PT 111 - N Chapter 6: Bandaging

PT 111_N
Chapter 6: Bandaging
Functions
● Used to support or stabilize a segment
● Restrict motion of a joint
● Control swelling, edema, or joint effusion when a dressing would not be required
● Sprain or strain
● Control Hemorrhage
● Prevent deformity
● Protect injured ares and for wound covering
Types of Bandages
1. Triangular and Cravat Bandages
• used for the temporary or permanent bandaging of wounds.
Immobilization of fractures and dislocations and as a sling for the
support of an injured part of the body.
Types of Bandages
Functions:
• Maintain and protect a dressing

• provide pressure
• maintain a splint
• provide support to a joint
• restrict motion
• control edema in an extremity
Types of Bandages
2. Roller Bandages
• used to hold dressings in place
• supports in injured part
• creates pressure for control of hemorrhage
• secures splints and immobilizes an injured part
• made of an elastic or non-elastic material formed in a cylindric roll and fabricated in
various widths and lengths
• most universally used bandage
Basic Techniques and Bandage Turns
1. Circular
• applied in a series of overlapping circular
• Encircle a part with each layer of bandage superimposed on the previous one.
• used only for anchoring a bandage
• provides greatest pressure of all types
2. Spiral
• Diagonal along the axis of each part each turn covering ½ the width of the preceding
one
3. Spiral Reverse
• Ascending and descending spiral turns applied with reverse turns when wrapping a
part with varying contours and dimensions
4. Recurrent Turns
• aka stump bandage
• direction is charged to 90 degrees and carried back and forth across the end part until
it is covered
5. Figure-of-eight
• Most widely accepted and commonly used technique
• Two spiral loops of bandage, one up and one down, crossing each other forming 8.
• Provides even greater compression around the joints
6. Spica
• Overlapping figure-of-eight
TYPES:
a. Ascending spica - begins with each turns directly over the joint and then steadily
fanning away from the joint.
b. Descending spica - starts distant from the joint and will finish its turn over the joint line
Lower Leg Spiral Bandage and Hip Spica
Shoulder Spica
Ankle/Foot Spica
WRAPS
TYPES:
1. Elastic
2. Self-adherent
3. Cloth
Objectives of Wrapping
• Provide compression to reduce effusion and swelling when treating and rehabilitating
injuries.
• Provide support and reduce range of motion when preventing, treating and rehabilitating
injuries.
• Secure pads when preventing and treating injuries.
• Secure dressings when treating wounds.

Types of Wraps
Elastic
• Provides compression to the extremities

• Use velcro fasteners, metal clips or tape to anchor the wraps.
• Can be reuse
• Made of cotton, rubber latex or
- Nylon in white and tan - Sizes: 2, 3, 4 & 6 inch;
Width: 5 yard length and 4 & 6 inch; Width: 10 yard length
- Cotton & Rubber latex – Sizes: 3 & 5 inch; Width: 11 yard length
Types of Wraps
Self-Adherent
• (+) elastic properties

• Ability to adhere to themselves without irritation to hair or skin.
• Provide adjustable compression
• Single use
• Sizes: 1, 1 ½, 2, 2 ¾ , 3, 4 & 6 inch; Width: 6 yard length
Types of Wraps
Cloth
• AKA ankle wraps

• Made of strong cotton weaves
• Size: 2 inch; Width: 36 or 72 yard length roll
• Prophylactic – prevent medial and lateral ankle sprains
• Provides mild support.
• Can be reuse
Recommendations for Wrap Application
Preparation:
• Determine the position of the patient.

• Provide support and reduction in range of motion position the joint in the ROM in which
the joint will be stabilized.
• Wraps applied directly to the skin or for cloth wraps, over socks as do not possess
adhesive properties.
Elastic Wraps
• Apply with firm, constant tension.
• Overlap each successive turn of the wrap by ½ of its width, while being careful to
eliminate gaps, wrinkles or inconsistent roll tension, which may cause skin irritation.
• Apply the compression in a distal-to-proximal sequence to assist in venous return. Never

cover the distal aspects of the extremities with the wrap. Keep the tips of the fingers and
toes visible and monitor for impairment of circulation.
Elastic Wraps (cont.)
• Anchor elastic wraps with Velcro fasteners, metal clips, or non-elastic

or elastic tapes.
• Place the end of the wrap and anchor on the dorsal or anterior aspect
of the body part for comfort and easy removal.
• Tear a 6-8 inch piece of tape and double the strip onto itself, leaving the adhesive mass
exposed on both sides.
• Place the strip(s) in a longitudinal position directly on the skin and then apply the wrap.
• When applying the first wrap or turn around the body part, fold the looses end over by
1/3 – ½ of the wrap’s width.
• When applying the next wrap or turn, cover the folded end and continue with the
technique.
• When wrapping technique is completed, apply the anchor partially on the wrap and
partially on the skin in an overlapping manner.
Self-Adherent
• Apply the wrap with firm and consistent tension, following body
contours.
• Anchoring does not require fasteners, clips or additional tape and

advantage of the wrap.
• Avoid gaps, wrinkles, or inconsistent roll tension.

Cloth
Removal of Wraps
• Remove elastic and cloth wraps by unwrapping the material after use.
• Use taping scissors to cut the tape anchors.
• Remove elastic sleeve by pulling it off the extremity a distal direction.
• Use taping scissors or tape cutters to remove self-adherent wraps.
• Wash and dry elastic and cloth wraps after each use and reuse.
Chapter 7: Taping
TAPES
• Preventing, treating and rehabilitating injuries
TYPES:
1. Non-elastic
Has an adhesive backing that can adhere directly
2. Elastic to the skin and other materials
3. Cast
Objectives of Taping
• Provide support and reduce range of motion in preventing injuries
• Provide support and reduce range of motion in treating and rehabilitating existing
injuries
• Secure pads in preventing and treating injuries
• Secure dressings in treating wounds

Tearing a Tape
Types of Tapes
Non-elastic
• Made of cotton and/or polyester with a zinc oxide adhesive mass backing.
• White – most commonly used; Size: ½, 1, 1 1/2 & 3 inch, Width: 10-15 yard lengths
• Quality: Determines the amount and durability of the adhesive backing and roll tension
Types of Tapes
Elastic
• AKA stretch tape

• White & Tan – most commonly used; Sizes: 1, 2, 3 & 4 inch, Width: 5 yard length
• Made of twisted cotton with adhesive backing
• Heavyweight ad lightweight designs
• Ability to conform to the contour of the body while providing support
Types of Tapes
Cast
• Fiberglass fabric containing a polyurethane resin that reacts to water and air causing a
chemical reaction.
• Semirigid or rigid types – conform to the contour of the body
• Size: 1, 2, 3, 4 & 5 inch, Width: 4 yard length
Recommendations for Non-elastic & Elastic Tape
Application
• Gather the equipment and supplies needed (adherent tape, pre-tape material, taping
scissors and various tapes, wraps and pads) prior beginning technique application.
• As s general rule, each technique begins and ends with anchor strips.
• To avoid gaps, overlap each strip of tape by at least ½ of its width.
• To avoid wrinkles, smooth each strip of tape with the fingers or hands as it is applied.
• Avoid gaps, wrinkles or inconsistent roll tension which may lead to skin irritations (cuts
and blisters).
• Follow the sequence of strips in each technique, avoiding multiple wraps or turns around
a muscle or joint.
• Exercise caution when applying tape on individuals with broken skin, rashes of the skin or
known allergies to taping materials.
Application of Non-elastic & Elastic Tape
• Individual positioned on the taping table or bench with the skin clean and dry.
• Begin taping techniques.
• Decide whether non-elastic or elastic tape will be applied directly to the skin or over
pre-tape material.
• Prior to taping apply adherent spray to lessen migration of the tape.
• Pre-tape/underwrap/prewrap should be thin and porous foam material on 3 inch rolls.
• Apply one layer of the material in an overlapping, covering the body area.
• Use thin foam pads over the bony prominences & high friction areas to reduce irritation
which can lead to cuts or blisters of the skin.
Removing Non-elastic & Elastic Tape
• On hand grasps the tape and pulls it across the skin while the other
hand pulls the skin in the opposite direction. Do not rip the tape from
the skin.
• Tape removal solvents in spray or liquid forms work as well. Apply the
solvent between the skin and tape to dissolve the adhesive.
• Taping scissors are designed with a blunt end to reach under the tape
and reduce the chance of damage to the skin.
• Tape cutters are molded plastic tools with a single-edged metal blade
located at the end.
• To remove the tape, slip the blunt end of the scissors or cutter under
the tape and cut in a proximal-to-distal direction away from the body.
Keep the scissors or cutter parallel to the skin, following the contour
of the body and avoiding bony prominences.
Application of Cast Tape
Equipment needed:
1. Gloves
2. Taping scissors
3. Water
4. Self-adherent wrap
5. Stockinet or Padding material
• Rigid Tape – applied following acute fractures
• Semirigid Tape - used when total immobilization is not required; often used in athletic
setting.
• Applied over stockinet and soft cast padding, Gore-Tex padding or self-adherent wrap.
Rigid Tape
• Apply over one layer of stockinet placed directly on the skin and covered with 2-3 layers
of soft cast padding material.
• Protect the padding material under the cast tape from excessive moisture to prevent skin
maceration and itching or Gore-Tex padding.
Recommendations for Cast Tape Application
• Wear examination or surgical gloves coated with petroleum jelly or silicone to protect the
hands from tape resin and prevent the tape from adhering to the gloves during
application
• Open the sealed foil pouch and remove the roll of tape. Most rigid and semi rigid tapes
require immersion in water of 70-75 degrees Fahrenheit to begin the chemical reaction.
~3-5 mins is allowed to apply, mold shape or circular pattern with slight roll tension.
• Overlap each layer by 1/3 to ½ of the width of the tape.
• Avoid gaps, wrinkles, inconsistent roll tension or direct contact of the tape with the skin
to lessen irritation.
Recommendations for Cast Tape Application
• Use taping scissors to make partial cuts in the material to fit the contours od the body.
Pad bony prominences to lessen the occurrence of irritation.
• Place the last 8-10 inches of tape on the body without roll tension. Smooth and mold the
tape to the body part with the hands to achieve adhesion of the layers.
• ~10-15 mins after removal of the tape from its pouch, curing is complete.
Removing Semi-rigid & Rigid Tape
• Semirigid – uses taping scissors or cast saw and spreaders or unwrapping.
• Rigid – uses cast saw, cast spreaders and scissors

Thank you for listening!
Reference:
Orthopedic Taping, Wrapping, Bracing & Padding by Joel W. Beam

PT 111 - N Chapter 6: Bandaging

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PT 111_N

• Maintain and protect a dressing

• Secure pads when preventing and treating injuries.

• Secure dressings when treating wounds.

• Provides compression to the extremities

• (+) elastic properties

• AKA ankle wraps

• Determine the position of the patient.

• Apply with firm, constant tension.

• Apply the compression in a distal-to-proximal sequence to assist in venous return. Never

• Anchor elastic wraps with Velcro fasteners, metal clips, or non-elastic

Elastic Wraps (cont.)

• Anchoring does not require fasteners, clips or additional tape and

• Avoid gaps, wrinkles, or inconsistent roll tension.

• Use taping scissors to cut the tape anchors.

• Remove elastic sleeve by pulling it off the extremity a distal direction.

• Use taping scissors or tape cutters to remove self-adherent wraps.

• Secure pads in preventing and treating injuries

• Secure dressings in treating wounds

• AKA stretch tape

• Overlap each layer by 1/3 to ½ of the width of the tape.

• Rigid – uses cast saw, cast spreaders and scissors

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