Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
+Spica Bandage of the Foot.+ In applying this bandage, the initial
extremity of the roller should be fixed just above the ankle and
secured by two circular turns; the bandage should then be carried
obliquely over the dorsum of the foot to the metatarsophalangeal
articulation; a circular turn around the foot should be made at this
point and the bandage continued upward over the metatarsus by making
two or three spiral reverse turns; it should then be carried parallel
with the inner or the outer margin of the sole of the foot, according
as it is applied to the right or left foot, directly across the
posterior surface of the heel, and from this point it should be
conducted around the outer border of the toe and over the dorsum,
crossing the original turn in the median line of the foot, thus
completing the first spica turn. These spica turns should be repeated,
gradually ascending, by allowing each turn to cover three-fourths of
the preceding one, until the foot is covered, with the exception of
the posterior portion of the sole of the heel; the turns should cross
one another in the medium line of the foot and should be kept parallel
throughout their course.
+Bandages for the Foot and Leg.+ Whenever possible the patient should be
kept in bed, or, at least, in the recumbent position with the leg
elevated, but when circumstances do not permit of this the veins can be
supported in various ways. Elastic stockings are excellent but
expensive, and not durable. Bandages of rubber cloth, or woven bandages
rendered elastic by the character of the mesh, or Martin’s plain rubber
bandage may be employed. The last named is put on smoothly but not too
tightly, for in walking the leg swells, so that a uniform pressure is
established. As the rubber prevents evaporation it acts like a wet
compress, stimulating the granulations, but very often producing eczema
around the ulcer. The rubber bandage should be washed carefully at night
with soap and cold water and must be kept clean. In one patient a firm
elastic stocking of vulcanized rubber will give the greatest ease and
comfort, while in another the resulting irritation will prove
unbearable. As regards the flannel bandage it has already been described
at some length.
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