another wrap question

Brianna
on 6/17/06 7:19 pm - Lebanon, PA
I hate to be a pain, but how in the world do you all keep your heel covered??? I am supposed to wrap the entire leg/foot, from just below the toes to my knee, but I can't for the life of me find a way to wrap my heel and have it stay! It always slides up and bunches, re-wrapping at work is not an option.. when the therapist wraps it, it stays, and I thought I was doing it the same way, but obviously not
robert
on 6/18/06 8:10 am - gadsden, AL
I know how you feel -practice makes perfect they say and in this case it applies all to well. I had the same problem until at first too. I copied and pasted the message below in hopes it might help you. This is a question that is best shown to someone than tried to explain over a message bord - If possible bring all your wraps to the Doctor that showed you how to wrap and ask them to reshow you because your having problems. Sorry I can not be more helpful ... Lower Leg Bandaging The lower leg bandage is indicated on patients who are referred for lymphedema treatment but have mainly a venous insufficiency problem. It is easy to apply with a limited amount of bandages and this can be easily taught to a partner or caregiver. It will maintain excellent mobility for the patient since it is not affecting the knee joint. It is however essential to monitor the patient closely for any swelling starting right above the proximal edge of the bandage. This is why this is mainly used while the patient is still in treatment. It will usually require 4-5 rolls of compression bandage to effectively bandage the lower leg. All bandage techniques demonstrated assume no wounds on the extremities. Make sure to check for proper circulation in the toes throughout the application of the bandage. If the toes turn purple or cold, start over again. Step 1 Cover the lower leg with Stockinette, either tubular or flat. When using the flat material, use approximately 2 layers to cover the lower extremity. Have some extra overlap over the toes and over the knee. At a later stage this can be folded back for a more finished look. Step 2 Cover the lower leg with at least 2 layers of cast padding, applied in a spiral motion over the foot, a figure-8 over the ankle and a spiral motion over the rest of the lower leg, to just underneath the patella. Step 3 Anchor the smallest of the compression bandage (6cm width) over the fore foot. Next bring it behind the heel. Circle the fore foot again and go back behind the heel. Repeat this a total of 3 times. After the third time, come up from behind the heel and finish rolling the bandage over the lower leg with a herringbone technique. At this time make sure not to cover the anterior ankle, since having too much material will limit ankle motion and can be a cause of irritation. On the lower leg use a 2/3rd overlap, meaning that only 1/3rd of the bandage will stick out from underneath. Step 3a This step needs to be used for patients with more severe edema with significant foot involvement. For patients with more venous edema it can often be omitted. Adding this step will significantly thicken the bandage over the foot and therefore make it much harder for the patient to fit into a regular shoe. Wearing a regular closed shoe will act by itself as a compression factor. Start by circling the ankle in three steps, still ensuring not to cover the anterior ankle. After this, continue the bandage on the lower leg with the herringbone technique, maintaining 2/3rd overlap. Step 4 For this step use on size up, the 8cm wide bandage. Anchor at the forefoot, just as in step 3 and spiral up over the ankle. Make sure to only use 2 layers over the anterior ankle. Continue on the lower leg with a herringbone technique, maintaining 2/3rd overlap. Step 5 Start just above the ankle with the 10cm bandage, using the herringbone and while maintaining 2/3rd overlap. Step 6 Feel the bandage for firmness. Where the bandage feels softer to touch is where the next roll will start. Again, use a 10cm bandage, using the herringbone and maintain the 2/3rd overlap. This bandage should end right underneath the patella. If not, add another bandage roll to complete the compression bandage. Secure the bandage with 4-5 strips of tape. To finish the bandage off, the absorption material can be folded back and either taped to the bandage or folded underneath the last layer of compression material. If the extremity is wide or tall, use larger size bandages to accommodate the patient. For very large extremities use double-length rolls of compression bandages. These are available from different manufacturers in the wider sizes (10 and 12 cm). For patients with severe toe or finger involvement it may be necessary to also wrap these individually. Most authors use one or more rolls of gauze bandage for this purpose. Experience has shown that products such as Coban can be an excellent substitute for this. Cut the Coban in ¼ inch strips and gentle wrap these around the toes or fingers. The main advantage of using this material is that it significantly reduces bulk, which can be especially irritating between the toes.
robert
on 6/25/06 5:25 am - gadsden, AL
http://en.hartmann.info/EN/Home/Products/Therapeutic_blank_Bandages/article_55012.html this website has the answers you seek(ed) sorry it took a while to find it, Someone else found it and It was on another message board site I go to.
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