of the study using a padding layer and a larger sample is needed.

Bandages↗

PubMed2003

How effective is training in compression bandaging techniques?

The aim of this review was to investigate whether formalized compression bandage training is required for nurses to achieve compression bandaging of high quality, that is bandaging which produces sustained graduation from toe to knee. Medline, CINAHL and Embase databases were used in the search. Randomized controlled trials and quasi-experimental trials were included where (at a minimum) nurses experienced in compression bandaging had their skills reviewed before and after training, and then reviewed once more at a later follow-up session. Three studies matched these criteria. In all three, nurses in general did not achieve sustained graduated compression before training, despite being defined as experienced bandagers. There was a substantial improvement in bandaging skills immediately following training. Two trials found that this improvement was sustained for between 2 and 4 weeks. The results of the third study suggested that improvements might not be sustained in the longer term. This review raises issues for further research including the current standard of compression bandaging, by those individuals who consider themselves competent in this skill. In addition, there needs to be argument on how nurses' bandaging skills can be improved and maintained, including the depth of role of feedback. In the meantime, nurses need to be as diligent as possible in maintenance of their compression bandaging skills, and the training they give junior staff. The effectiveness of current training cannot be assessed by short-term improvements and must not be assumed.

Bandages↗

PubMed2000

Ultrasound therapy for the prevention and correction of contractures and bone mineral loss associated with wing bandaging in the domestic pigeon (Columba livia).

Figure-of-eight wing bandaging is widely used to treat wing injuries, to immobilize wings before and after fracture repair, and during transient wing paralysis. However, prolonged bandaging can lead to bone loss and to contractures and reduced range of joint motion. Studies evaluating the efficacy of therapeutic ultrasound to reverse and prevent bandaging-associated contractures in pigeons (Columba livia) showed a significant increase in elbow and carpal extension after 10 twice weekly ultrasound treatments when started either 4 or 11 days after bandage placement. In addition, after 42 days of wing bandaging, three ultrasound treatments stimulated a faster reversal of carpal wing rotation loss than removal of the bandage over the 10-day treatment period. Finally, bone loss in response to 28 days of bandaging was significant, progressed at 2.8% per week, and was not affected by ultrasound treatment twice weekly during this period. Therefore, therapeutic ultrasound prevented and reversed loss of wing extension associated with figure-of-eight bandaging but did not lessen the disuse osteoporosis created by bandaging in these birds.

Absorptiometry, Photon↗

PubMed1983

The treatment of ankle sprain by bandaging and antiphlogistic drugs.

A prospective randomized investigation comprised 119 patients with ankle sprains, treated by the application of a layer bandage or elastic adhesive tape bandage. In addition, the patients received drug treatment as a double blind test: placebo, or oxyphenbutazone 100 mg or clonixin 300 mg three times daily. The drug study comprised 106 patients. Clinical examination and measurements of foot volume were carried out initially and 5-7 days after injury. The patients were asked to complete a follow-up questionnaire describing their symptoms and walking ability. No statistically significant difference was observed between the differently bandaged groups with regard to clinical findings and foot volume. Elastic adhesive tape bandage caused more complications, mainly compression, irritation of the skin or rash, compared with the layer bandage (p less than 0.05). Clonixin proved useful in controlling swelling and in the authors opinion gave the best clinical result. The bandages used in the study were tested in 20 patients by mechanically rotating the bandaged ankle under general or spinal anaesthesia. The layer bandage proved more stable in the lateral direction than the elastic adhesive tape bandage (p less than 0.001).

Adolescent↗

PubMed1986

Bandage backfall: labyrinthine and non-labyrinthine components.

A cataleptic animal clings in a vertical position, unmoving, for abnormally long periods by supporting some of its weight on its hindlegs, grasping with the forepaws, flexing its forelimbs, and holding the head horizontal. When the head is snugly wrapped with a bandage, the head slowly falls backward, the neck hyperextends, the forelimbs extend and the grasp is released, resulting in the animal falling backward to the ground. It was earlier suggested that in cataleptic animals, the bandage inhibits vestibular and kinesthetic mechanisms of head support, yielding the backfall sequence [35]. However, preliminary experiments showed that labyrinthectomized rats made cataleptic by haloperidol fall backwards when placed in a vertical clinging position, even without a bandage, suggesting that in the rat the bandage-backfall reaction depends only on the vestibular system. In the present paper, this result is verified but, by additional experiments, the latter conclusion is shown to be incorrect. In labyrinthectomized rats made cataleptic by other means (lateral hypothalamic damage, or bulbocapnine), backfall from clinging did not occur unless a bandage was applied. Therefore, the bandage does indeed appear to inhibit the kinesthetic mechanisms that maintain head support in labyrinthectomized cataleptic rats. Haloperidol, particularly in high doses, greatly weakens postural support in labyrinthectomized rats (causing the animal to sag down and fall back when clinging), although the effect is not detectable in rats with labyrinths intact. However, labyrinthectomy reveals that the bandage can trigger an active dorsiflexion of the neck which in itself appears to inhibit clinging and righting. Bandage-induced dorsiflexion is present to a much lesser degree in intact animals, indicating that labyrinthine mechanisms inhibit the dorsiflexion reflex. Therefore, in the intact, cataleptic rat the bandage backfall reaction appears to be produced by the combined effects of a passive component (inhibition of kinesthetic support mechanisms), and an active component (elicitation of dorsiflexion of the neck).

Animals↗

PubMed2000

The influence of 2 surgical bandage systems on wound tissue oxygen tension.

HYPOTHESIS: Local wound heating improves tissue oxygen tension in postoperative patients. SETTING: University hospital. PATIENTS: Forty normothermic and well-hydrated patients recovering from elective open abdominal surgery. INTERVENTIONS: A comparison between an experimental bandage system (Warm-Up; Augustine Medical Inc, Eden Prairie, Minn) and conventional gauze covered with elastic adhesive (Medipore Dress-it; 3M, St Paul, Minn). The experimental system is heated to 38 degrees C and does not touch the wound. MAIN OUTCOME MEASURES: Subcutaneous tissue oxygen tension was measured postoperatively and on the first postoperative day. In a subgroup, we also evaluated the effects of bandage pressure per se on tissue oxygen. RESULTS: Initial postoperative tissue oxygen tensions were approximately 30 mm Hg greater with the experimental bandage, even before warming. Subcutaneous oxygen tension during heating remained significantly greater in patients with the warmed bandage than the conventional elastic bandage (116 +/- 40 vs 85 +/- 34 mm Hg, respectively) while the patients were breathing approximately 50% oxygen. The difference was smaller on the first postoperative day, but still statistically significant (82 +/- 30 vs 65 +/- 22 mm Hg, respectively). In the subgroup analysis, tissue oxygen tension increased significantly by 12 +/- 4 mm Hg when the heating bandage was substituted for a conventional bandage (P<.001). CONCLUSION: In normothermic and well-hydrated surgical patients, much benefit from the heating bandage system appears to result from pressure relief. These data suggest that relieving wound pressure markedly improves tissue perfusion and oxygenation.

Abdomen↗

PubMed2004

Randomized clinical trial of four-layer and short-stretch compression bandages for venous leg ulcers (VenUS I).

BACKGROUND: A randomized clinical trial was undertaken to determine the relative effectiveness of four-layer and short-stretch bandaging for venous ulceration. METHODS: A total of 387 adults with a venous ulcer, who were receiving leg ulcer treatment either in primary care or as a hospital outpatient, were recruited to this parallel-group open study and randomized to either four-layer or short-stretch bandages. Follow-up continued until the patient's reference leg was ulcer free or for a minimum of 12 months. The primary endpoint was time to complete healing of all ulcers on the reference leg. Secondary outcomes included proportion of ulcers healed, health-related quality of life, withdrawals and adverse events. Analysis was by intention to treat. RESULTS: Unadjusted analysis identified no statistically significant difference in median time to healing: 92 days for four-layer and 126 days for short-stretch bandages. However, when prognostic factors were included in a Cox proportional hazards regression model, ulcers treated with the short-stretch bandage had a lower probability of healing than those treated with the four-layer bandage: hazard ratio 0.72 (95 per cent confidence interval 0.57 to 0.91). More adverse events and withdrawals were reported with the short-stretch bandage. CONCLUSION: Venous leg ulcers treated using a four-layer bandage healed more quickly than those treated with a short-stretch bandage.

Adult↗