The essentials of bandaging: $b including the management of fractures and dislocations, with directions for using other surgical apparatusHill, Berkeley
Science
The essentials of bandaging: $b including the management of fractures and dislocations, with directions for using other surgical apparatus
Hill, Berkeley
Bandages and bandaging; Dislocations -- Treatment; Fractures -- Treatment; Surgery, Minor
Step 3. The splints are next adjusted and moulded to the limb, being
temporarily secured by a few ends of bandage tied round them. One
assistant grasps the splints and foot at the ankle and keeps up
extension, while another holds the thigh. The surgeon then proceeds
to roll the bandages, first round the foot and ankle, and then up the
leg, rubbing in the _warm_ starch as he proceeds. Each turn of the
roller should be made as tightly as possible, for when the case dries
it always grows loose by the evaporation of the water it holds. As
reverses are always difficult to cut through afterwards, they should
be avoided, and the bandage laid on in simple spiral or figure of
8 turns. When the perinæum is reached, the surgeon wraps round the
pelvis a broad strip of cotton wool, while an assistant on each side
of the patient supports his body on a folded sheet or jack-towel, and
a third holds the broken limb. The bandaging is then continued in a
well-fitting spica, and ended by a few circular turns round the body.
If the splint touches the crest of the ilium it should be shortened
till it clears that point, or it will gall the patient afterwards.
A fold of soft lint in addition to the cotton wool should line the
splint at the perinæum, or the sharp edge of the bandage, when it is
dry, will chafe there also. When the first bandage is complete, the
limb should be smeared again with starch, and a dry bandage rolled
over it from below upwards, which must be similarly saturated with
starch as it is laid on the limb, and when finished the whole is well
covered with starch.
If the fracture is recent, and no union has taken place, a long
splint should be put on outside the case, fastened to the foot and
extended by a perineal band, while the starch is drying, that the
limb may not shorten. With children it is best to apply the wooden
splint in all cases, as they are apt to wriggle about, or sit up in
bed and disarrange the case while it is in a pliant condition. If
the wood splint is not used, the limb should be supported in a good
position by sand-bags laid along its sides.
[Illustration: Fig. 56.—Starch Bandage.]
In three days the starch is quite dry, but the drying may be hastened
by hot-water bottles or hot sand-bags laid in the bed. It must then
be cut up along the front from bottom to top; it will often be
found loose, especially where swelling had existed before; this is
best remedied by paring the overlapping edges with scissors. If any
projecting part is chafed, an accident that ought not to happen,
the case may be lifted from the sore part by a little more wool laid
around, _not on_ the part pinched. The limb being in a satisfactory
position, and the case fitting properly, a roller is carried up over
the whole to keep it in place while it is worn (fig. 56).
The patient need not now be confined to bed; on the contrary, the
limb should be supported by a sling round his neck, while he gets
about with crutches, if his leg be the part injured.
Public-domain text, read in full here on John Shaqi.
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