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At least 19 recordsLinked to original sources
PubMed1975

Pressure measurements beneath below-knee amputation stump bandages: elastic bandaging, the Puddifoot dressing and a pneumatic bandaging technique compared.

Elastic wrap bandaging is unreliable and dangerous in terms of pressure and pressure distribution (tourniquet effect). The Puddifoot dressing is safe and is less likely to produce a tourniquet effect. The range of pressures it produces is low--possibly too low to achieve ideal moulding or oedema control. A pneumatic bandage achieved a relatively narrow range of pressures between capillary and arteriolar blood pressures. It minimized tourniquet effects and differences between skilled and unskilled bandagers. It is sufficiently promising to merit development.

Amputation Stumps↗
PubMed1997

The influence of bandage characteristics and inter-individual application variations on underneath bandage pressures.

INTRODUCTION:: Cohesive bandages are applied to the legs of racehorses and horses with limb injuries for protection (prevention of abrasion) and support (reduction of movement at the fetlock joint). The support capacity of all commercially available bandages has been questioned. Consequently, the protection aspect of bandaging and the negative side effects, which can be caused by bandaging (eg pressure induced ischemia with subsequent necrosis), were emphasized. High pressures underneath bandages were shown to cause reduced blood flow. Pressures underneath certain types of bandages were shown to be higher than under others. It is unclear if these differences were due to differences in material characteristics between the bandage types or caused by differences in application by the trainers. The purpose of this study was to determine (a) if differences between different types of bandages are observed if these are applied similarly and (b) if earlier observed differences in pressures underneath bandages are reproducible when wrapped by different trainers. METHODS AND MATERIAL:: (a) A wrapping machine for the application of bandages to an artificial joint (simulating the human knee joint) was designed and built. The machine allows to wrap bandages with adjustable, constant tension under well defined wrapping angles in order to simulate a wrapping technique similar to the wrapping by trainers. The artificial joint is equipped with two pressure sensors (Parotec, Germany). After bandage application, the artificial joint was placed in a specially designed testing machine and cycled through 200 cycles from 0 degrees to 90 degrees of flexion at a frequency of 0.5 Hz. Pressure data were collected at a frequency of 20 Hz. The force required to unwind the bandage from its core was measured with a material testing machine. Five samples each of four different 4" wide cohesive bandages were tested: 'E': high modulus latex, 'V': low mod. latex, 'C': low mod. latex, 'F': medium mod. laminate non-latex. All bandages were applied at manufacturer suggested tensions (50% intercept length). (b) Fifth-three trainers from the Kentucky Horse Center (Lexington, KY) and the Payson Park Training Facility (Indiantown, FL) volunteered for the study. They applied their favoured brand and a type 'F' bandage to an artificial horse limb. Underneath bandage pressures were collected using a pressure mat (Mikro Emed, Novel GmbH, Germany) placed over the fetlock joint. RESULTS AND DISCUSSION:: (a) Maximum pressures during maximum flexion underneath the type 'E' bandage (5.7+/-0.4 N/cm(2)) were significantly higher than for all other bandages (no difference between other bandages, range 3.5+/-0.6 to 4.0+/-0.4 N/cm). The unwinding force for the type 'F' bandage was significantly lower (10.1+/-5.5N) than for all other bandages (range 22.7+/-11.3 to 42.3+/-15.1N). (b) Trainers applied the type 'E' bandage significantly tighter than the other bandages (18.7+/-3.7 N/cm(2) vs a range of 7.5+/-5.4 to 10.4+/-6.1 N/cm(2)); a tendency was observed that the type 'F' bandage was applied looser than the type 'V' bandage. The results of part (b) of this study are consistent with the earlier study. Based on the results of part (a) of this study it can be speculated that (I) The high pressures underneath the type 'E' bandage are clearly due to its material characteristics, and (II) The differences between the other bandages are not caused by material characteristics but probably by the differences in unwinding force. If the unwinding force is higher than the force required to extend the bandage to 50% intercept length, trainers will probably wrap tighter as suggested and desired.

Journal Article↗
PubMed1998

Compression bandaging effects on lower extremity peripheral and sub-bandage skin blood perfusion.

Laser-Doppler blood perfusion was simultaneously measured on both great toes and the lateral upper-calf before and during fore-foot-to-knee compression bandaging of one test-leg in ten vascularly healthy female volunteers. Two bandaging methods were sequentially used separated by a 30 minutes interval. Bandage A consisted of a layer of zinc impregnated gauze and an elastic wrap; bandage B had the elastic wrap only. Sub-bandage pressures of the test-leg were measured at distal and proximal lateral below-knee standardized sites. The study purpose was to determine the effects of moderate compression pressure achieved for bandages A under and distal to bandaged regions. Initial (mean +/- sem_ sub-bandage pressure achieved for bandages A and B were similar, being respectively 32.9 +/- 2.8 and 28.4 +/- 3.9 mm Hg. Both bandages types were associated with significant reductions in test-leg toe blood perfusion amounting to 44.2 +/- 13.1 percent and 27.5 +/- 10.5 percent for bandages A and B respectively. Contrastingly, test-leg sub-bandage blood perfusion did not differ from its pre-bandage baseline mean level for either bandage type. These findings show that a widely used bandaging method and a slight variant each significantly reduces distal (toe) blood perfusion without reducing sub-bandage skin perfusion. Absence of sub-bandage perfusion decreases may be related to a partially compensating reflex vasodilatory response, but such effects if present are inadequate to prevent reductions in distal perfusion. These results reinforce the need for due care and risk-benefit consideration with respect to therapeutic compression levels.

Adult↗
PubMed1999

A comparison of sub-bandage pressures produced with two multi-layer bandaging systems.

Fourteen nurses with experience in the use of high-compression bandaging were asked to bandage the same limb with two different bandaging systems: the 'Charing Cross' four-layer regimen (System A), and a modified system incorporating two new bandages (System B). A sub-bandage pressure monitor was used to quantify the efficacy of the resulting bandaging for the two systems. The results indicated that there was no significant difference between site sub-bandage pressures achieved using the two bandaging systems. Sub-bandage pressure profiles, however, fluctuated with patient posture, the best profiles being obtained with System B and the patient in the sitting position.

Bandages↗
PubMed1993

[Conservative treatment of subcapital humerus fractures. A comparative study of the classical Desault bandage and the new Gilchrist bandage].

In a randomized prospective comparative study, we treated 28 patients with a fresh fracture of the proximal humerus alternating with a classical Desault-bandage or with the new Gilchrist-bandage. The two different bandages had no influence on the fracture healing or the functional end results. The Gilchrist-bandage was clearly superior to the Desault-bandage in a subjective and objective appreciation: the patients had less complaints in applying the bandage, had less skin irritations and felt less pain during the whole immobilisation period.

Adult↗
PubMed2002

Bandages and bandaging techniques for compression therapy.

Bandaging skills are essential for community nurses not only as a method of supporting joints, or retaining a dressing but also as an important treatment of leg ulceration. It is important to be able to choose the correct type, size, and composition of bandage and then apply it safely using the most appropriate technique, as incorrectly applied bandages may lead to pressure necrosis and subsequent limb amputation. Bandaging applications have changed little over the last 100 years and the two most commonly used techniques are still the spiral and the figure-of-eight methods. There are advantages and disadvantages of both, and successful bandaging depends on choosing the correct product and good technique, both in stretching the bandage to the correct tension, and ensuring proper overlap between layers.

Bandages↗
PubMed2001

Multicentre, randomised controlled trial of four-layer bandaging versus short-stretch bandaging in the treatment of venous leg ulcers.

BACKGROUND: Aim of the study was to compare the healing rates of venous ulcers obtained with four-layer bandages (4LB) versus short stretch bandages (SSB). DESIGN: Multicentre, randomised controlled trial performed in 5 centres of the Netherlands and in 2 centres in Austria ("PADS-study" = Profore Austrian Dutch Study). PATIENTS AND METHODS: 112 patients (53 treated with 4LB and 59 treated with SSB) completed at least one post-treatment follow-up, 90 completed the study. Bandaging and ulcer assessment was performed at weekly intervals. Randomisation was carried out for each centre and was stratified according to the size (more or less than 10 cm2) of the ulcerated area. Local therapy consisted of plain absorbing, non-adherent dressings. Time to complete healing was recorded up to a maximum of 16 weeks. The two treatment-groups were comparable regarding their baseline-characteristics. RESULTS: In total 33/53 (62%) of ulcer-patients were healed in the 4LB group, compared with 43/59 (73%) in the SSB group (difference 11%, 95% CI -28% to 7%). 77% of the ulcers with an initial area less than 5 cm2 healed as compared with 33% of the larger ulcers. The different healing rates in the centres could be explained by the different sizes of the treated ulcers. Based on Kaplan-Meier estimates the median healing time was 57 days for the 4LB (95% CI 47-85 days) and 63 days for the SSB (95% CI 43-70 days). CONCLUSION: The ulcer healing rate and the median healing time did not differ among the two types of bandages. The main discriminant criterion for healing was the initial ulcer size. In centres who are experienced users of short-stretch bandages, no statistically significant different healing rates of venous ulcers could be found after 4LB or SSB.

Adult↗
PubMed1998

Using a bandage pressure monitor as an aid in improving bandaging skills.

This prospective study used a bandage pressure monitor to assess the bandaging skills of 16 nurses caring for patients with venous leg ulcers. Baseline measurements showed that only 50% of the nurses demonstrated bandaging skills that were adequate to good. However, by the end of the feedback/post-training session, 81% of those examined had reached this standard and this figure rose to 86% on recall. These data seem to support the view that the use of a pressure monitor is a useful adjunct in the teaching of bandaging skills.

Bandages↗