Bandages for Specific Body Regions

Chest and breast bandaging

Applying fixing material to the breast region requires mandatory consideration of the affected side. The main rule: if the right breast is being bandaged, the turns are directed from left to right; if the left, from right to left.

The bandaging process consists of the following stages:

1. Fixation turn. The bandage is run in a circle around the chest strictly below the breast, creating a secure support.
2. Main stroke. Upon reaching the breast itself, the fabric gently encompasses its lower and inner parts, after which it is directed diagonally to the contralateral shoulder.
3. Descent. From the shoulder side, the bandage descends down the back to the axillary cavity.
4. Cycle completion. The material encompasses the lower and outer parts of the breast, after which a circular fixation turn is performed again.

These strokes are sequentially repeated until the anatomical region is completely and securely covered.

Immobilizing bandages for the shoulder girdle

Two classical schemes are used to fix the arm in case of clavicular or shoulder girdle injuries. Both solve the problem of securely pressing the limb to the torso, but differ in arm position and turn geometry.

Desault bandage

The patient bends the arm at a right angle and presses it against the torso. The scheme consists of a strict alternation of four turns:

• First turn: runs in a circle from the healthy side to the injured one, tightly pressing the arm to the chest.
• Second turn: starts from the healthy axillary region, ascends obliquely up the anterior surface of the chest to the injured supraclavicular region. Then it descends vertically down the posterior surface of the shoulder, crossing with the forearm.
• Third turn: the bandage is led through the affected forearm back into the axillary cavity on the healthy side.
• Fourth turn: from the healthy armpit, the fabric goes obliquely across the back to the injured shoulder girdle, descends down the injured shoulder, wraps around the elbow from front to back, and returns obliquely up the back into the healthy axillary cavity.

Velpeau bandage

Indicated for clavicular fractures and after reduction of a shoulder dislocation. In this case, the hand of the injured limb is placed on the healthy shoulder. Bandaging begins from the injury side:

• First turn: starts from the middle of the back, runs horizontally, encompassing the chest along with the arm, and goes into the axillary cavity on the healthy side.
• Second turn: passes across the back obliquely up to the injured shoulder girdle, completely wrapping around it.
• Third turn: descends strictly vertically down, catches the elbow from below, and is directed back into the axillary cavity on the healthy side.

Important rules: all three strokes are repeated multiple times. At the same time, each new horizontal turn must lie lower than the previous one, and each vertical one must shift medially from the previous one.

Fixation on the abdomen and pelvic region

Conventional circular wraps on the abdomen have a major drawback: they slip extremely easily during movements. To prevent this, it is strongly recommended to supplement the classic abdominal bandage with a spica bandage on the upper third of the thigh.

Technique of the pelvic spica bandage:

1. Initial fixing circular turns are formed around the abdomen. They must be located above the navel.
2. A descending turn is performed: the bandage is led from the lateral surface of the abdomen down to the inner surface of the thigh.
3. The fabric wraps around the thigh posteriorly, passes to the lateral (outer) surface, and rises forward onto the abdomen again.
4. The next turn completely repeats the previous complex contour, but is located slightly lower.
5. The process concludes with secure fixation — a final circular turn around the abdomen.

Depending on where exactly the bandage intersection is formed, such a bandage can be applied to the inguinal region, the upper third of the thigh, the perineum, the gluteal region, or performed on both sides simultaneously.

Bandages for the hand and fingers

The spiral technique is most commonly used to isolate injuries on the hand. It can be used both for a single finger and for the entire hand as a whole.

Spiral bandage on an individual finger:

• Bandaging always begins with a securing circular stroke on the wrist.
• Then the bandage is obliquely lowered across the dorsal surface of the hand directly to the end of the injured finger.
• Ascending spiral turns are formed from the end of the finger up to its base.
• Having completed covering the finger, the bandage is returned through the dorsal surface of the hand back to the wrist, where it is fixed with a circular stroke.

«Glove» bandage: If it is necessary to cover all the fingers of the hand, the exact same spiral technique is used, but the bandage strokes described above are sequentially repeated for each finger individually.

Class and exam questions

What else to study on this topic

• Variants of intersection displacement in the pelvic spica bandage (groin, perineum, buttocks).
• Features of turn alternation in the Desault bandage and control of forearm position.
• Technique of passing the bandage across the dorsal surface of the hand in the «glove» bandage.
• Specifics of fixing the descending turn to the inner surface of the thigh.

Other topics in "CHAPTER 10. GENERAL ISSUES IN TRAUMATOLOGY"

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.