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GIFT OF
Pacific Coast

PRACTICAL BANDAGING

INCLUDING

ADHESIVE AND P^ASTER-OF-PARIS
DRESSINGS v ,;i\\

ELDRIDGE L. ELIASON, A.B., M.D.,

ASSISTANT INSTRUCTOR IN SURGERY IN THE UNIVERSITY OF PENNSYLVANIA MEDICAL SCHOOL;
ASSISTANT SURGEON. UNIVERSITY OF PENNSYLVANIA HOSPITAL; ASSISTANT SURGEON,

HOWARD HOSPITAL; MEMBER OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA.

155 ORIGINAL DRAWINGS AND PHOTOGRAPHS

PHILADELPHIA AND LONDON
J. B. LIPPINCOTT COMPANY

GIFT PACIFIC COAST JOURNAL
OF NURSING TO HYGEINE DEPT.

Electrotyped and Printed by J. B. Lippincott Company
The Washington Square Press, Philadelphia, U.S.A.

mouoor

To
PROF. EDWARD MARTIN, A.M., M.D.

TO WHOSE EXAMPLE, AID AND
PRECEPT THE AUTHOR OWES MUCH

743534

PREFACE

THIS work has been written for students and nurses, and
for that reason has been made as simple and non-technical as
possible. An endeavor has been made to clear up a number
of points in the application of bandages, that have been more
or less indefinitely presented heretofore. All the recognized
classical bandages in common use are described. In addition,
however, the author has added paragraphs or illustrations
of methods or turns which have been found more efficient
in his experience. An effort has been made to have the illus-
trations absolutely correct and for this reason all the draw-
ings were made from a model dressing.

Some of the illustrations are retained as photographs, thus
hoping to make the impression more realistic and lasting.

Due to the increasing usage of gauze bandage the plia-
bility of which covers a multitude of sins, there is a tendency
to neglect the fundamental principles of bandaging. One
should remember that every bandage properly applied takes
less material, retains its place better and gives a much better
impression, than one improperly applied.

One chapter is given up to the miscellaneous bandages and
dressings and includes handkerchief bandages, cravats, slings,
swathes and various especially constructed dressings in more
or less common use.

A short chapter handles in a brief manner rubber or
elastic bandages and their substitutes.

Chapter IV treats in detail the question of adhesive
plasters, describing the various types, their storage, applica-
tion and removal. Illustrations show the various dressings
employed.

PREFACE

The last chapter discusses plaster of Paris in all its
phases. The reader is shown every step from the making of
the individual plaster bandage to the application of the com-
pleted dressing in its many forms and finally its removal.

This work is meant merely to describe the various dress-
ings and their application. No attempt has been made to
consider the indications for such dressings.

THE AUTHOR.
PHILADELPHIA, JULY, 1914.

CONTENTS

PART I
ROLLER BANDAGES PAGK

FUNDAMENTAL FACTS t

PREPARATION OF BANDAGES 2

How TO ROLL BANDAGES 3

STARTING BANDAGES 5

REQUISITES OF A BANDAGE 5

ENDING A BANDAGE 6

FUNDAMENTAL TURNS OR BANDAGES 6

SPIRAL OF FINGER 10

SPIRAL REVERSE OF THE FINGER 10

DEMIGAUNTLET BANDAGES 12

GAUNTLET BANDAGE 12

SPICA OF THE THUMB 15

SPIRAL REVERSE OF UPPER EXTREMITY 15

SPICA OF THE SHOULDER 16

SPIRAL REVERSE OF THE LOWER EXTREMITY 17

SPIRAL OF THE FOOT COVERING THE HEEL 19

SPICA OF THE FOOT 21

FlGURE-OF-8 OF THE LEG 22

SPICA OF THE GROIN 25

DOUBLE SPICA OF THE GROIN 29

CROSSED BANDAGE OF THE PERINEUM 31

POSTERIOR FiGURE-OF-8 OF SHOULDERS AND BACK 33

ANTERIOR FIGURE-OF-S OF SHOULDERS AND CHEST 34

SUSPENSORY OF THE BREAST 34

SUSPENSORY OF BREAST : 36

SUSPENSORY OF BOTH BREASTS 37

FlGURE-OF-8 OF THE BREASTS (KlWISCH) 38

DESAULT 38

DAVIS BANDAGE 41

VELPEAU (MODIFIED) 42

VELPEAU MODIFIED (DULLES) 46

FlGURE-OF-8 OF THE HEAD AND NECK 47

BARTON BANDAGE 47

GIBSON BANDAGE 48

OBLIQUE OF THE JAW 49

DOUBLE OBLIQUE OF THE JAW 50

RECURRENT OF THE SCALP 51

vii

CONTENTS

TRANSVERSE RECURRENT OF THE SCALP. . . : 52

RECURRENT OF SCALP WITH DOUBLE ROLLER 52

MONOCLE OR CROSSED BANDAGE OF ONE EYE 53

BINOCULAR OR CROSSED BANDAGE OF BOTH EYES 54

PART II
MISCELLANEOUS BANDAGES

TAILED BANDAGES 55

PERINEAL " T " BANDAGE 55

PERINEAL BANDAGE (CUNNINGHAM) 56

THE " T " BANDAGE OF THE SCALP 57

THE " T " BANDAGE OF THE EYE 57

THE " T " BANDAGE OF THE EAR 58

THE DOUBLE " T " OF THE CHEST 59

THE FOUR-TAILED BANDAGE OF CHIN 60

FOUR-TAILED BANDAGE OF THE NOSE AND UPPER LIP 60

QUADRANGLE BANDAGE OF OCCIPUT 61

QUADRANGLE BANDAGE OF THE VERTEX 61

QUADRANGLE BANDAGE OF NECK 61

QUADRANGLE BANDAGE OR SLING OF THE SHOULDER 61

QUADRANGLE BANDAGE OR SLING OF ARM AND FOREARM 62

MANY TAILED BANDAGES (SCULTETUS) 63

SWATHES 63

HANDKERCHIEF BANDAGES 65

OCCIPITOFRONTAL TRIANGLE 66

FRONTO-OCCIPITAL TRIANGLE 66

BITEMPORAL TRIANGLE 66

VERTICOMENTAL TRIANGLE 66

AURICULO-OCCIPITAL TRIANGLE 67

THE TRIANGLE OF THE HEAD 67

SQUARE CAP OF THE HEAD 68

POSTERIOR TRIANGLE OF SHOULDERS 70

THE THORACICOSCAPULAR TRIANGLE 70

THORACICOHUMERAL TRIANGLE 71

TRIANGLE SUSPENSORY OF THE BREASTS 71

BRACHIOCERVICAL TRIANGLE (a) 71

BRACHIOCERVICAL TRIANGLE (b) 72

BRACHIOSCAPULAR TRIANGLE (a) 73

BRACHIOSCAPULAR TRIANGLE (b) 73

MAYOR'S BANDAGE 74

MODIFICATION OF MAYOR'S BANDAGE 75

SHOULDER TRIANGLE 75

HAND TRIANGLE 76

ANTERIOR PELVIC TRIANGLE 76

CONTENTS ix

POSTERIOR PELVIC TRIANGLE 76

SCROTAL HAMMOCK 76

SCROTAL TRIANGLE 78

SCROTAL SQUARE 78

GLUTEAL TRIANGLE 78

INGUINAL TRIANGLE 78

TlBIOCERVICAL SLING 78

KNEE TRIANGLE 79

FOOT TRIANGLE 79

CRAVATS 79

PART III
ELASTIC BANDAGES

MARTIN'S RUBBER BANDAGE 80

ELASTIC WEBBING 81

ESMARCH TUBE OR TOURNIQUET 81

ELASTIC FABRIC BANDAGE 81

UNNA'S DRESSING 81

PART IV
ADHESIVE DRESSINGS

SURGEON'S ADHESIVE PLASTER 83

" ZO " ADHESIVE PLASTER 83

JANUS ADHESIVE PLASTER 83

DE LA COUR'S ADHESIVE PLASTER 83

ISINGLASS PLASTER 84

ABDOMEN 86

UMBILICUS 87

SHOULDER (SAYRE DRESSING) 88

SAYRE MODIFIED 89

ACROMIOCLAVICULAR JOINT 9O

TAPED ADHESIVE (MONTGOMERY STRAP) 92

CATHETER STRAPS 92

DUMB-BELL ADHESIVE STRAP 92

LACED ADHESIVE 92

SPLINTS 93

FURUNCLE CONE 93

BACK 93

STIRRUP EXTENSION STRAP (BUCK'S EXTENSION) .' 94

ANKLE 95

CHEST 96

KNEE 98

LEG 98

INGUINAL DRESSING 99

x CONTENTS

ACHILLES TENDON 99

THE TESTICLES 100

ADHESIVE SUSPENSORY 100

PELVIC BINDER 101

PART V
PLASTER-OF-PARIS OR GYPSUM BANDAGES

GENERAL CONSIDERATIONS 102

APPLICATION OF A PLASTER CAST 103

METHOD OF REMOVING A PLASTER CAST 106

FENESTRATION OF CASTS 108

AMBULATORY CASTS 109

SEGMENTED OR BRACKET CASTS no

PLASTER SPLINTS no

BAVARIAN SPLINT 1 12

PLASTER JACKET 113

PLASTER SPICA OF THE LOWER EXTREMITY 1 15

PLASTER SHOULDER CAP 1 18

SODIUM SILICATE (LIQUID GLASS) 119

STARCH BANDAGE 1 19

ILLUSTRATIONS

1. Roller Bandage, a, Single; b, Double i

2. Bandage Roller 2

3. Rolling Bandage by Hand 3

4. Method of Holding a Bandage 4

5. Circular Turns of a Bandage 5

6. Oblique Fixation of a Bandage 5

7. a, Slow Spiral Turns; b, Rapid Spiral Turns 7

8. 9. Spiral Reverse 8

10. Figure-of-8 Turns (Ascending Spica) 9

11. Figure-of-8 Turns (Descending Spica) 9

12. Recurrent Turns 10

13. 14, 15. Spiral Reverse of Finger 1 1

16. Demigauntlet Bandage 12

17. Gauntlet with Spiral of Ring Finger 12

18. Spica of the Thumb (Ascending) 13

19. Spica of the Thumb (Descending) 13

20. 21. Spiral Reverse of the Upper Extremity 14

22. Spiral Reverse of the Upper Extremity 15

23. Spica of the Shoulder 17

24. Spica Loops of the Shoulder 17

25. Spiral Reverse of Lower Extremity 18

26. a, Spiral of Foot Covering the Heel; b, Second Stage 20

27. Spiral of Foot Covering the Heel 20

28. Spica of the Foot (First Step) 21

29. Spica of the Foot 21

30. Figure-of-8 of the Leg (Method i) 22

31. Figure-of-8 of the Leg (Method 2) 23

32. Figure-of-8 of the Leg (Method 3) 24

33. Figure-of-8 of the Leg 26

34. Spica of the Groin (First Turn) 27

35. Spica of the Groin 27

36. Spica of the Groin 28

37. Spica of the Groin (Ascending) with Oblique Fixation 29

38. Spica of the Groin (Descending) with Oblique Fixation 29

39. Double Spica of the Groin (First Turn) 30

40. Double Spica 30

41. Crossed Bandage of Perineum (First Turn) 31

42. Crossed Bandage of Perineum 31

ji ILLUSTRATIONS

43. Crossed Bandage of the Perineum 32

44. Posterior Figure-of-8 of the Shoulders and Back 33

45. Suspensory of the Breast (Right) 34

46. Suspensory of the Breast .. . 35

47. Suspensory of the Breast 36

48. Suspensory of Both Breasts 37

49. Figure-of-8 of the Breast 38

50. Figure-of-8 of the Breast 39

5 1 . Desault Bandage 40

52. Davis Bandage 41

53. Velpeau (Start) 42

54. Velpeau 43

55. Velpeau (Side View) 44

56. Velpeau (Posterior View) 45

57. Velpeau (Modified) 45

58. Velpeau Modified (Dulles) 46

59. Figure-of-8 of the Head and Neck 47

60. Barton Bandage 47

61 . Gibson Bandage 48

62. Oblique of the Jaw (Reverse Side) 49

63. Oblique of the Jaw (Right Side) 49

64. Double Oblique of the Jaw 50

65. Recurrent of the Scalp (First Step) 51

66. Recurrent of the Scalp 51

67. Transverse Recurrent of the Scalp (First Steps) 52

68. Recurrent of the Scalp with Double Roller 53

69. • Crossed Bandage of the Eye 54

70. Crossed Bandage of Both Eyes 54

MISCELLANEOUS

71. a, " T " Bandage; b, Four-tailed Bandage 55

72. " T " Bandage of the Perineum 56

73. Modified " T " Bandage of the Perineum 56

74. Modified " T " Bandage of the Perineum 57

75. " T " Bandage of the Scalp 58

76. " T " Bandage of the Eye 58

77. " T " Bandage of the Ear 58

78. " T " Bandage of the Groin 59

79. " T " Bandage of the Buttock 59

80. Double " T " of Chest 59

81. Four-tailed Bandage of the Chin 60

82. Four- tailed Bandage of the Nose and Lip 60

83. Quadrangle Bandage of the Occiput 61

84. Quadrangle Bandage of the Vertex 61

85. Quadrangle Bandage of the Neck 62

ILLUSTRATIONS

86. Quadrangle Bandage of the Shoulder 62

87. Quadrangle Bandage of the Arm and Forearm 62

88. Many Tailed Bandages 63

89. Swathe 64

HANDKERCHIEF BANDAGES

90. a, Handkerchief; b, Cravat 1 65

91. Occipitofrontal Triangle 66

92. Fronto-occipital Triangle 66

93. Bitemporal Triangle 67

94. Verticomental Triangle 67

95. Auriculo-occipital Triangle 68

960. Hunter's Cap 68

966. Hunter's Cap 68

970. Square Bandage of the Head (Method i) 69

97&. Square Bandage of the Head (Method 2) 69

97c. Square Bandage of the Head (Method 3) 69

98. Posterior Triangle of the Shoulders 70

.99. Thoracicoscapular Triangle 7°

100. Thoracicohumeral Triangle • 71

101. Triangle Suspensory of the Breast 71

102. Triangle Suspensory of Both Breasts 72

103. Brachiocervical Triangle or Sling 72

104. Brachiocervical Triangle Sling 72

105. Brachioscapular Triangle Sling - 72

106. Brachioscapular Triangle Sling 73

107. Brachioscapular Triangle Sling 73

108. Brachioscapular Triangle Sling 74

109. Mayor's Bandage 74

1 10. Modification of Mayor's Bandage 75

in. Shoulder Triangle 75

1 12. Hand Triangle 76

1 13. Anterior Pelvic Triangle 76

114. Scrotal Hammock 77

115. Scrotal Hammock 77

116. a, Knee Triangle; b, Foot Triangle 78

1 170. Rubber Bandage 80

1 176. Elastic Fabric Bandage 80

H7c. Esmarch Tourniquet 80

118. Heating Adhesive Plaster 84

1 19. Removing Adhesive Strips 86

I2oa. Rose Binder Pattern 87

I20&. Rose Binder Being Applied 87

I2oc. Rose Binder (Posterior View) 88

ILLUSTRATIONS

I2od. Rose Binder (Anterior View) 88

121. Sayre Dressing Modified 89

122. Acromioclavicular Support 90

123. Adhesive Dressings 91

124. Back Strapping 93

125. Buck's Extension 94

126. Ankle Strapping 95

127. Chest Strapping 97

128. Knee Strapping 98

129. Inguinal Dressing 99

130. Achilles Tendon Strapping 100

131. Pelvic Binder 101

PLASTER

132. Making Plaster Bandages 102

133. Method of Squeezing Water from Bandage 104

134. Instruments for Removal of Plaster Casts 107

135. Removal of Cast 108

136. Fenestration of Cast 109

137- Segmented or Bracketed Cast no

138. Making Plaster-of- Paris Splint in

139. Making a Plaster Splint of Flannel 112

140. Plaster Splint 113

141. Moulding and Binding in Position 113

142. Plaster Splints Removed 114

143. Patient Suspended for Application of Plaster-of- Paris Jacket. ... 114

144. Plaster Jacket 114

145. Showing the Application of a Plaster Spica of the Groin. Using

the Martin-Eliason Sling 1 16

146. Cast Completed and the Patient is Being Placed in Bed 117

147. Plaster Shoulder Cap 1 18

PRACTICAL B ANJD AQING

INCLUDING

ADHESIVE AND PLASTER-OF-PARIS
DRESSINGS

PART I

ROLLER BANDAGES

Fundamental Facts. — A roller bandage is a strip of
material of any width or length rolled upon itself to form
a compact body. It may be rolled from one end, single roller
(Fig. i, a), or both ends, double roller (Fig. i, b). When
the word bandage is spoken of unqualified, a single roller is

FIG. i. — Roller bandage, a, single; 6, double.

meant. The roller has an upper and lower edge, an inner and
outer surface, a body, an initial or free end, and a terminal
or hidden end.

The purposes of a bandage are to retain dressing, to render
support, and to make compression.

The material composing the bandage depends on the pur-
pose of the bandage. Bandages for retaining dressings are of

2 PRACTICAL BANDAGING

gauze or muslin. Gauze is oftenest used as it is soft and
pliable and lends itself easily to the shape of the part covered.
Flannel and sheet wadding are used for protective dressings,
as, for .cxailip'IeV beneath plaster of Paris. Crinoline or tar-
latan is used in the production of the comnion plaster-of-Paris
bandages for fixation dressing or " cast " of a permanent
nature, as for fractures and dislocations. Elastic bandages

FIG. 2. — Bandage roller.

are employed for compression either as a tourniquet or for
general uniform pressure, as in treatment of leg ulcers, vari-
cose veins of leg, joint affections, shock and hemorrhage.

Preparation of Bandages. — Commercial bandages of any
description may be obtained from almost any drug store or
surgical supply house. They may be bought, if so desired,
put up in sterile packages. Should it be desired to make one's
own bandages a length of the desired material is procured

ROLLER BANDAGES

and the selvage removed. The width is now divided at the
extremity into the desired bandage width and each strip torn
down about a foot. The alternate strips are then pulled
separate ways tearing the entire length of the piece of ma-
terial. Cutting the strips gives a neater bandage. The
material, folded into several layers, the top layer marked
off into bandage widths with a pencil, is cut along the lines,
with heavy scissors.

FIG. 3. — Rolling bandage by hand.

How to Roll Bandages — Bandages are rolled on a ma-
chine, the bandage roller, or by hand.

By Machine. — By the use of the bandage roller (Fig. 2)
the bandage can be rolled in a very short time. It is a small
winch, which is fastened to the table. The bandage is fed
through the guide bars, moistened on its end and wound
around the smaller end of the winch rod. It is then slid over
to the increasing diameter of the rod until it sticks fast.
When the entire bandage is rolled, the roll is grasped tightly
with the left hand and the winch turned two or three times,

4 PRACTICAL BANDAGING

thus tightening the roll. Back the winch rod three or four
turns and withdraw from the roll.

By Hand (Fig. 3). — Eighteen inches at one end of the
bandage is folded repeatedly on itself until the reduplicated
portion is three or four inches long. This is now tightly
rolled by a finger and thumb until the roll is large enough and
firm enough to withstand a fair amount of pressure in the
direction of its long axis, without bending, between thumb
and forefinger. Grasp the roll between the thumb and index
finger of the left hand, the body of the roll being beneath and
the free end passing over the index finger, between it and the

FIG. 4. — Method of holding a bandage.

thumb, of the right hand. Holding the roll firmly with the
left hand, allowing free portion of bandage to slip through the
right hand, supinate both hands, then, grasping roll between
the thumb eminence and fourth and fifth fingers of the right
hand, release pressure of the left finger and thumb pronating
both hands. Repetition of these movements rolls the bandage.
Rolling a bandage may also be accomplished on one's thigh
or on a flat surface, placing the rolled portion of the bandage
on the flat surface between it and the flexor surface of the
tips of the fingers. By gentle pressure the fingers are pushed
forward in the direction of the free end of the strip lying
extended beyond, thus rolling the bandage on itself. The
bandage when rolled should be tight, with even edges, and
free from ravellings.

ROLLER BANDAGES 5

Starting Bandages.— Grasp roller with body uppermost
( Fig. 4 ) , in right hand, with three or four inches of free end.
Apply this initial extremity smoothly on the part and, holding
the end firmly against the part, allow roller to run to the
right around the part to the back when it is transferred to the
left hand, the right hand now fixing the initial extremity.
The left hand brings the roller front where it again is taken
by right hand and the second turn begun, exactly overlaying
the first in order to " fix " the initial extremity. These turns

FIG. 5.— Circular turns of a bandage. FIG. 6.— Oblique fixation of a bandage.

are called simple or circular turns and should be placed at
the point of the least diameter of the part bandaged (Fig. 5),
(i.e., at ankle or wrist, rather than at mid-calf or mid-fore-
arm). The initial extremity may be fixed by the oblique
method also, as shown in (Fig. 6).

Requisites of a Bandage. — The desired result should be ac-
complished with the least turns possible. All similar turns
should, as far as possible, have the same distance between
them, and their edges as near parallel as possible. Each turn
must be evenly and firmly applied, showing no wrinkles or

6 PRACTICAL BANDAGING

ravellings or gaps between turns. The surface of the band-
age must lie flat on the part bandaged. If applied too loosely
the bandage displaces easily. If applied too tightly it is un-
comfortable and may obstruct the blood supply causing swell-
ings, discoloration, numbness and tingling, pallor, coldness
or subsequent gangrene if tight enough to shut off blood
supply. In applying turns near a joint care should be taken
to have the joint in the position in which it is to remain after
the dressing is completed. Special care must be taken with
regard to bony prominences that they are well protected from
pressure by the interposition of cotton. Skin surfaces ought
never to be bandaged in direct contact. Always interpose
gauze or lint whenever possible. Leave some portion of the
part distal to the bandage exposed whenever possible, in order
that the circulation may be watched. In applying a simple
circular bandage around a cylindrical part, place the initial
extremity at right angles to the axis of the part. In case one
bandage is too short for the dressing, confine the distal ex-
tremity by one or two fixation turns of a second bandage,
and then proceed as before.

Ending a Bandage. — After the application is completed,
the distal extremity may be secured by a pin, adhesive strips,
sewing, or splitting the end of the bandage for a distance
of more than half the diameter of the part and passing the
ends around in opposite directions and tying. Should none
of these methods be feasible, simply tuck the end of the band-
age under the last turn applied.

Fundamental Turns or Bandages — A circular bandage is
applicable to cylindrical parts, the turns being applied at
right-angles to the long axis of part and each turn exactly
overlapping the preceding ( Fig. 5 ) .

A spiral bandage covers a part in a spiral manner. Begin-
ning with a circular turn to fix the bandage, it is then carried
slightly upward and spirally around the part, each turn

ROLLER BANDAGES

paralleling the preceding one
which it overlaps from one-half
to two-thirds its width. The
spiral bandage may be ascend-
ing or descending depending
upon whether the succeeding
turns approach or recede from
the trunk. The ascending
spiral is the one generally em-
ployed. A slow spiral covers
a conical part slowly, leaving *
no gaps (Fig. 7, a). A rapid
spiral proceeds up the part
rapidly, leaving gaps between
turns (Fig. 7, b).

A spiral reverse bandage is
used under those conditions
where the shape of the part to
be covered is that of a rapidly
increasing cone. Here, in order
to have the bandage lie flat,
and yet permit no gaps, the
direction of spiral turns must
be changed. The reverse ac-
complishes this and is made
as follows : When in the appli-
cation of spiral turns, a point
is reached where by reason of
the increased conical shape of
the part, the bandage, in order
to lie flat and not lose its
parallelism to the last turn, or
to prevent gaping, must be
reversed, then the body of

PIG. 7. — a, slow spiral turns; 6, rapid
spiral turns.

PRACTICAL BANDAGING

the bandage is unrolled five or six inches, the thumb of
the left hand is placed on the upper edge of the last turn, and
held firmly to prevent loosening (Fig. 8). Relax the pull
with the right hand, approximating the part and at the same
time pronate the hand, thus turning over or reversing the
body of the bandage. Carry the bandage directly down

FIGS. 8 and 9. — Spiral reverse.

the long axis of the limb and then obliquely to the
right until the turned upper edge meets the left thumb
(dotted line in Fig. 8). Pass the roller around the
limb (Fig. 9) the lower edge overlapping one-half the
previous roll. It is then grasped by the fingers of the left
hand, the left thumb still remaining at the reverse. Now

ROLLER BANDAGES 9

give gentle traction to settle the reverse in place. Reverses
are always made toward the operator or toward the smaller
end of the cone and should not be employed unless needed.

Figure-of-8 turns are the ones most used in bandaging.
The bandage consists of two loops made in the form of an
eight (8) and are usually employed in covering a joint or in
place of a spiral reverse. When a number of figure-of-8
turns are applied, each a little higher or lower, overlapping a
portion of each preceding turn, so as to give an imbricated

FIG. 10. — Figure-of-8 turns. (Ascending
spica.)

FIG. ii. — Figure-of-8 turns. (Descending
spica.)

appearance it is called a spica (Fig. 10). The spica -is ascend-
ing (Fig. 10) or descending (Fig. n) depending upon
whether the turns proceed up or down the part.

Recurrent turns are used to cover the scalp (Fig. 12),
stumps, and extremities. First, fix the initial extremity by
circular turns, then reverse and pass backward and forward
over the part to be covered, applying the first turn over the
centre and each succeeding turn alternating on each side.
Complete the bandage by reversing after the last recurrent
turn and applying two or three circular turns over the first
or fixation turns.

PRACTICAL BANDAGING

For years the classical bandages have been taught the
same way with but few modifications. Many useless turns
have been retained to the present day, although daily proven
unpractical and useless clinically. The classical bandage will
be given below, also those modifications that seem of more
practical use than the original.

Spiral of Finger (Fig. 17, Ring Finger) (Bandage 3
Yards x i Inch). — Fix bandage by circular or oblique turns

around the wrist. Carry
diagonally across dorsum of
hand to base of finger. En-
circle the finger by a rapid
spiral in the same direction
until the root of the nail is
reached. Cover in the finger
with spiral turns progressing
to the base of the finger by
overlapping each previous
turn one-half the bandage
width. On completion of
the finger carry the bandage
across the dorsum of hand
and down around the wrist.
All the turns, both wrist and
finger should be in the same
general direction.

Spiral Reverse of the Finger (Figs. 13, 14 and 15)
(Bandage 3 Yards x i Inch) . — Fix the bandage by two circu-
lar turns, or an oblique .turn around the wrist, then carry it
diagonally over the dorsum of the hand to the base of the
finger. Descend the finger by a rapid spiral covering the tip
by two or three recurrent turns, holding the turns with the
forefinger and thumb of the left hand. Now reverse the last
dorsal turn and carry the bandage around the finger, with

FIG. 12. — Recurrent turns.

ROLLER BANDAGES

PRACTICAL BANDAGING

spiral reverse turns, in the same direction of the first turns
around the wrist. Continue these turns, overlapping one-half
to one-third, until the upper edge of the bandage reaches
the finger web. Then direct the two circular turns around
the wrist.

Demigauntlet Bandages (Fig. 16) (Bandage 3 Yards x i
Inch). — Fix the bandage around the wrist. Carry the band-

FIG. 1 6. — Demigauntlet bandage.

FIG. 17. — Gauntlet with spiral of ring finger.

age across the back of the hand and loop around the base
of the thumb or little finger, then back to wrist and around
it in same direction. By applying repeated similar turns
around each successive digit, the entire dorsum of the hand is
covered.

Gauntlet Bandage (Fig. 17) (Bandage 3 Yards x I
Inch). — This bandage is simply composed of spiral reverse

ROLLER BANDAGES I3

bandages of all the digits. Each digit, beginning with either
the first or fifth, is covered in order with the spiral or spiral
reverse turns, care being taken that all the turns on each

FIG. 19. — Spica of the thumb (descending). FIG. 18. — Spica of the thumb (ascending).

finger have the same direction around the wrist and fingers.
No turns should cross the palm.

NOTE. — The reader will notice that in none of the illustrations is
the fixation turn designated by a number. The No. I is always found
on the first turn characterizing the bandage depicted.

PRACTICAL BANDAGING

ROLLER BANDAGES

Spica of the Thumb (Fig. 18)
(Bandage 3 Yards x i Inch). — Fix
the initial extremity by one or two
turns around the wrist, then carry the
bandage downward across the base
of thumb and down the thumb by a
rapid spiral to the root of the nail.
Here apply one or two spiral turns
until the upper edge of the bandage
touches the web of the thumb. Fig-
ure-of-8 turns are then made around
the thumb and wrist overlapping one-
third to one-half the turn preceding,
thus making the spica. An ascending
(Fig. 18) or descending spica (Fig.
19) may be applied. Finish by one or
two turns around the wrist.

Spiral Reverse of Upper Extremity
(Figs. 20, 21 and 22) (Bandage 5
Yards x 2^/2 Inches). — Fix initial ex-
tremity on the wrist and then carry
the bandage obliquely down over the
dorsum of the hand to the web of
the thumb, around the outer side of
the index finger, across the palm and

FIG. 22.— Spiral reverse of the around the little finger, with the
lower edge of the turn crossing the

upper extremity.

!6 PRACTICAL BANDAGING

second joint of the ring finger. Make a circular turn at this
point and as the bandage crosses the little finger the second
time, it should cover one-half the preceding turn. Then carry
obliquely upward across to and around the first joint of the
thumb. Crossing the palmar surface again to ulna side
another turn is taken around the hand below the thumb,
overlapping one-half the previous turn. Now make one or
two figure-of-8 turns around the hand above and below the
thumb, until the hand is covered. Next carry the bandage
to the wrist and cover the forearm with spiral or spiral re-
verses as required until within four inches of the elbow. Flex
the elbow and carry the bandage with, its centre over the
point of the elbow, and return to front of forearm covering
one-half or one-third the last turn. The bandage is carried
from here across the front of the elbow and up around the
lower part of arm overlapping one-half of the turn covering
the elbow tip. The next turn passes around the upper fore-
arm covering in the lower edge of the elbow turn. Proceed
from here on up the arm with spiral reverse turns as required.
Finish with one or two circular turns.

Spica of the Shoulder (Fig. 23) (Bandage 8 Yards x 2^
Inches). — Fix the initial extremity by a circular turn around
the upper arm, having the upper edge reaching the axillary
folds. It is next carried obliquely upward and across the
prominence of the shoulder around the chest under the oppo-
site axilla and returned crossing the previous turn over the
shoulder at a point midway between chest and back. Now
make a loop around the arm then around the body. Repeat
this last figure-of-8 turn until the shoulder is covered, the
turns rising higher in ascending and getting lower in descend-
ing spica (Fig. 24), each overlapping the last turn one-half
to two-thirds over the shoulder, but exactly covering the
preceding turns under the opposite axilla. In applying this
bandage the operator stands beside and facing the shoulder

ROLLER BANDAGES I7

that is being bandaged. To bandage the left shoulder fix
the initial extremity from before backward high up on the
arm by one or two circular turns then passing backwards
and upwards over the shoulder tip and around the back. It is
much more secure to fix your spica bandage of the shoulder
by a spica loop beginning well away from the shoulder and
looping the arm as do the subsequent turns (Fig. 24). Here
the initial extremity lies hidden under turn (i) posteriorly.

PIG. 23. — Spica of the shoulder.

FIG. 24. — Spica loops of the shoulder.

Spiral Reverse of the Lower Extremity (Fig. 25) (Band-
age 8 Yards x 2^/2 to 3 Inches). — Fix the initial extremity
obliquely across the ankle-joint, then carry the bandage diag-
onally down across the dorsum of the foot to ball of great
toe (if on right foot), under the foot and around the base
of the small toe. A circular turn here and then one or two
spirals are made until the instep is reached, when reverses
are used up to the point of the instep. The next turn in-
stead of reversing passes up around the ankle low down,
then down around the foot and up the outside of the foot
around the ankle (figure-of-8 turns) covering one-half the

PRACTICAL BANDAGING

FIG. 25. — Spiral reverse of lower extremity.

ROLLER BANDAGES !9

previous turn, the foot turns approaching the heel, the ankle
turns receding from the heel. The bandage is now carried up
the leg with spiral and, as needed, spiral reverse turns until
the upper edge of the last turn reaches the lower border of
the patella (with leg extended). Pass the next turn directly
over the patella (knee-cap) and a succeeding turn over the
lower half of the patella after which the upper half is covered
with a turn and the bandage then carried up the thigh with
spiral reverse turns. When desiring to bandage the left
foot, the first turn after fixation of the bandage is obliquely
down across the instep to the base of the little toe, under
foot, and around the great toe base, then proceed as above.
This bandage is very difficult to retain in place if the leg is
dependent or in use. It is best used therefore in reclining
cases. For ambulatory cases the figure-of-8 bandage is pre-
ferable.

Spiral of the Foot Covering the Heel (Figs. 26 and 27)
(Bandage 3 Yards x 2 Inches). — To bandage the right foot,
fix the initial extremity around the ankle obliquely ; then pass
down diagonally across instep to ball of great toe, around the
sole and around the base of little toe and up on the dorsum.
A circular turn here is followed by spiral or spiral reverse
turns until the apex of instep is reached. The bandage is then
carried with its centre over the point of the heel, up the
outside of the foot to instep, then down the inner side of foot
obliquely, under the sole, transversely across the outer side
of the heel, behind the tendo Achilles, back to the instep,
down the outer side of foot, obliquely under the sole, trans-
versely across the inner side of the heel, behind the tendo
Achilles and back to the instep. End bandage by circular
turns around the ankle. For left foot, fix bandage as for
right foot, the bandage being applied toward the operator's
right hand, then carry obliquely down across instep to base
of little toe, proceeding from here as for right foot.

PRACTICAL BANDAGING

FIG. 27

FIG. 26. — a, Spiral of foot covering the heel ; b, second stage.
FIG. 27. — Spiral of foot covering the heel.

ROLLER BANDAGES 2I

Spica of the Foot (Figs. 28 and 29) (Bandage 3 Yards x
2 Inches). — Fix the bandage around the ankle, then, for right
foot, carry the turn obliquely across the dorsum of the foot
to the ball of the great toe. A circular turn is made around
the base of the foot across and up the instep, around the
heel. The upper edge of the bandage should just grasp the
heel, the lower edge being left loose. Now return to the

FIG. 28. — Spica of the foot (first step). FIG. 29. — Spica of the foot.

lower instep crossing the last turn in the middle of the foot
and covering two- thirds of the width of the bandage. Repeat
similar alternate turns around the foot and the heel taking
care that those on the foot approach the heel and that those
on the back of the heel ascend the ankle. The upper edge of
the last turn around the foot should cover the lower edge of
the first turn around the heel. The bandage is ended by one
or two circular turns around the ankle. It will be noted that

PRACTICAL BANDAGING

the last one or two turns crossing under the foot have one
edge loose. This can be avoided by reversing the bandage on
the side of the foot before going up the instep. To bandage
the left foot, after fixing the bandage around the ankle in the
above manner, direct the next down across the instep to the

FIG. 30. — Figure-of-8 of the leg (method i).

base of the little toe and then make a circular turn around the
ball of the foot. From this point proceed as for right foot.
Figure-of-8 of the Leg (Fig. 33) (Bandage 5 Yards x 2
or 3 Inches. — Method i (short loop method) (Fig. 30) :
The bandage is similar to the spiral reverse of the lower ex-

ROLLER BANDAGES

FIG. 31. — Figure-of-8 of the leg (method 2).

tremity until, on ascending the calf, reverses are needed. Then
incline the bandage rapidly upward by rapid spiral or oblique
turn to lie flat, make a turn around the leg and returning

PRACTICAL BANDAGING

ROLLER BANDAGES 25

in downward direction to front of leg, cross the first turn
just outside the crest of the tibia. Successive similar turns
of the figure-of-S variety are made overlapping one-half of
each previous turn as the bandage ascends the leg. It will
be noted that there is a gap posterior between the two loops
of the 8 and that the lower edge of the upper loop does not
lie flat. Both of these defects are covered by the ascending
turns as they ascend the leg. Complete the bandage by two
circular turns above the calf.

Method 2 (long loop method) (Fig. 31): This makes
use of a large loop below and a small loop above when start-
ing the figure-of-8 turns, both approaching the place of
greatest diameter where two circular turns end the bandage.

Method j (Fig. 32) : Likewise similar to the spiral re-
verse until the increased diameter of the calf demands re-
verses. Then a long loop of the figure 8 carries the bandage
above the greatest diameter of the calf where a circular turn
passes directly around the leg above the calf and then de-
scends, crossing the long loop just outside the crest of the
tibia to pass across the lower leg in a short loop. There
turns are repeated, each large loop covering one-half the last
turn and each circular turn passing above the greatest
diameter of the calf.

The figure-of-8 of the leg is a very popular bandage and
reasonably so, for it retains its place better than any other
leg bandage. The increased amount of bandage necessary
for its application is its only objection. All three methods
give the same appearance when completed (Fig. 33).

Spica of the Groin (Figs. 34 and 35) (Bandage 8 Yards
x 3 Inches). — The initial extremity is fixed by two circular
turns high up around the thigh. If the right groin is to be
bandaged, from the outer surface of the thigh the bandage is
carried diagonally across the groin just above the pubis and
around the crest of the iliac (hip) bone of the left side,

PRACTICAL BANDAGING

FIG. 33. — Figure-of-8 of the leg.

thence across the lower back, between the right iliac (hip)
crest and trochanter. From here the turn passes obliquely
downward and crosses the first ascending turn, about the
middle of the groin. Apply three or four of these figure-of-8
turns, each turn covering about one-half the previous turn

ROLLER BANDAGES

FlG. 34. — Spica of the groin (first turn).

PIG. 35- — Spica of the groin.

2g PRACTICAL BANDAGING

as it rounds the thigh and groin but always passing around
and below, not above, the iliac crest on its course around the
pelvis permitting the upper turns to grasp the hip bones but
not to pass above them. The bandage is usually ended by a
circular turn around the pelvis just below the crests. There
is a much more practical and secure method of applying the
spica of the groin, by starting the bandage with the initial

FIG. 36. — Spica of the groin.

extremity passing over the groin obliquely and around the
thigh, thence across above the symphysis and continued as
above. This is finished with the spica turns and not by cir-
cular turns around the trunk or thigh (Figs. 37 and 38).
Should it be desired to bandage the left groin the circular
turns around the thigh pass from within toward the outer
surface. The first ascending turn passes obliquely in the
line of the groin up to and between the opposite crest and

ROLLER BANDAGES

the trochanter. The remaining turns are exactly similar to
the ones applied for the right groin.

Double Spica of the Groin (Figs. 39 and 40) (Bandage
8 Yards x 3 Inches). — Fix the initial extremity by two cir-
cular turns on the right thigh as high as possible. Direct the
bandage from the outer aspect of the thigh, across the groin,
above the symphysis pubis, around the pelvis gripping the
crest on each side, diagonally across lower abdomen, crossing

FIG. 37. — Spica of the groin (ascending) with oblique fixation.
FIG. 38. — Spica of the groin (descending) with oblique fixation.

the previous turn just above the symphysis whence it reaches
the outer surface of the left thigh. Make a circular turn
around the thigh, as high up as possible and on the second
arrival on the inner aspect of the left thigh carry the bandage
up the line of the groin around the left iliac crest and then
make a complete circular turn around the pelvis. When the
right side is reached the second time, drop obliquely down-
ward along the right groin to the point of starting. The
remaining bandage is merely a repetition of this one com-

PRACTICAL BANDAGING

FIG. 39. — Double spica of the groin (first turn).

FIG. 40. — Double spica.

ROLLER BANDAGES

plete turn, covering about one-half each previous turn. When
the bandage is completed there will be noted three spicas;
one in each groin and one over the symphysis. This bandage,
as well, can be applied with the same modifications as are
made in the single spica of the groin, namely, omission of the
horizontal turns around the pelvis and thigh. Here too, this
spica bandage may be either ascending or descending.

Crossed Bandage of the Perineum (Figs. 41, 42 and 43)
(Bandage 8 Yards x 3 Inches). — Start the bandage crossing
the lower abdomen and left groin diagonally, passing behind

FIG. 41. — Crossed bandage of perineum FIG. 42. — Crossed bandage of

(first turn). perineum.

and well up on the left thigh, crossing the perineum to right
groin (i). From here carry the roller along the line of the
right groin around the iliac (hip bone) crests, diagonally
across the abdomen (2) and around the posterior aspect of
the thigh high up. From here the bandage crosses the first
turn in the perineum proceeding up the line of the left groin
(3) around the left hip, grasping the crest of the hip bone,
across the back around the right hip crest diagonally across
the abdomen (4), to pass around the outer and posterior as-
pect of the thigh high up, thus completing one entire turn. It
should be noticed that the initial extremity, E, is covered by

PRACTICAL BANDAGING

turn 4 as it crosses the abdomen in the same direction. Cross-
ing the perineum direct the bandage, overlapping two-thirds
the width of the previous turns, along the right groin (5),
around right crest, around the back and left crest, diagonally
across the abdomen (6), around the outside of the right
thigh, posteriorly, to cross the perineum. Now pass up the

FIG. 43. — Crossed bandage of the perineum.

line of the left groin (7), around the left hip across the
back around the right hip down across the abdomen (8),
around the outside of the left thigh posteriorly and across the
perineum. Passing up the right groin (9), continue around
back to left side (10), etc., until a sufficient number of turns
are applied. The bandage should show four series of spicas
as seen in the illustrations.

ROLLER BANDAGES

The bandage may be applied, fixing the initial extremity
around the thigh and alternating the direction of the spica
perineal turns. This older method has no advantage over
the above and is much more confusing.

Posterior Figure-of-8 of Shoulders and Back (Fig. 44)
(Bandage 5 Yards x 2 Inches). — Standing behind the patient
apply the initial extremity of the bandage on the posterior

FIG. 44. — Posterior figure-of-8 of the shoulders and back.

aspect of the sound axilla. Carry the bandage obliquely
across the back to pass over the opposite shoulder well out on
the point, down through the axilla to its posterior border then
across the back to the other shoulder going around it and
through the axilla to point of starting. Repeated turns five
or six in number, proceeding up the back and toward the base
of the neck, by each turn overlapping the preceding one, com-
pletes the bandage. The finished bandage shows a spica mid-
way the shoulders.
3

-4 PRACTICAL BANDAGING

Anterior Figure-of-8 of Shoulders and Chest — This band-
age is similar to the above, differing only in that it is applied
anteriorly over the chest rather than posteriorly over the
back.

Suspensory of the Breast (Fig. 45) (Bandages 8 Yards
x 3 Inches). — To bandage the right breast fix the bandage

FlG. 45. — Suspensory of the breast (right).

by two circular turns around the chest just below the breast,
passing from patient's right to left. On arriving beneath the
right breast the second time direct the next turn upwards be-
tween the breasts and across the left shoulder, then down
across the back to point of starting beneath the right breast.
Repeating these turns alternately for four or five times com-

ROLLER BANDAGES 3-

pletes the bandage. The horizontal turns ascending by over-
lapping one-half and the oblique turns proceed outward over
the breast overlapping about one-half the width of each
previous turn. The points of crossing should be just under
the breast. The turns as they pass over the shoulder tend to
overlap each other much more than when crossing the breast

FIG. 46. — Suspensory of the breast.

To bandage the left breast fix the bandage by circular
turns as for right breast. On arriving beneath the left breast
carry the bandage upward under the axilla across the back,
over the right shoulder down between the breasts to point of
starting. Alternate turns finish the bandage as on the right
side (Fig. 46).

36 PRACTICAL BANDAGING

Suspensory of Breast (Fig. 47) (Bandage 8 Yards x 3
Inches). — To bandage the right breast apply the initial ex-
tremity of the roller at the inner and upper aspect of the
affected breast. Carry the bandage well out on the point
of the opposite shoulder loop under the axilla, then cross the
previous turn on the point of the shoulder. Passing diag-
onally down across the back around the side and under the

FIG. 47. — Suspensory of the breast.

affected breast to point of starting. Fix with a second turn
drawing both snugly. Repeat this figure-of-8 turn six or
eight times overlapping the preceding turns two-thirds of the
bandage width over the breast and four-fifths the width over
the point of the shoulder. The succeeding turns approach
the neck, covering in the breast and opposite shoulder. The
bandage is a poor one.

ROLLER BANDAGES 37

Suspensory of Both Breasts ( Fig. 48 ) ( Bandage 8 Yards
x 3 Inches). — Start the initial extremity under the right
breast and fix by two circular turns, then carry the bandage
obliquely up under the right breast, and over the left shoulder,
obliquely across the back and under the right breast, across

FIG. 48. — Suspensory of both breasts.

under the left breast overlapping one-half the previous
horizontal circular turn. Pass, then, diagonally across and
up the back over the right shoulder, down under the left
breast and around the back to the starting point. This is one
complete turn which repeated four or five times finishes the
bandage. Horizontal turns should ascend as they overlap

3g PRACTICAL BANDAGING

and oblique turns should advance outward and upward on the
breasts as they overlap.

Figure-of-8 of the Breasts (Kiwisch) (Figs. 49 and 50).
— After applying two or three turns of a suspensory of both
breasts, cover the breasts by three or four spiral turns and
then by three or four figure-of-8 turns to compress the
breasts, passing under the right breast over the left breast,

FIG. 49. — Figure-of-8 of the breast.

around the back, then over the right breast under the left
breast and around back. Repeat three or four times, ending
the bandage by a circular turn across both breasts.

Desault (Fig. 51) Bandages 3 Rollers Each 8 Yards x 3
Inches). — Pad triangular in shape, base 2 to 2^ inches, thick-
ness tapering to nothing and five or six inches long. Place
the wedge-shaped pad in the axilla of injured side. It should
be the proper size to fill the wedge space between the abducted

ROLLER BANDAGES

arm and the chest. Hold in place by ascending spiral turns
of the thorax, the last two turns passing up across the trunk,
over the opposite shoulder, looping around the upper arm,
back over the shoulder and across the trunk to axilla of af-
fected side. The addition of this turn completes the original
Desault, not being found in the modified Desault (first
roller). The arm is brought against the pad and the fore-

FIG. 50. — Figure-of-8 of the breast.

arm to a right angle. Place the initial extremity in axilla of
sound side and then by descending slow spiral turns, each
overlapping one-half the bandage width, the arm is bound to
the side from the level of the anterior axillary fold to the
bend of the elbow (second roller).

Third Roller. Place the initial extremity in the posterior
aspect of the sound axilla, then carry the bandage diagonally

40 PRACTICAL BANDAGING

across the back over the affected shoulder, just grasping the
point of the shoulder with the bandage firmly enough to pre-
vent slipping back or front. Carry the turn from here down
the front of the arm, under the elbow and across the back
to the point of starting. Now carry the bandage forward
under the sound axilla, across the chest, over the affected

FIG. 51. — Desault bandage.

shoulder down behind the arm, under the elbow in front of
the upper part of the forearm, across the chest to the sound
axilla. Three turns, each covering two-thirds of the previous
turn, usually suffice. A few circular turns may finish the
bandage. The forearm is slung from the neck. It will be
noticed that the roller just described forms a triangle in

ROLLER BANDAGES 4I

front and in back. Its direction of application can readily be
remembered by the use of the key A. S. E., each letter rep-
resenting one of the three, axilla, shoulder, elbow. The
original Desault is composed of three rollers but the modified
bandage is the one most popular at the present day.

FIG. 52. — Davis bandage.

The modified Desault omits the first roller, retaining the
second and third roller in detail.

Davis Bandage (Fig. 52) (Bandage 8 Yards x 2.^/2
Inches). — Fix the initial extremity by passing two or three
circular turns around the lower chest and right arm, from
patient's right to left. On arriving behind the affected elbow

42 PRACTICAL BANDAGING

carry the next turn down diagonally in front and around
under the forearm, to pass under the elbow obliquely, over
the front of the forearm, over the wrist and around the back.
Then pass around over the affected elbow in front of the
forearm and under the wrist to back. Repeat these last two
turns alternately three or four times, overlapping about two-
thirds the succeeding turns, forming a spica in front of the

FIG. 53. — Velpeau (start).

forearm. Finish by two or three circular turns around chest
and arm, if desired.

To bandage the left side apply the turns as above except
on arriving at the sound side carry the bandage under the
forearm in front of and around the lower arm and elbow
across the back, then over and around the forearm, under the
elbow and around the back. Finish as above.

Velpeau (Modified) (Figs. 53, 54, 55 and 56) (Bandage
8 Yards x 3 Inches). — Place the hand of the affected side, on
the opposite shoulder thereby bringing the elbow near the
midline of the body. This position pushes the shoulder up-

ROLLER BANDAGES 43

ward, outward and backward. Place the initial extremity in
the axilla of the sound side, posterior aspect. Carry the
bandage across the back to a point well out on the shoulder,
down around the arm about the position of the deltoid
tubercle. From liere the bandage passes behind the elbow, be-
tween it and the body, crossing the chest to the point of

FIG. 54. — Velpeau.

starting. Fix this turn by a similar one, completely over-
lapping it. Then from the same point of starting the bandage
is carried across the back horizontally, crossing in front of
the elbow, confining the arm and forearm, but leaving the
tip of the olecranon exposed. Alternate vertical and horizon-
tal turns are now employed to complete the bandage. The

44 PRACTICAL BANDAGING

vertical turns overlap two-thirds approaching the neck and
elbow but not passing over the point of the elbow. The
horizontal turns overlap one-half the previous turns and are
continued as high on the chest as the axillary folds will allow.
Another modification of the Velpeau is described as fol-

FIG. 55. — Velpeau (side view).

lows (Fig. 57) : With the upper extremity in the same
position as above, fix the bandage by spiral turns around the
arm and thorax; when the roller reaches the axilla of the
well side it passes up across the back, over the shoulder well
out on the point, down the front of the arm, under the elbow,
up the back of the arm, over the tip of the shoulder and

ROLLER BANDAGES

FIG. 56. — Velpeau (posterior view).

FIG. 57. — Velpeau modified.

PRACTICAL BANDAGING

across the chest to the point of starting. Repeated turns
overlapping upward and inward accomplish the bandage.

Velpeau Modified (Dulles) (Fig. 58) (Bandage 8 Yards
x 3 Inches ) . — With the right upper extremity in the Velpeau
position fix the bandage by two circular turns just above the
elbow passing around the arm, forearm and chest. On arriv-

FiG. 58. — Velpeau modified (Dulles).

ing in the sound axilla carry the bandage obliquely up across
the back, over the point of the shoulder of the injured side,
down in front of the arm, under the elbow, up the back of
the arm over the point of same shoulder, then diagonally
across the chest and forearm to the base of sound axilla,
finishing with a circular turn similar to the fixation turns.

ROLLER BANDAGES

Repetition of these turns five or six times overlapping about
two-thirds of each succeeding turn complete the bandage,
bringing the last turn well up in the axilla, close to the neck,
and half-way up the forearm.

Figure-of-8 of the Head and Neck (Fig. 59) (Bandage 3
Yards x 2 Inches). — Fix the initial extremity around fore-
head and just below the occiput. On arriving below the left
ear the second time, drop down below the occiput, around the
neck and back to below the occiput. From here carry the

FIG. 59. — Figure-of-8 of the head and neck.

FIG. 60. — Barton bandage.

bandage over right ear around forehead over left ear, back
to just below occiput. Repeat this figure-of-8 turn two or
three times, overlapping upward or downward as desired.
The bandage may be applied without the fronto-occipital cir-
cular turns.

Barton Bandage (Fig. 60) (Bandage 5 Yards x 2
Inches). — Place the initial extremity on the nape of the neck
just behind and below the left ear. Carry the bandage be-
neath the occipital protuberance between the opposite ear and
the parietal eminence, thence obliquely over the head to mid-

48 PRACTICAL BANDAGING

line anterior to the highest point of scalp. From here pass
down the left side of the head and face under the chin up
beside the face, crossing the previous turn in the middle line
on top of the head. It is next carried between the left
parietal eminence and ear to point of starting, when a turn
is made horizontally around front of the chin. Three such
complete turns usually suffice, each exactly covering the last.
A modified "Barton" (see dotted line) is described start-
ing with two circular occipito frontal turns, then passing from

FIG. 61.— Gibson bandage.

occiput down under the ear around the chin and back to occi-
pital protuberance. From here the bandage is similar to the
original " Barton." Except that two more occipito frontal
turns complete it.

Gibson Bandage (Fig. 61) (Bandage 5 Yards x 2
Inches). — Place the initial extremity on the right temple and
carry the roller over the front of the top of the head, down
over the opposite temple, under the chin and up to the start-
ing point. Add two more similar turns exactly overlapping.
When at the right temple again, reverse, and carry the band-

ROLLER BANDAGES 49

age around the head and forehead, just above the ears. Re-
peat this turn twice. From a position above the right ear
carry the bandage posterior, under the occipital protuberance
and then around the anterior aspect of the chin. Repeat this
turn twice. Returning to the nape of the neck a reverse is
made and the bandage carried over the centre of the head to
end on the horizontal turns in the centre of the forehead.
Pin all intersections. This bandage is poor and seldom used.

FIG. 62. — Oblique of the jaw (reverse side). FIG. 63. — Oblique of the jaw (right side).

Oblique of the Jaw (Figs. 62 and 63) (Bandage 5 Yards
x 2 Inches). — To bandage the right side of the jaw, place the
initial extremity on the right temple and carry the bandage
by two circular turns from before backward around the head
and forehead above the ears. On the third arrival over the
right ear carry the bandage down under the occipital pro-
tuberance, around under the jaw and up the right side of the
face, having the anterior edge of the bandage just posterior to
the outer angle of the eye. Thence it is carried over the head
and down back of the left ear, under the jaw and again up the
right side of the face posterior to the first turn and over-
4

50 PRACTICAL BANDAGING

lapping it one-half on the affected side and exactly covering
the previous turn on the sound side. Repeat two or three
times and, on arrival above the left ear, reverse the bandage
and carry around the head in circular turns immediately over
the fixation turns. Instead of reversing above the left ear
the last turn may be carried under the chin, below the right
ear, around under the occiput, ending in circular turns over-
lapping the fixation turns. The bandage of the left side

FIG. 64. — Double oblique of the jaw.

of the jaw is started over the left temple and carried back-
ward in circular turns. From this point the bandages are
identical.

Double Oblique of the Jaw (Fig. 64) (Bandage 5 Yards
x 2 Inches. — Place the initial extremity on the right temple
and fix by one or two fronto-occipital turns. On arriving
above the left ear, drop down across the back of the neck,
under the right ear, under the chin, and then carry it up the
left side of the face just back of external angle of the eye.
Carry the bandage over the front of the head, between parietal
eminence and the right ear, down back of the neck, under
the left ear, under the chin, up the right side of the face,

ROLLER BANDAGES SI

just back of the external angle of the eye, across the front
part of the head crossing the previous turn in the midline,
back over the left ear to the nape of the neck. Repeat these
turns two or three times, exactly overlaying the preceding
turns except the turn at the side of the face where they over-
lap two-thirds or more in a backward direction. End the
bandage by one or more fronto-occipital turns.

FIG. 65. — Recurrent of the scalp (first step).

FIG. 66. — Recurrent of the scalp.

Recurrent of the Scalp (Figs. 65 and 66) (Bandage 5
Yards x 2 Inches). — Fix the bandage by one or two circular
turns, horizontally around the head, above the eyebrows and
ears but below the occipital protuberance. This is important
to give support to the bandage and prevent displacement up-
wards. On arriving at the occiput, reverse, and carry the
bandage over the middle of the head and to midpoint on the
circular turns in front. Again reverse and carry back to the
occiput covering in one-half of the first turn. Continue to
carry it backward and forward on alternate sides of the head

52 PRACTICAL BANDAGING

until the scalp is covered, when the bandage is completed by
two circular turns. In the application of the recurrent turns,
the turns must of necessity be held front and back until the
circular turns can bind them in place.

Transverse Recurrent of the Scalp (Fig. 67) (Bandage 3
Yards x 2 Inches). — Fix the initial extremity over one ear
by two occipitof rontal turns. On arriving again over the left
ear, reverse the bandage, carry directly over the vertex to
just below the right ear. Here, again, reverse and carry back

FIG. 67. — Transverse recurrent of the scalp (first steps).

to above the left ear covering in one-half the previous turn.
Continue such recurrent turns alternately proceeding toward
the forehead and toward the occiput until the entire scalp
is covered and the last turns develop into circular turns, cover-
ing the fixation turns. The recurrent turns must be held on
both sides by operator and an assisting hand until the final
circular turns bind them in position.

Recurrent of Scalp with Double Roller (Fig. 68) (Band-
age 5 Yards x 2 Inches). — The centre of the roll is placed on
the forehead and the two ends carried back to the occiput.

ROLLER BANDAGES 53

Here the left hand roller crossing under the right hand roller
is reversed and carried over the centre of the scalp to the root
of the nose. It is crossed here by the right hand roller which
has made a circular turn overlapping the fixation turns.
Again reversing the original left hand roller, recurrent turns
are made alternate on each side the scalp, each loop being
caught by the right hand or circular roller. Continue such
recurrent turns until, overlapping two-thirds the bandage

FIG. 68. — Recurrent of the scalp with double roller.

width, the entire scalp is covered. Then the smaller roller
is cut and the larger one takes two extra circular turns. The
double roller has the advantage over the single in that one
pair of hands can apply it.

Monocle or Crossed Bandage of One Eye (Fig. 69)
(Bandage 5 Yards x 2 Inches). — To bandage the left eye, fix
the initial extremity on the left temple by a circular turnaround
the head from left to right. When the roll is above the right
ear, incline the bandage down behind the head, under the left
ear and across the left eye, the lower edge of the bandage
crossing the root of the nose. It next passes over the right

PRACTICAL BANDAGING

side of the top of the head and down to the back of the neck.
Repeat this turn two or three times overlapping one-half the
width of the bandage, ascending on the cheek and descending
on the scalp. Finish with a circular turn around the head.

Binocular or Crossed Bandage of Both Eyes (Fig. 70)
(Bandage 5 Yards x 2 Inches) . — Bandage the left eye as just
described and after finishing the circular turn, pin it at the
back of the head. Then bring it up over the left side of the

FIG. 69. — Crossed bandage of the eye.

FlG. 70. — Crossed bandage of both eyes.

head, down across the root of the nose, over the right eye,
low on the cheek, and under the right ear, back to the occiput.
Finish just as in the left eye.

Both eyes can be bandaged simultaneously. After applying
the first turn crossing the left eye, carry the bandage around
the head above the ears, then down across the root of the
nose, across the cheek covering the ear. Then a full turn
around the head. Repetition completes bandage (Fig. 70).

The binocle can be applied with the double roller, carrying
the rollers each back over an ear crossing posteriorly and re-
turning on opposite sides under the ears, again crossing each
other at the root of the nose.

PART II

MISCELLANEOUS BANDAGES

Tailed Bandages (Figs 71, a and b, and 72) . — These may
be three tailed, or the " T " bandage, the four tailed and the
many tailed.

Perineal "T" Bandage (Fig. 71, a). — One example of
the " T " bandage consists of a narrow strip long enough to
more than encompass the waist and usually 2^/2 inches to 3

a
FIG. 71.-

"T" bandage; b, four-tailed bandage.

inches wide. At this centre is sewed a similar strip three or
four inches wide making the stem of the " T." This is split
at its free end for a short distance, to enable it to be easily
torn. It is used to hold dressings against the perineum.
The cross bar of the " T " goes around the waist with the
stem posterior, from which position it is brought through
the perineum and torn down the desired length to pass on each
side of the genitals. The two ends are tied together around

PRACTICAL BANDAGING

FIG. 72. — "T" bandage of the perineum.

FIG. 73. — Modified "T" bandage of the perineum.

the waist, like a belt, and the two perineal strips brought up
and tied to the belt (Fig. 72).

Perineal Bandage (Cunningham) (Figs. 73 and 74).—

MISCELLANEOUS BANDAGES

This consists of a waist band 48 inches long and 3 to 5 inches
wide. To the centre of this and at right angles to it are
sewed one upon the other two strips, 4 inches wide and 36
to 40 inches long. The anterior strip is split. The belt is
applied around the waist and tied in front, the split strips
crossed in the perineum behind the elevated scrotum and
tied or pinned to the belt. The untorn strip is then brought
up covering the penis and scrotum and fastened to the belt.

FIG. 74. — Modified "T" bandage of perineum.

The "T" Bandage of the Scalp (Fig. 75) (Bandage
Width 2 to 3 Inches). — With the junction of the stem and bar
of the " T " over the forehead, side of head or the occiput,
the horizontal limb is carried around the forehead and occiput
just above the ears. The stem is carried across the top of
the head and the three ends tied or pinned together.

The " T " Bandage of the Eye (Fig. 76).— Into the angle
between the stem and the bar of the " T " sew a right angle

5g PRACTICAL BANDAGING

triangle of gauze or muslin, cut the size and shape to suit the
case. Carry the limbs of the bar around the head above the
ears, and the stem under the chin and up the opposite side

FIG. 75. — "T" bondage of the scalp.

FIG. 76. — "T" bandage of the eye.

FIG. 77. — "X" bandage of the ear.

of the face to meet and be attached to the horizontal ends
by pin or knot.

The "T" Bandage of the Ear (Fig. 77). — Sew across
the junction of the two limbs a triangle of fabric, equilateral

MISCELLANEOUS BANDAGES

in type, cut to suit the case. Pass the horizontal limbs around
the head above the ears and the stem under the neck to meet
the horizontal limbs. Fasten the three ends by tying or
pinning.

Bandages of similar construction can be fitted to the
groin, buttock, and scrotum (Figs. 78 and 79).

FIG. 78. — " T " bandage of the groin.

FIG. 79. — " T " bandage of the buttock.

FIG. 80. — Double "T" of chest.

The Double " T " of the Chest (Fig. 80). — The best ex-
ample of this is the Murphy binder made of the shape and
dimensions shown in Fig. 80. A simpler dressing is made by
taking a strip of material 8 to 10 inches wide and long
enough to encompass the chest easily. Four inches from the

PRACTICAL BANDAGING

centre of one edge, two strips/ two inches wide and twelve
inches long, are sewn one on each side of the centre. The
wide strip passes around the chest well up in the axilla and
the two strips pass over the shoulders and are attached to the
upper edge of the wide strip opposite.

The Four-tailed Bandage of Chin (Fig. 81). — This is
made by tearing a piece of material the desired width, and
two or three feet long, one-third or three- fourths the distance
from its middle point to the end. Its chief use is for a

FIG. 8 1. — Four-tailed bandage of the chin.

FIG. 82. — Four-tailed bandage of the nose
and lip.

fractured inferior maxilla. The untorn portion is placed on
the chin and the two upper ends tied behind the neck, while
its lower ends are tied over the head. Then tie the ends
from the knot on top of the head to the ends from the knot
back of the neck.

Four-tailed Bandage of the Nose and Upper Lip (Fig.
82). — A piece of material, preferably gauze, three inches
wide and two feet long is torn down both ends to within an
inch of the centre. The body of the bandage is placed over
the nose and lip, the ends carried back, the upper ones tied

MISCELLANEOUS BANDAGES

at the back of the neck and the lower ones tied back of the
head.

Quadrangle Bandage of Occiput (Fig. 83). — A piece of
material, 4 to 5 inches wide and 26 to 30 inches long, is torn
down the centre of each end, one-third the length of the entire
strip. The untorn portion is placed over the occiput and the
torn ends are crossed on each side. The two upper ends are
tied under the jaw and the two lower ends are tied across the

FIG. 83. — Quadrangle bandage of the
occiput.

FIG. 84. — Quadrangle bandage of the
vertex.

forehead. The dressing may be so cut as to leave the ears
uncovered.

Quadrangle Bandage of the Vertex (Fig. 84). — This band-
age is similar in construction to that of the occiput. Its body
or untorn portion is placed over the vertex, while its front
ends are passed above the ears and tied under the occiput,
the back ends cross over these and are tied under the jaw.

Quadrangle Bandage of Neck (Fig. 85). — Similar in
construction to the above bandage. The body is placed well
down on the nape of the neck and the ends tied as in figure.

Quadrangle Bandage or Sling of the Shoulder (Fig. 86).

PRACTICAL BANDAGING

—A piece of material 6 to 8 inches wide and long enough to
more than encompass the shoulder and chest is torn down its
centre from each end to within 4 or 5 inches of its centre.
The body of the sling is placed over the shoulder, the two

FIG. 85. — Quadrangle bandage of the neck

FIG. 86. — Quadrangle bandage of the shoulder.

FIG. 87. — Quadrangle bandage of the
arm and forearm.

upper ends, carried one around each side of the thorax, are

tied under the opposite axilla, the two lower ends are crossed

under the axilla of the affected side and tied around the arm.

Quadrangle Bandage or Sling of Arm and Forearm (Fig.

MISCELLANEOUS BANDAGES 63

87). — A piece of material, 10 to 12 inches wide, is prepared
as in the sling of the shoulder. A slit is cut in the centre
of the body to receive the point of the elbow. The upper
ends pass directly around the trunk and are fastened under
the opposite arm. The lower ends are carried diagonally
across the trunk and fastened over the opposite shoulder.

Many Tailed Bandages (Scultetus) (Fig. 88). — This
consists of a piece of muslin or gauze of the desired width
and long enough to more than surround the part. Into each
end, tears are made about 2 inches apart for a distance of a

FIG. 88. — Many tailed bandages.

few inches. It is used to retain dressings that need frequent
changing and is applied under the part, the tails being brought
up on each side and each corresponding pair tied, the lowest
pair is first tied in a single knot and the end tucked under the
next pair which is tied down and so on until the last pair is
reached and tied by a bow knot. The opposite ends may be
overlapped and each pair pinned with a safety pin, rather
than tied.

Swathes. — Are merely wide pieces of cloth that are
used to go around a part, and are fastened with pins. A

64 PRACTICAL BANDAGING

common swathe is used to retain an upper extremity in the
acutely flexed position (Fig. 89). A piece of cotton or gauze,
the width of the shoulder from base of neck to acromion and
long enough to make a figure-of-8 around the flexed elbow
and body, is passed horizontally between the flexed elbow and
body, with its middle opposite the elbow. The front end is

FIG. 89. — Swathe.

now carried up around the forearm and over the shoulder of
the affected side, diagonally across the back and under the
axilla of the opposite side. Here it is pinned to the other
end which has been brought over in front of the flexed
extremity. The latter end is continued as a circle about the
thorax posteriorly and is pinned to the part surrounding the
flexed arm. This dressing is a very excellent one for use in

MISCELLANEOUS BANDAGES 65

fractures and injuries in and immediately around the elbow-
joint.

Handkerchief Bandages (Fig. 90, a). — Handkerchief
bandages are made of handkerchiefs or other material in the
shape of a square which varies in size to suit the need. The
sides of the square are usually 20 to 24 inches long. This
folded once in the form of a right angle triangle constitutes
the handkerchief or triangle bandage commonly known as a
" sling." When folded repeatedly on itself in the same direc-

FIG. 90. — Handkerchief a, cravat b.

tion it becomes the "'cravat" bandage (Fig. 90, b). The
materials used are silk, gauze, muslin, light duck and linen.

The handkerchief bandage is the most adaptable of all
the forms of bandages. It can be substituted for the roller
bandage and the tailed bandages and can be used as a torni-
quet. Its chief usefulness, is as a sling in emergency dressing,
(for handkerchiefs are almost everywhere obtainable) and to
retain cumbersome dressings that demand frequent changing.

The long side of the triangle is its base, the right angle
is the apex and the acute angles make the extremities or ends
of the bandage.
5

PRACTICAL BANDAGING

When the bandage is applied it derives its name from the
part of the anatomy with which its base comes in contact.
The ends are usually knotted preferably with a flat or reef
knot so placed as to make the least possible pressure.

Occipitof rental Triangle (Fig. 91) (Bandage Base 30
Inches). — Place the base of the triangle just below the most
prominent part of the back of the head, draw the apex for-
ward and down over the forehead. Draw the ends a'round
the head over the ears and knot over the forehead. Turn

FIG. 91. — Occipitof rental triangle.

FIG. 92. — Fronto-occipital triangle.

the apex up over the knot and pin it. By drawnig the sides
of the apex snugly down over the both ears you have two
secondary apices which may be turned up and pinned ( dotted
line).

Fronto-occipital Triangle (Fig. 92). — Similar to the one
above except it is applied from before, backward.

Bitemporal Triangle (Fig. 93). — This also is similar to
above, differing only in that it is applied with the base over
the temporal region.

Verticomental Triangle (Fig. 94) (Bandage Base 36

MISCELLANEOUS BANDAGES 67

Inches). — The base is placed on the front of the top of the
head and the apex is carried back to the nape of the neck.
The ends are carried down one on each side of the face,
crossed under the jaw then drawn around the neck on each
side and tied over apex. The apex is turned up and pinned.
Auriculo-occipital Triangle (Fig. 95). — Place the base
of the triangle on the side of the face in front of the ear,
the apex pointing backward. Carry the ends to the opposite

FIG. 93. — Bitempora! triangle.

FlG. 94. — Verticomental triangle.

side in front of the ear. The apex is brought around the
back of the head and folded back over the two ends which are
united over it. Pin the apex back.

The Triangle of the Head (Figs. 96 a and b) (Hunter's
Cap.). — Square of material 28 inch side. Fold the hand-
kerchief across one inch from its middle. With the shorter
side under, turn the corners of the folded edge in to meet
each other. With the extremities of the large triangle held
on the stretch, roll the base of the triangle upon itself as far
as the edge of the shorter posterior layer. Lift the bandage
and on relaxing the tension the two layers will separate.

PRACTICAL BANDAGING

Apply the single posterior layer over the head, with the edge
surrounding the face. The rolled edge is pulled down around
the back of the neck and the ends tied under the jaw.

FIG. 95. — Auriculo-occipital triangle.

FIG. 960. — Hunter's cap.

FIG. 966. — Hunter's cap.

Square Cap of the Head (Figs. 97 a, b and c). — ( I ) Use
a handkerchief with sides long enough to tie over the vertex

MISCELLANEOUS BANDAGES

and under the chin. Fold it across an inch from its centre and
place it over the top of the head with the free edges over

FIG. 970.— Square bandage of the head FIG. 97&.— Square banaage of the head

(method i). (method 2).

FIG. 97c. — Square bandage of the head (method 3).

the forehead, the longer one being next the scalp. Tie the
two outer, corners under the chin. The two inner corners
are pulled forward until the posterior edge fits snugly to the

70 PRACTICAL BANDAGING

back of the neck. Fold the two corners back one on each
side of the head, in the form of triangles, and pin or tie.

(2) Similar square and placed as the one above. The
free ends are twisted until the dressing is snug and then tied
together under the chin.

(3) Likewise similar to the one above except that the
two anterior corners are tied together and the two posterior
corners are tied together.

Posterior Triangle of Shoulders (Fig. 98) (Handkerchief
with Base 40 to 42 Inches Long). — Apply the centre of the

FIG. 98. — Posterior triangle of the shoulders. FIG. 99. — Thoracicoscapular triangle.

base back of the neck, allowing the apex to drop down be-
tween the shoulders. The ends are crossed over the chest and
carried under the axillae and fastened together over the apex
which is turned up and pinned on itself.

The Thoracicoscapular Triangle (Fig. 99). — Place the
base of a large triangle low down on the chest with apex
thrown over the desired shoulder. Carry the extremities
around the chest and fasten together over the apex which is
turned up and pinned back upon itself. The excess of free
edge on one side of the triangle is lapped and pinned.

By splitting the apex and carrying one over each shoulder

MISCELLANEOUS BANDAGES ^

the bandage can be made to serve double duty. The slack
on each can be taken up and pinned.

Thoracicohumeral Triangle (Fig. 100). — Place the centre
of the base of the triangle around the affected arm, just above
the elbow, apex pointing to the shoulder. Carry the ex-
tremities around the chest and tie. Draw the apex well up
on the shoulder, tuck in on one side, fold down and pin front
or back.

Triangle Suspensory of the Breasts (Fig. 101) (Single).
— Place the base of a large triangle with its centre under the

FIG. 100. — Thoracicohumeral triangle. FIG. 101. — Triangle suspensory of the breast.

inner aspect of the affected breast, the apex passing up over
the breast and shoulder and dropping posterior. Pass the
two ends one under the corresponding axilla, the other over
the opposite shoulder. Fasten together posteriorly over the
apex which is turned back and pinned. ( Fig. 102. ) ( Double. )
Separate the layers of the apex and carry one over each
shoulder and after lengthening by a strip of bandage fasten
under the united extremities.

Brachiocervical Triangle (a) (Fig. 103). — With the arm
held at the side, flex the forearm at right angles and place
the base of a large triangle around the wrist with the apex

72 PRACTICAL BANDAGING

toward the elbow. Carry the anterior extremity around the
opposite side and the posterior extremity around the cor-
responding side of the neck and fasten so as the knot is

FIG. 102. — Triangle suspensory of both
breasts.

FIG. 103. — Brachiocervical triangle or
sling.

FIG. 104. — Brachiocervical triangle sling. FIG. 105. — Brachioscapuiar triangle sling.

placed on one side of the neck. The apex is tucked under or
brought forward and pinned around the arm.

Brachiocervical Triangle (&) (Fig. 104). — Flex the fore-
arm into the acute position. Place the triangle between the

MISCELLANEOUS BANDAGES

arm and the chest with the base passing diagonally across
the axilla of the affected side and the apex hanging down
over the chest The upper extremity passes over the shoulder
of the injured side. Bring the lower extremity around the
outside of the arm and elbow and carry it over the sound
shoulder to be tied to the upper extremity posteriorly. The
apex is brought up around the forearm and pinned high up
on the upper extremity.

Brachioscapular Triangle (a) (Fig. 105). — For suspen-
sion from the uninjured side, the posterior extremity is

FIG. io6.: — Brachioscapular triangle sling. FIG. 107. — Brachioscapular triangle sling.

carried over the uninjured shoulder, the anterior extremity
placed under the axilla of the injured side and the two knotted
together posteriorly. The apex is folded around the arm and
pinned. Second method differs from the above only in that
the posterior extremity is carried back of the chest.

Brachioscapular Triangle (&) (Fig. 106). — First method:
For suspension from the injured side. The only change is in
having the posterior extremity pass over the shoulder of the
injured side. However, a further roller or cravat is usually
needed to fasten the knotted ends to the neck to prevent its
slipping from the shoulder.

Second method (c) (Fig. 107) : Place the base of the

PRACTICAL BANDAGING

triangle around the trunk a little above the level of the flexed
forearm, and tie posteriorly. The apex which has been
dropped down anteriorly is looped up enclosing the forearm
and lower arm and carried over the corresponding shoulder to
be lengthened by a roller, if necessary, to meet the united
extremities posteriorly.

Third method (d) (Fig. 108) : Place the base of the
triangle obliquely under the wrist and carry the posterior apex
under the opposite axilla, the anterior being looped up over

FIG. 1 08. — Brachioscapular triangle sling.

FIG. 109. — Mayor's bandage.

the forearm and elbow, then carried over the corresponding
shoulder to be tied to its fellow posteriorly. Tuck the fulness
of the bandage back of the arm and bring the apex forward to
be pinned.

Mayor's Bandage (Fig. 109). — Flex the forearm at a
right angle and bind the arm to the chest by tying the two
extremities of the handkerchief triangle around the chest
and arm just above the elbow, allowing the two folds of the
apex to hang down in front. Carry both folds of the apex
up behind the forearm, the under one passing over the sound
shoulder and the upper one over the affected shoulder. Fasten

MISCELLANEOUS BANDAGES

a piece of roller bandage to one apex, carry it down the back
around the untied extremities and fold up to be fastened over
the opposite shoulder to the other apex. This dressing con-
stricts the wrist with the hand left hanging. It is better to
retain the hand in the bandage.

Modification of Mayor's Bandage (Fig. no). — Place the
handkerchief triangle base on the chest and tie the extremities

FIG. no. — Modification of Mayor's bandage.

FIG. in. — Shoulder triangle.

behind the back, the folds of the apex hanging down in front.
Carry the top fold beneath the forearm and arm over the
opposite shoulder. Carry the under fold over the forearm
and arm and up over the other shoulder. Loop a piece of
roller bandage under the united extremities and fasten an end
to each apex fold.

Shoulder Triangle (Fig. ill). — Place the base of the
triangle over the point of the shoulder letting the apex fall
down the arm. Carry the extremities around the shoulder

PRACTICAL BANDAGING

under the axilla, cross and bring them around the arm, tie
them over the apex back, and pin.

Hand Triangle (Fig. 1 12). — Place the base of the triangle
on the palmar aspect of the wrist. Carry the apex under the
palm around the finger ends and up to the dorsum of the
wrist. Carry the two extremities around the wrist and hand,
fold the apex, if long enough, back upon them and tie.

Anterior Pelvic Triangle (Fig. 113). — With the base of
the triangle up and the apex hanging down in front, fasten
the two extremities around the brim of the pelvis. Carry the

FIG. 112. — Hand triangle.

FIG. 113. — Anterior pelvic triangle.

apex over the genitalia through the perineum and up pos-
teriorly to be attached to the united extremities.

Posterior Pelvic Triangle. — Similar to the above except
it is applied posteriorly and fastened in front.

Scrotal Hammock (Figs. 114 and -115). — This dressing
is made of flannel, 16 inches long and 8 inches wide, from the
ends of which a V-shaped wedge is cut, 4 inches deep. But-
ton-holes are cut in each corner. A belt of webbing or flan-
nel, with a button sewed on it over each anterior superior
spine, is fastened around the waist. Draw one edge of the

MISCELLANEOUS BANDAGES

FIG. 114. — Scrotal hammock.

FIG. 115. — Scrotal hammock.

PRACTICAL BANDAGING

dressing up snugly back of the scrotum and button the two
corners. Bring the other ends up, enveloping the scrotum,
and button to the belt. A hole may be cut in the anterior
fold for urination if so desired.

Scrotal Triangle. — Tie a cravat around the pelvis. Place
a small triangle with its base at the perineoscrotal junction and

carry one extremity up each side of
the scrotum to pass under the cravat
from above downward. Bring them
around their own outer edge and tie.
Bring the apex up over the genitalia
around the cravat from below up-
ward and pass it under the united
extremities.

Scrotal Square — Tie one side of
a square around the base of the geni-
talia. After twisting the other two
corners two or three times, pass
them around the tied corners from
above downward and around their
own outer edge to be tied in front.
Gluteal Triangle. — Place the base
of the triangle with the apex up just
below the fold of the buttock. Pass
the extremities around the thigh
i, knee triangle; b, foot and return to tie. Carry the apex up

triangle.

to be looped around a pelvic cravat.

Inguinal Triangle. — Similar to the gluteal triangle but
placed over the groin.

Tibiocervical Sling. — Pass a long cravat over the shoulder
of the sound side and knot it at the waist of the injured side.
Loop a triangle around the leg, with the base toward the
ankle, and tie the extremities through the cravat. Fold the
apex around the knees and pin.

FIG. 116.-

MISCELLANEOUS BANDAGES 79

Knee Triangle (Fig. 116). — With the base above the
patella and apex hanging down anteriorly, pass the extremi-
ties around the limb, cross, and return below the patella,
tying them over the apex. Turn the apex up and pin it.

Foot Triangle (Fig. 116). — With the centre of the base
of the triangle back of the ankle, the apex is carried under
the sole, over the to€S and instep to front of ankle. The
extremities encircle the ankle, confining the apex beneath
them.

Cravats. — The application of cravats is so very simple
that it is not deemed necessary to explain in detail. The
bandage is a very useful one to retain temporary dressings,
in emergency or first aid work and sometimes as a temporary
tourniquet. It is applied in the desired position, wrapped
around the part, and the ends pinned or tied together. Its
commonest use is as a wrist sling. The centre of the body
of the cravat is looped under the wrist and the two ends
carried one around each side of the neck and tied together,
preferably in front. It is sometimes used to sling the lower
extremity around the waist or neck.

When used as a tourniquet it is passed around the part
between the heart and the wound, and its ends tied together
so that the cravat is loose enough to allow of the introduction
and the twisting of a lever in the shape of the hand, or a
stick of some sort.

PART III

ELASTIC BANDAGES

There are three types of rubber bandages (Figs. 117 a, b
and c) : (i) Martin's bandage, (2) elastic webbing band-
a£e> (3) Esmarch tourniquet, and (4) Unna's dressing.

Martin's Rubber Bandage. — This is a strip of rubber
varying in width from 2 to 4 inches and in length from 3 to

FIG. 1170. — Rubber bandage.

FIG. 1176. — Elastic fabric bandage.

FIG. inc. — Esmarch tourniquet.

5 yards. It has attached to one end two tapes by which the
bandage is secured. In applying the bandage, no reverses are
used and very little tension is applied. It is preferable to
have a gauze or flannel bandage or stockinette next the skin
to absorb the moisture. The dressing should be kept free from
all ointments, oils, ether, etc., which are harmful to rubber.
80

ELASTIC BANDAGES gz

It should be removed at least once in 24 hours to allow it to
dry out. It is applied without reverses.

Elastic Webbing. — This is an improvement over, and has
none of the disagreeable features of the Martin bandage. It
is made of a rubber or elastic network covered with a fabric
of cotton or silk. It is used in the same way as the Martin
bandage, except that it demands no gauze or flannel next the
skin. It possesses the distinct advantage of permitting
evaporation of perspiration. No reverses are used in its
application.

Esmarch Tube or Tourniquet. — This is a rubber strap
about i to 1 1/4 inches wide, l/% inch thick and 5 to 6 feet long,
with a hook on one end and a chain on the other. Its chief
use is as a means of preventing hemorrhage from wounds in
the extremities. It is not properly a bandage. When applied
as a tourniquet, the part should be elevated for 10 minutes
before application. With a turn or two of bandage beneath
it, apply the tourniquet on a stretch until the pulse disappears
below it. Have the turns overlap each other and hook the
ends.

Elastic Fabric Bandage. — This elastic bandage is made
entirely of cotton woven in a manner to allow stretching
almost equal to that of. rubber. It possesses all the advantages
and qualities of a bandage interwoven with rubber, yet is
lighter, more durable, permits evaporation, may be washed
repeatedly, and has no odor. It is readily sterilized and can
be kept indefinitely. In its application reverses are un-
necessary.

Unna's Dressing. — This dressing is composed of layers
of gauze bandage soaked with a paste (Unna) composed of
gelatine, 1 5 parts ; glycerin, 1 5 parts ; zinc oxide, 30 parts ; and
water, 40 parts. This paste when cold has a gummy elasticity,
but when heated over a water bath, it becomes liquid. Appli-
cation: Heat the Unna paste over a water bath until it is
6

32 PRACTICAL BANDAGING

liquid but not hot enough to burn the skin. Paint it with
a brush on the skin of the part to be dressed. Cover with a
layer of gauze bandage. Repeated alternate layers of gauze
and paste to the number of three or four complete the dress-
ing. The dressing is allowed to dry out and is then covered
with a dry gauze bandage, dusted with talc or varnished.

If desirable, fenestra may be cut in the dressing to permit
of attention to underlying conditions.

The Unna dressing makes an excellent substitute for
rubber bandages used as support to the lower leg, as in
varicose conditions. It gives excellent support, is cheap,
allows of care of ulceration through opening in it, may be left
on from days to weeks in some cases and also seems to have
some medicinal effect on the eczematous condition which so
often exists. Drugs such as resorcin, boric acid and carbolic
acid in small proportions are sometimes added.

PART IV

ADHESIVE DRESSINGS

ADHESIVE plaster dressings are used chiefly for support,
fixation and compression in sprains, fractures and chronic
exudative conditions in tendons, bursse, etc.

Surgeon's Adhesive Plaster. — This is the original rubber
adhesive of a deep yellow color, made with caoutchouc as a
base. It is adhesive at all degrees of atmospheric tempera-
ture, retains its adhesiveness a long time and is not affected
by moisture in the atmosphere. When necessary to keep it
for a length of time it is best preserved in tin- foil, paper or
box.

" ZO " Adhesive Plaster. — This plaster is an improve-
ment over the surgeon's adhesive in that it is made from
rubber from which the irritating substances have been re-
moved. It is preferable to the surgeon's plaster because it is
less irritating, neater and cleaner looking, and in addition is
put up in sterile packets. Moreover, it never leaves its ad-
hesive material on the skin as sometimes occurs with the
surgeon's rubber plaster.

Janus Adhesive Plaster. — This plaster has one surface
coated with " ZO " and the other with plain adhesive. It is
sometimes used for fixing a dressing to the skin.

De La Cour's Adhesive Plaster. — The plaster is made of
lead, resin, and wax and is most often designated by the term
" resin plaster." The plaster has its surface protected with
tissue paper. When cool the paper strips off readily, but ad-
heres tightly when warm. Hence this adhesive plaster is
usually kept near ice in warm weather. A very convenient
manner of keeping a ready supply is to tear off the paper, cut
the strips the desired lengths, and fold up in oiled paper.

84 PRACTICAL BANDAGING

The strips should always be cut, never torn. Before applying
a strip, it must be heated. This may be done by laying it on
the sterilizer or autoclave or by passing it over a flame, ad-
hesive surface down, until the light yellow color of the back-
ing changes to a deeper yellow. It is very important that the
ends of the strips be well warmed (Fig. 118).

Various weight materials are used as backing for the
adhesive, the heaviest being mole skin. This mole skin ad-
hesive is used for the making, of extension dressings, sup-
portive belts, etc.

FIG. 1 1 8. — Heating adhesive plaster.

Isinglass Plaster. — This plaster is a gelatine adhesive
plaster, spread on different weight backings. It is to-day
manufactured under sterile precautions. It needs wetting
before applying and if it is applied near an open wound it
should be moistened with an antiseptic solution. Court-
plaster is merely isinglass spread on various colored cloths.

General Considerations: " ZO " and rubber adhesive are
applied at room temperature although a little warmth in-
creases their adhesive qualities. When tearing the adhesive

ADHESIVE DRESSINGS 85

roll into strips it is better to first separate the backing of web-
bing for half an inch or so across the entire width of the roll.
In starting the webbing, be careful not to allow the extreme
corner of the adhesive to fold upon its adhesive surface and
adhere, causing the ends to curl up after application. Should
this occur it is best to cut the end off rather than separate it.
With a pair of scissors, make cuts along the freed edge,
distant from each other the width of the strip desired, and
tear down the required length. Never attempt to tear ad-
hesive plaster across its width but always in the direction
of its long threads.

Before attempting to apply adhesive the operator should
remove his gloves and free his hands of powder or moisture.
The part to be dressed must be shaved and freed from all
soap and moisture by the application of alcohol, ether or
benzine. In the application of the adhesive strips care must
be taken that the skin is not folded or creased between the
strips, as this causes discomfort and destruction of the epi-
dermis resulting in ulceration. When convenient the ad-
hesive dressing should be covered with a snug gauze bandage,
which causes the adhesive to adhere more firmly, as well as
giving additional support.

The manner of the removal of adhesive from the skin is
very important. If it is to be removed dry, free the ends
and draw it slowly back upon itself, gently pressing the skin
down away from the adhesive surface (Fig. 119). This
method causes little discomfort. Another dry and more
rapid method is to free an end and then with a quick jerk
remove the plaster. This sometimes carries the outer layer
of the skin with it.

For removal with the help of solutions, ether, alcohol,
benzine, gasoline and turpentine may be used. The best
result is obtained, if end of adhesive strip is turned up and
the solution applied to its under surface with cotton or gauze.

PRACTICAL BANDAGING

Adhesive once removed from the skin after being in
place more than a few moments, can never be used again
with any degree of satisfaction, since it fails to stick tightly.
Resin plaster will adhere again if reheated.

When the adhesive is left on for some days, it causes
a dermatitis which is characterized by the formation of
pustules and an itching sensation. This is minimal under
resin plaster or " ZO " perforated sheets. Delicate skin,
especially that of an infant in warm weather, does not tolerate
adhesive plaster for any length of time.

FIG. 1 19. — Removing adhesive strips.

Abdomen (Figs. 120 a, b, c and d). — Adhesive plaster,
" ZO," on mole skin preferably, 7 inches wide and long
enough to a little more than encircle the patient's waist. The
plaster is folded lengthwise with ends meeting and cut in a
curved line from Iqwer corner of the fold to an inch of the
upper corner of the two ends. This gives 3 pieces, I, 2, 3.
The patient should be in the dorsal position with the hips
slightly elevated, when the plaster is applied. No. i piece is
applied with its long straight side passing around the wrist

ADHESIVE DRESSINGS

in a slightly upward direction, just catching the lower ribs.
A V-shaped notch is cut to expose the umbilicus and the
lower point is cut off to avoid adhesion with the pubic hair.
The pieces 2 and 3 are applied over i, one on each side with

FIG. 1200. — Rose binder pattern.

FIG. 1206. — Rose binder being applied.

the curved edge looking upward and inward to adhere to the
lower ribs. It is designated as " the Rose binder."

Umbilicus — Indication, umbilical hernia, small and re-
ducible. Prepare two strips of zinc oxide or resin adhesive
plaster il/2 inches in width, one strip being long enough
to encircle the abdomen two-thirds way, the other, two to

PRACTICAL BANDAGING

three inches long. Place an umbilical button, a coin or a
circle of gauze, J4 incn thick and of sufficient size to easily
cover the umbilicus, on the centre of the long strip. Place
the centre of the short strip over this, with its adhesive sur-
face facing the adhesive surface of the long piece. With the
abdomen relaxed, accomplished best by elevation of pelvis,
with the hernia reduced apply the button over the orifice.

FIG. 120 c. — Rose binder (posterior view). PIG. 120 d. — Rose binder (anterior view).

Draw the abdominal skin forward and carry the ends of
the strap backward and slightly upward, applying them
snugly.

Shoulder (Sayre Dressing). — Prepare two strips of ad-
hesive plaster two or three inches wide, long enough to en-
compass the chest one and a half times. A collar of gauze
or line a shade wider than the adhesive strip is placed around
the arm of the affected side. Looping one end of one of the

ADHESIVE DRESSINGS

strips around the collar, with the adhesive side toward the
chest, drawing the arm backward, the other end is carried
straight across the back and around the chest. Draw the
elbow forward and place the hand of the affected side on
the opposite shoulder. Having cut a hole in the centre of
the second strip for the elbow, place this hole over the
elbow. Then standing on the opposite side of the patient,

PIG. 121. — Say re dressing modified.

draw the two extremities taut in the line of the forearm.
Carry the posterior extremity diagonally across the back and
around the opposite shoulder, the anterior strip up the fore-
arm and over opposite shoulder. This, the original Sayre
dressing, has the disadvantages of a low placed imprisoned
hand, which becomes very uncomfortable due to pressure
on the knuckles and fingers.

Sayre Modified (Fig 121). — Dressings, the same as the

g0 PRACTICAL BANDAGING

Sayre except the anterior strap passing from the affected
elbow to the opposite shoulder has slits cut to enable the
fingers to come through. A small gauze pad is placed on the
dorsum of the hand and two or three thicknesses of gauze
between the forearm and chest. With the hand of the af-
fected side placed well up over the opposite clavicle the ad-
hesive strap is applied as seen in Fig. 121.

FIG. 122. — Acromioclavicular support.

Acromioclavicular Joint (Fig. 122). — Cut an adhesive
strip two inches wide and five feet long. Fashion a pad of
14 to 1 6 thicknesses of gauze 2 inches square with a. hole cut
in its centre. With the arm of the affected shoulder beside
the chest and the forearm flexed at right angles, loop the
centre of the adhesive strip under the elbow about I inch from
the tip. Place the pad over the outer end of the collar bone
and while an assistant presses down on the pad and up on
the elbow, cross the two ends of the adhesive over the pad.

ADHESIVE DRESSINGS

p2 PRACTICAL BANDAGING

carrying one end down across the chest and the other end
down across the back. Apply a cravat sling at the wrist.
The dressing is used chiefly in dislocation of the outer end
of the collar bone or clavicle.

Taped Adhesive (Montgomery Strap) (Fig. 123, a). — Al-
though two or more straps are employed, being all alike, the
description of one will suffice. A strip of adhesive the de-
sired length and width, depending on its use, has attached to
one end a narrow tape from 3 to 6 inches long. The tape can
be attached by stitching or by passing it through a hole near
the end of the adhesive and knotting before folding over the
adhesive, as seen in illustration. The last two inches of the
tape end has its adhesive surface covered by an adhesive strip
applied with the fabric side out. This prevents adhering to
the dressings. These straps are useful to retain dressings
that need frequent changing. They are applied in pairs op-
posite each other and tapes tied over the dressing. To change
the dressing, untie the tapes and turn back on either side.

Catheter Straps (Fig. 123, b) . — This type strap is made
as the above, differing only in having the tape replaced by
heavy silk thread. The adhesive straps are cut */2 inch wide
and 2^/2 inches long. Two to four are usually employed.
Place longitudinally along the shaft of the penis and hold
in place by a spiral bandage.

Dumb-bell Adhesive Strap (Fig. 123, c) . — With the web-
bing loosened at one extremity fold the adhesive plaster back
upon itself. Cut out in the shape of one end of a dumb-
bell, the centre of the bar corresponding to the folded edge of
the plaster. When unfolded this forms a symmetrical dumb-
bell or double-bladed canoe paddle dressing. Strip off the
webbing and apply as desired. Its common use is as a tension
strap for repaired hair lips and other wounds whose edges
are inclined to separate.

Laced Adhesive (Fig. 123, d). — To one edge of two ad-
hesive strips the desired length and width, are sewed small

ADHESIVE DRESSINGS

dress hooks, opposite each other. The two straps are applied
one on each side of the wound, with the hooks next the
wound, and laced together with a silk thread.

Splints (Fig. 123, e). — Adhesive plaster is often used to
splint a broken finger by binding the injured member to the
neighboring finger, or by reduplicated strips. Coaptation

FIG. 124. — Back strapping.

splints are frequently united in series by placing them
parallel between two sheets or wide strips of adhesive, thus
forming a Gooch splint (see figure).

Furuncle Cone (Fig. 123, /). — Cut a circle of adhesive
the desired size. Make an incision from the circumference to
its centre and overlapping make a dart. If desired the apex
of the cone may be cut off to permit evaporation.

Back (Fig. 124). — Fifteen or twenty " ZO " adhesive
strips I inch wide and from 10 to 12 inches long are re-

PRACTICAL BANDAGING

quired. Apply the first strip reaching from just below the
angle of the shoulder-blade on one side to the posterior
superior spine of the iliac bone of the opposite side. Cross
this strip with a similar one passing from the other shoulder-
blade to the opposite posterior iliac spine. Apply these strips
alternately, crossing them in the midline of the back and
proceeding down the back, each strip overlapping one-half

FIG. 125. — Buck's extension.

the width of the corresponding one immediately preceding.
Stirrup Extension Strap (Buck's Extension) (Fig. 125).
— Fold a long piece of mole skin adhesive upon itself for the
desired length of the extension. For example, it should
measure 6 or 8 inches longer than the distance from its
highest point of application to the foot, in case of a lower
extremity dressing. With the loop edge the centre of the
handle, cut the doubled material in the shape of one end of
a double-bladed canoe paddle, the blade being lengthened

ADHESIVE DRESSINGS

toward the handle. The blades should be a little less than
one-half the circumference of the part it is to cover and the
handle should be 2^ to 3 inches wide. Cut a small hole in
the centre of the handle and place over the hole the centre
of the stirrup or spreader, a piece of wood, the width of the
strap, a little longer than width of part where the adhesive
leaves it, and y± inch thick. Cover exposed sides of spreader
and for 6 to 8 inches out on adhesive side of strap with a

FlG. 126. — Ankle strapping.

strip of adhesive of same width and with hole in centre. A
stout cord passes through the superimposed holes.

Ankle (Fig. 126).— Take about 10 strips of " ZO," 10
inches long and J4 to % mcn wide, and 10 strips of the
same width, but from 14 inches to 16 inches long, shave off
any hair that may be present. Place the foot at right angles
to the leg. A long strip is applied with the centre over the
back part of the sole of the heel and the two ends carried up
one on each side of the Achilles tendon, putting the most

95 PRACTICAL BANDAGING

tension on the end corresponding to the side of the strained
ligament. A short strip is next applied to the posterior aspect
of the heel as low down as possible and each end is applied on
one side of the foot as near the plantar surface as possible.
The strapping is continued by alternating first a long strip
up the leg, then a shorter strip down the foot. Each strip
overlaps about one-half the width of the previous one. The
leg strips approach the front of the leg and the foot strips
ascend the foot. Extending up the middle of the dorsum of
the foot and ankle there should be a space at least three-
quarters of an inch wide left free of plaster, in order to
obviate any possibility of interference with the circulation.
Occasionally a few circular strips are applied around the
instep for additional support. Cover the entire dressing with
a few turns of gauze bandage to retain it for a few hours
until the plaster adheres.

Another method of strapping the ankle is by using six
or eight pieces of adhesive I inch wide and 18 inches long.
To fix the internal ligament, start the first piece on the dorsum
of the foot; pass outward around the outer edge, beneath the
instep, up the inner side diagonally, and up the ankle an-
teriorly, crossing to the outer side of the calf. Apply all
the strips in the same manner, each overlapping about one-
half the previous one. To splint the external ligament, re-
verse the direction of the strips, starting on the outer side of
the foot then around under the instep and up the inner side of
the leg. These dressings are used very often as supportive
measures in the treatment of sprains of the ankle and tarsus.

Chest (Fig. 127). — For fractured ribs have six or eight
adhesive " ZO " strips, 3 inches wide and long enough to
reach from the spine to the sternum. Have the patient stand
or lie with the affected side toward the surgeon and with the
hand of the same side on his head. The other shoulder should
be against the wall or something solid, if patient is in stand-
ing position. Apply the end of the strip firmly at the spinal

ADHESIVE DRESSINGS 97

column at least 3 or 4 inches above the site of the injury.
The patient is told to empty the lungs and as he does so, the
plaster strip is drawn forcibly downward and forward and
smoothly applied to the chest, in a nearly horizontal direction.
Each strip is applied in this manner, overlapping one-half

FIG. 127. — Chest strapping.

the previous one. The dressing should extend, if possible,
3 inches or 4 inches above and below the injured rib or ribs.
It is claimed by some that it is better to apply the strips below
first, overlapping from below upward. The dressing properly
applied will make the patient comfortable, relieving him of
the knife-like pain on respiration. If this is not accomplished
the dressing must be applied tighter. For pleurisy the dress-
7

PRACTICAL BANDAGING

ing should cover as much of the side as possible. In case of
the upper ribs being broken, and in women, better fixation is
obtained by passing a strip 3 inches to 4 inches wide entirely
around the chest, above the breasts.

Should additional rigidity and fixation be desired, suc-
cessive layers of strips may be
applied crossing each other in
different directions.

Knee (Fig. 128).— Have
prepared 15 to 30 strips, ^4 mcn
wide and 12 inches to 14 inches
long. The leg is extended on the
thigh and the hair shaved. A
strip is applied with one end on
the outer side of the thigh 6
inches to 7 inches above the
joint, and carried diagonally
down across the knee below the
joint line, and on the inner aspect
of the leg. The second strip is
started on the inner aspect of the
thigh, 6 inches or 7 inches above
the joint, and then carried
diagonally down and across the
joint, crossing the last strip in the
midline below the patella and
then passing on down on the
outer aspect of the leg. The
remaining strips are applied al-

. FIG. 128. — Knee strapping. J . 1-1 j

ternately on each side, and over-
lapping one-half the width as they ascend the limb.

Leg — Adhesive strips, J/£ inch wide and long enough to
three-quarters encircle the leg, are torn. Number varies with
desired size of dressing. Apply strips as described in strap-
ping knee. The dressing is used for varicose leg ulcers.

ADHESIVE DRESSINGS 99

Inguinal Dressing (Fig. 129). — This is made of a piece
of flannel 6 inches wide and 16 inches long to each end of
which is sewed a strip of adhesive plaster 16 inches long.
The flannel part surrounds the leg, the adhesive pieces cross
over the inguinal region, and adhere to the flanks.

Achilles Tendon (Fig. 130). — The foot is put at right
angles to the leg or in position of a slight toe point. An ad-
hesive strap 1 8 inches long and 2 inches wide is split at one

PIG. 129. — Inguinal dressing.

end for two-thirds of its length. The uncut portion of the
plaster is applied to the sole of the foot, the angle of the
slit reaching the point of the heel. The outer strip is now
crossed over the tendon diagonally to the inner side and
carried up the calf. The inner strip is crossed over the tendon
diagonally to the outer side and carried up the outer side of
the calf. A circular strip may be placed around the ex-
tremities of the strips above and below. The dressing is

100

PRACTICAL BANDAGING

often better made with several strips of the above length and
YZ inch wide applied in much the same manner, except that
they are started under the instep, passed up beside the

heel and across the tendon up the
calf. The dressing is employed
for strains of the tendon, tenosyno-
vitis, and rupture of the tendon or
muscle.

The Testicles — First remove
the hair from the part of the scro-
tum to receive the adhesive. Then
cut 1 5 to 20 adhesive strips 5 inches
long and l/4 inch wide. The af-
fected testicle is pushed down into
the scrotum, the scrotum drawn
tense over it by encircling the top
of the testicle with forefinger and
thumb. This accomplished, apply
adhesive strip around the upper
part of the testicle. Now pass the
other strips around the testicle in
the direction of its long axis, be-
ginning and ending on the circular
strip and overlapping a third of the
previous strips. When covered by
a layer in this direction, pass
another layer at right angles to the
first.

Adhesive Suspensory. — A strip
of adhesive 5 inches wide and 12
inches long is split down the middle
for two-thirds its length. The
penis and scrotum are pulled up on the abdomen and the
broad end of the adhesive applied firmly across the perineo-
scrotal junction. The split in the plaster is lengthened down

PIG. 130. — Achilles tendon
strapping.

ADHESIVE DRESSINGS

101

to the penoscrotal junction. The penis is drawn into the apex
and the two ends fastened to the abdomen.

Pelvic Binder (Fig. 131). — Cut adhesive strip 3^ inches
to 4 inches in width and long enough to pass one and a half
times around the hips. Face the centra '.ihu'd, pf tHe^frip
with a similar though shorter strip, so that the adhesive sur-
faces are together. With the patient lying O6*»iq£? |£|4fc&JGP'
or standing, pass the binder across the lower abdomen be-
tween the crests of the iliac bones. After placing a small
"bunion plaster" pad around each anterior spine of the

FlG. 131. — Pelvic binder.

pelvis, draw the two ends of the binder taut, crossing them
over the sacrum and carrying each toward the opposite
trochanter.

Sometimes, in patients with pendulous abdomens, this long
strap binder is not feasible as it is rolled up by the abdomen
pressing down on it. In such cases, several strips 2 inches
to 3 inches wide and reaching from anterior superior spine
across the back to opposite anterior superior spine are applied
crossing each other in the centre in a diagonal direction to-
ward the opposite trochanter.

PART V

.RLASTERrQF;PARIS OR GYPSUM BANDAGES

. m 'General Coh&idelrations. — Plaster dressings are used for
fb&tidij'oipaftfej tfvj£r an extended period of time. Less com-
mon fixation dressings are silicate of soda and starch dress-
ing. The material used for the bandage is unwashed crino-
line. This is cut in strips the desired width and the mesh
filled with fresh plaster of Paris, dry and free from lumps.

FIG. 132. — Making plaster bandages.

A much quicker way is to spread the entire width of the
crinoline with the plaster, and, after rolling it, cut it the de-
sired lengths by the use of a saw and mitre box (Fig. 132).
The plaster, if exposed to damp air, will become air slaked
and then the cast will crumble apart. To avoid this bake in an
oven all plaster that has been in stock for some time. Spread
the plaster on the unrolled bandage after which the bandage
102

PLASTER-OF-PARIS OR GYPSUM BANDAGES

is rolled loosely and if to be kept for any length of time is
stored in air-tight receptacles.

Plaster bandages can be bought already prepared, and
put up in air-tight receptacles. Most such bandages are rolled
too tightly, to wet through easily, and are made of gauze
which is not as good as crinoline.

As a broad, general principal, a plaster cast should extend
beyond the joint on each side of the fracture. They are ap-
plicable for practically every fracture except those of the
head, clavicle, ribs and of the femur in infancy. A newly
applied cast should be viewed in a few hours. If this is im-
possible the cast should always be split while yet damp. Al-
ways advise the patient to report if there is any undue swell-
ing, coldness, discoloration, numbness, tingling or throbbing,
any one of which may indicate that the dressing is too tight.
A properly applied cast should be comfortable. Any con-
tinued complaint on the part of the patient should demand
careful examination or even the removal of the cast.

Application of a Plaster Cast — The part to* be dressed
should be shaved and washed and then covered with flannel
bandages, cotton, tricot hose, or sheet wadding, torn in band-
age strips and applied in the manner of a bandage, also all
bony prominences should be well padded with some soft
material (preferably non- absorbent cotton) to prevent pres-
sure points. Have ready a gown for the doctor and protec-
tion for the bed and floor. Have a basin or bowl with suffi-
cient warm water in it to completely cover the plaster bandage
when set on end in the bowl. A bowl of loose, dry plaster,
some table salt, and some vaseline or petrolatum should also
be handy. A pinch of the salt dissolved in the water will
hasten the hardening or setting of the plaster. The vaseline
may be rubbed into the operator's hands in the absence of
gloves to prevent the plaster sticking to them or on the
patient's skin for the same reason. The plaster rollers are

104

PRACTICAL BANDAGING

immersed one at a time in the warm water as needed and
allowed to remain standing on end until the air bubbles have
ceased to rise from the roller. The bandage must not be
submerged until the operator is nearly ready for it, for if
allowed to remain in the water too long the plaster sets and
becomes hard, and is rendered useless. On removing the
roller from the water both ends should be grasped (Fig. 133)

FIG. 133. — Method of squeezing water from bandage.

and the excess water squeezed out by a twisting motion. To
obviate loss of plaster in submerging, .each bandage may be
wrapped in filter paper or Japanese paper napkins. With
wrapper still on, the bandage is removed from the water and
squeezed. The water escapes but not the plaster. The part to
be bandaged is held by an assistant, two, if necessary, in the
exact position ultimately desired. In applying the plaster
bandage the principles of an ordinary bandage are used, with
few exceptions. The plaster bandage is never pulled taut;

PLASTER-OF-PARIS OR GYPSUM BANDAGES

nor reverses used in the first layer or two, for as the bandage
does not slip, the change in direction is accomplished by the
folding of a dart in the inferior edge, and then using short
figure-of-8 turns. The turns should overlap about one-half
the previous turns and the loose borders in any turn are
smoothed back with the thumb and finger as " darts " which
readily adhere and stay in place. An excellent finish can be
given the dressing by turning back cuff-like fashion, the ends
of the flannel bandage, wadding, or tricot used, and holding
it in place by the final turns of the plaster bandage, catching
the free edge. While the cast is still pliable it may be molded
to fit the contour of the part. This is a dangerous procedure
except in skilled hands as pressure points are likely to be
produced.

The discarded plaster in the basin should not be poured
down the waste, as it will harden and close the drain pipe.

In order to reinforce a cast, use is made of strips of box-
wood, card-board, gutta percha, tin and zinc, bent to fit the
part, and covered in by the plaster bandage (Fig. 145, a).
At times the reinforcement is made by simply reduplicating
several turns of the bandage of a recurrent nature, each ap-
plied on the preceding ones and smoothed down. To give
additional support and strength, a cream of plaster (gyp-
sum), made by mixing the plaster with water, is applied by
the hands in a thin layer between the succeeding turns. The
plaster cream is mixed as follows : The desired amount of
cold water is placed in a basin and dry plaster powder is
dusted by hand into the water until the solution is saturated,
which is indicated by the plaster floating on the water. When
this point is reached stir with the hand until the plaster has a
creamy consistency. A strong objection to the use of this
cream between the layers, is the increased weight added to the
cast, and at the same time rendering it more brittle. Finally,
the completed cast is covered with this gypsum cream, which

I0<5 PRACTICAL BANDAGING

is smoothed off with a wet cloth. This when dried gives
a gloss that is especially desirable in cases where urine is
liable to come in contact with the cast. A coating or varnish
may be applied, after the cast has thoroughly dried. Great
care must be exercised during the application and afterward,
until setting has occurred, that the limb is held in the one
position desired, and that the cast is not indented by fingers
or other pressure. After 10 to 20 minutes when the cast
has begun to harden, the limb may be rested on a soft pillow
for its full length. Free access of the air to the plaster is
necessary, as it takes from 20 to 24 hours to dry out thor-
oughly. When a hot air apparatus is at hand the cast may be
baked for half an hour. Immediately after the completion
of the bandage, the circulation of the part distal to the band-
age should be examined, a part being left exposed for this
purpose. Should the cast be too tight as shown by discolored,
cold, numb or tingling extremities, it should be cut through
longitudinally, while still moist, and any underlying con-
stricting band of wadding or bandage cut through. Follow
this with elevation of the part, and it will seldom be necessary
to remove the entire cast

Method of Removing a Plaster Cast. — While the cast is
yet moist a groove is cut with a sharp knife, longitudinally,
to within an inch of each end. The sensation readily im-
parted to the hand when the knife cuts through upon the
flannel bandage or wadding, tells one when the cast is divided.
A Gigli or chain saw may be placed, Fig. 134, at the time
of application, under the plaster bandage in the desired posi-
tion and later the plaster cut by a sawing motion and the
sides pulled apart as in Fig. 135. An additional safeguard
against possible injury to the underlying parts is the applica-
tion of a zinc strip, or an oiled rubber tubing placed under the
plaster bandage, in the line of incision, its ends protruding to
indicate where to cut. A similar line of incision on the

PLASTER-OF-PARIS OR GYPSUM BANDAGES

107

I0g PRACTICAL BANDAGING

opposite side of the cast will enable one to remove it in two
longitudinal sections. Should it be desired to cut the cast
after it is hardened, mark the line of the intended cut with
the knife, then apply a few drops of water, vinegar, acetic
acid or dilute hydrochloric acid along the groove and proceed
to cut through the cast, using more fluid from time to time
to facilitate the cutting. If a furrow is cut from a cast it can

FIG. 135. — Removal of cast.

be readily sprung off and on again if desired. In removing
a cast always cut through the under dressing and remove it
with the cast, as it always adheres to the plaster. When a
cast is reapplied its edges may be held together with a band-
age or adhesive straps.

Fenestration of Casts (Fig. 136). — This is to permit the
dressing of the wounds without necessitating removal of the

PLASTER-OF-PARIS OR GYPSUM BANDAGES

cast. The site of the wound should be accurately determined
by measurement before the part is bandaged. The gauze
dressing over the wound should be the size and shape of the
desired fenestra or window. After marking out on the still
damp plaster the outlines of the opening, the window is cut
out with a sharp knife, just as in removing a cast. The rough
edges of the cast are covered with radiating strips of adhesive,
shellac, gutta percha tissue, or oiled silk. A second method
of fenestration is to place a pill box top, a glass, or graduate
over the wound and carry the turns of the plaster around

FIG. 136. — Fenestration of cast.

this. A third method is to cut two pieces of blotting paper
the size and shape of the desired opening, pass a pin through
the centre of one and place over the wound, allowing the
pin to stick up. Apply the plaster around the pin, then when
ready to cut out the window, place the second piece of blotter
with the pin through its centre, and cut out around it.

Ambulatory Casts — This manner of fracture dressing is
applicable to fracture of the leg and ankle where there is no
need for extension, or, when the patient must be around even
though unable to use two crutches, because of disability of
one arm. The upper limit of the cast should be above the
knee, for fractures above the middle of the leg, and only up

PRACTICAL BANDAGING

to the tibial tuberosities in lower fractures. The cast must
be especially heavy at the knee and ankle and the sole of the
foot, to prevent cracking from weight. It transfers the
weight from the tuberosities of the tibia to the ground or
floor. Between the sole of the feet and the cast a thick pad

of cotton is interposed to give
cushion support to the foot. Thick
padding is necessary also around
and under the tibial tuberosities.
This dressing is sometimes used
in cases of delayed union, the
theory being that the slight mo-
tion at the site of fracture will
stimulate callus formation.

Segmented or Bracket Casts
fm (Fig. 137). — When it is desired
to have access to wounds of joints
or wounds extending around a
large part of the circumference of
the extremity, the part is bridged
over by bands of metal, the ex-
tremities of which are incorpor-
ated in the segments of plaster
above and below. Sufficient curva-
tion is given the strips to allow
for the desired ministrations to
the parts.

Plaster Splints. — These may
be made from plaster bandages,
folded repeatedly one on the other, and applied still
wet and molded to the part. Cut from lint, patterns of the
splint you desire, care being taken that the lint is cut so that
when applied on each side of the limb the soft side is next
the skin. Make the pattern slightly larger than you wish the

PIG. 137. — Segmented or bracketed
cast.

PLASTER-OF-PARIS OR GYPSUM BANDAGES

III

splint. The pattern can be made more accurately by taking
measurements of one-half the circumference of the limb,
at various known levels, as, for example, at the knee and
ankle, in leg splints. Lay the lint, soft side down, on a table
and then apply repeated layers of plaster bandage and wet
plaster until the desired thickness is obtained (Fig. 138).
Usually 6 or 8 layers are sufficient. Rather than make the
body of the splint with layers of gauze or crinoline bandage,
one may use two or three layers of lint cut to fit pattern and
impregnated with the plaster cream. These are laid upon the

FIG. 138. — Making plaster-of -Paris splint.

corresponding patterns and the splints are completed (Fig.
139). The splint is now applied to the part, the plaster side
out, and bound snugly in place with a gauze bandage (Fig.
140). A second splint, made in similar manner, is applied
to the opposite side and bound in position with a gauze band-
age. At these places where the splint must be molded to
sudden change in shape or diameter, a dart is made, after
first cutting in the splint edge for one to two inches. In most
cases two splints are desirable (Fig. 141). Each should be
broad enough to encircle nearly one-half the limb. They are
especially applicable for the leg and forearm and are held in
place by a circular plaster strip, by adhesive straps or by
roller bandage. Plaster splints thus used have many ad-
vantages over the older circular " cast." A nurse can be

112

PRACTICAL BANDAGING

making it while the doctor is busy at other parts of the
dressing. It is very convenient for removal (Fig. 142) and
inspection of the parts without disturbing the position, as
one or the other splint may be lifted. By having only one

FIG. 139. — Making a plaster splint of flannel.

of the splints take in one joint and the other take in the

other joint on each side of the fracture, by alternate removal,

the freed joint can be given massage and passive movement.

Barvarian Splint — Suspend the limb in a sufficiently large

PLASTER-OF-PARIS OR GYPSUM BANDAGES

piece of lint or flannel. Stitch the sides together down the
front of the leg and around under the foot. Now apply a
casing of plaster cream at least *4 incn thick. Over this
apply a flannel layer. When dry, trim off excess, cut stitches

FIG. 140. — Plaster splint.
FlG. 141. — Moulding and binding in position.

and turn back, protecting the edge with leather or adhesive.
The dressing is retained by bandage, straps or laces.

Plaster Jacket (Figs. 143 and 144). — This dressing is to
be applied to the trunk or neck, when fixation and extension

PRACTICAL BANDAGING

FIG. 142. — Plaster splints removed.

FIG. 143. — Patient suspended for appli-
cation of plaster-of-Paris jacket.

FIG. 144. — Plaster jacket.

PLASTER-OF-PARIS OR GYPSUM BANDAGES

are desired. The patient is partially suspended from the
ceiling, or tripod, with straps under occiput and chin and one
under each axilla, or placed prone on a Bradford frame. A
cylinder of stockinette or tricot, twice as long as the desired
cast, is placed over the part to be jacketed, and holes cut
out for the arms. A strip of gauze bandage is placed between
this and the skin to be used as a scratching string. A ,pad
of gauze or a folded towel y2 inch thick and 4 inches square
is placed on the lower abdomen as a dinner pad. Bony promi-
nences are well padded, and the plaster bandages, 3 inches to
6 inches wide are applied, in ascending and descending spirals,
well up under the arms, or around the neck, in cervical cases
and well down over the pelvis. Additional turns may be made
over the shoulders and ngure-of-8 turns under the axilla.
After the plaster has " set " and is still wet, the margins are
trimmed out, above and below, and the stockinette extremities
pulled back, as a cuff on each end, and sewed together thus
enveloping the cast outside and inside. To lighten the cast
portions of it may be cut out of the anterior surface. Re-
move the dinner pad. This dressing is used for conditions
of the vertebrae demanding fixation and extension, such as
tuberculous disease, severe sprains and dislocations.

Plaster Spica of the Lower Extremity (Figs. 145 and
146). — For the application of plaster cast to the pelvis and
thigh use may be made of the hip rest or, better, the Martin-
Eliason sling. In the absence of hip rest or sling the super-
imposed fists may be used as a support. The parts to be
enveloped in plaster are covered with tricot hose, or sheet
wadding, with abundant padding over the sacrum and an-
terior superior spines and a dinner pad placed on the lower
abdomen. Pad the back of the knee well and place a strip
of wadding down each side of the crest of the shin. Place
the canvas slings under the patient, one under the head,
another under the shoulder, the third under the pelvis and the

PRACTICAL BANDAGING

PLASTER-OF-PARIS OR GYPSUM BANDAGES

117

PRACTICAL BANDAGING

fourth to hold the unaffected lower limb. Slide the frame
over the bed. After attaching the slings to their respective
pulleys, the patient is raised from the bed. Remove the bed
and apply the cast, by making spica turns around hips and
thigh, incorporating reinforcing strips across the groin.
In cases of fracture in the upper third of the femur it is

FIG. 147. — Plaster shoulder cap.

best to encase the thorax up to the arm pits, both thighs and
the injured leg as far as the ankle, placing the limb in the
desired position. The pelvic sling remains in the cast.

Plaster Shoulder Cap (Fig 147). — With the arm held at
the patient's side and a triangle pad between it and the chest,
envelop the whole with flannel bandage and apply several
layers of plaster bandages passing around the chest and arm

PLASTER-OF-PARIS OR GYPSUM BANDAGES

and over the shoulder well in toward the base of the neck.
The lowest turns should pass around just above the bend of
the elbow. Sling the arm at the wrist.

Although this is the most rigid cap it is sometimes irk-
some because of the chest constriction. If such is the case
make the cap to come only to the midline of the body front
and back and incorporate in it bandage strips or webbing
straps, as shown in Fig. 147.

Sodium Silicate (Liquid Glass) — Sodium silicate in aque-
ous solution is often used in making a fixation dressing. Pre-
pare the solution by evaporating 25 per cent, and adding
gelatine, a drachm to the pound. Cover the part to be dressed
with a single layer of gauze bandage and paint the silicate
directly on it with a brush. Then apply successive layers of
bandage and silicate until the desired thickness is obtained.
Usually 4 or 5 thicknesses are sufficient. It is not necessary
to apply any padding beneath the dressing, although it may
be used if the skin is hairy.

A casing made with silicate has many advantages over
plaster. It is less trouble to apply it, is lighter, more compact
and, weight for weight, is very much stronger and more rigid.
It is especially useful for splinting toes, fingers and arms.

Its one disadvantage is the length of time it requires to
dry. This period is shortened considerably by the addition
of gelatine, or mastiche added in small quantities. Stability,
until the dressing hardens, is lent by the incorporation of
strips of card-board.

This dressing is readily removed by cutting with bandage
scissors or by using warm water, as silicate is readily soluble
in water, but not in alcohol or ether.

Starch Bandage — Make a cold starch solution of a
creamy consistency. Heat this until it becomes a clear, sticky
fluid. Dress the part to be bandaged with a flannel bandage,
or sheet wadding. Making use of a previously shrunken

I20 PRACTICAL BANDAGING

gauze or crinoline bandage, immerse it in the starch fluid
until it is well saturated, then apply as you would a plaster-
of-Paris bandage. Probably a much neater way is to apply
the bandage dry and then paint it with the liquid starch. As
many layers as desired are applied, reen forced, if necessary,
by strips of metal, card-board, etc.

Care must be taken in the application of starch dressing
that due allowance be made for any shrinkage that may occur.

The two objections to the dressing are its lack of strength
and the long time it takes to get dry and hard, 24 to 36 hours
usually being necessary.

INDEX

Abdomen, 86
Achilles tendon, 99
Acromioclavicular joint, 90
Adhesive dressings, 83-101
laced, 92

plaster, De La Cour's, 83
Janus, 83
surgeon's, 83
" ZO ", 83
strap, dumb-bell, 92
suspensory, 100
taped (Montgomery strap), 92
Ambulatory casts, 109
Ankle, 95
Anterior figure-of-8 of shoulder

and chest, 34
pelvic triangle, 76
Application of plaster cast,io3~io6
Arm and forearm, quadrangle

bandage or sling of, 62
Auriculo-occipital triangle, 67

Back, 93

Bandage, Barton, 47
of buttock, "T," 59
of chin, four-tailed, 60
circular, 6
circular turns of, 5
crossed, of perineum, 31
Davis, 41, 42
Desault, 38-41
of ear, " T," 58
of elastic fabric, 81
ending, 6
of eye, " T," 57
figure-of-8, 19, 22-25, 33, 34,

38, 47
four-tailed, of nose and upper

lip, 60
gauntlet, 12
Gibson, 48
of groin, " T," 59
Mayor's, 74

modification of Mayor's, 75
monocle or crossed, of one eye,

oblique fixation of, 5
of jaw, 49

Bandage, of occiput, quadrangle.
61

perineal (Cunningham), 56

perineal " T," 55

requisites of, 5

of scalp, " T," 57

spica, 17, 31

spiral, 6

reverse, 7

starch, 119, 120

Velpeau (modified), 42-46

Dulles, 46
Bandages, demigauntlet, 12

elastic, 2, 80-82

handkerchief, 65

how to roll, 3

material composing, i

method of holding, 4

miscellaneous, 55-79

plaster-of-Paris, or gypsum,
102^-120

preparation of, 2

purposes of, I

rolled by hand, 4
by machine, 3

roller, 1-54

starting, 5

tailed, 55
Barton bandage, 47

modified, 48
Bavarian splint, 112
Binder, pelvic, 101

Rose, 87
Binocular or crossed bandage of

both eyes, 54
Bitemporal triangle, 66
Brachiocervical triangle (a and

&), 71, 72
Brachioscapular triangle (a and

b), 73, 74

Breast, suspensory of, 34, 36
Breasts, figure-of-8 of (Kiwisch),

suspensory of both, 37

triangle of, 71
Buck's extension, stirrup extension

strap, 94

Buttock, " T " bandage of, 59
121

122

INDEX

Cap, plaster shoulder, 118

Cast, plaster, application of, 103-

106
method of removing, 106-

108

Casts, ambulatory, 109
fenestration of, 108
segmented or bracket, no
Catheter straps, 92
Chest, 96-98

double " T " of, 59
Chin, four-tailed bandage of, 60
Cone, furuncle, 93
Considerations, general, 84-86, 102
Cravats, 79

Crinoline or tarlatan, 2
Crossed bandage of perineum, 31

or binocular, of both eyes,

54
or monocle, of one eye,

53
Cunningham, perineal bandage, 56

Davis bandage, 41, 42

De La Cour's adhesive plaster, 83

Demigauntlet bandages, 12

Desault, 38-41

Double oblique of jaw, 50

roller, recurrent of scalp with,
52

spica of groin, 29

" T " of chest, 59
Dressing, inguinal, 99

Sayre, shoulder, 88

Unna's, 81, 82
Dressings, adhesive, 83-101
Dulles (Velpeau modified), 46
Dumb-bell adhesive strap, 92

Ear, " T " bandage of, 58
Elastic bandage, 80-82

fabric bandage, 81

webbing, 81

Eye, monocle or crossed bandage
of one, 53

" T " bandage of, 57
Eyes, both, binocular or crossed

bandage of, 54
Esmarch tube or tourniquet, 81

Fabric bandage, elastic, 81
Fenestration of casts, 108
Figure-of-8 of breasts (Kiwisch),

38
of head and neck, 47

Figure-of-8 of leg, 22-25

short loop method, 22
long loop method, 25
method-3, 25

of shoulder and back, pos-
terior, 33

and chest, anterior, 34
Finger, ring, 10
spiral of, 10

reverse of, 10, n
Flannel, 2
Foot, spiral of, covering heel, 19, 20

triangle, 79

Four-tailed bandage of chin, 60
of.nose and upper lip, 60
Fronto-occipital triangle, 66
Furuncle cone, 93

Gauntlet bandage, 12
Gauze, 2

General considerations, 84-86, 102
Gibson bandage, 48
Gluteal triangle, 78
Groin, " T " bandage of, 59
Gypsum, or plaster-of-Paris band-
ages, 102-120

Hand triangle, 76
Handkerchief bandages, 65
Hammock, scrotal, 76
Head and neck, figure-of-8 of, 47

square cap of, 68-70

triangle of, 67

Inguinal dressing, 99

triangle, 78
Isinglass plaster, 84

Jacket, plaster, 113-115
Janus adhesive plaster, 83
Jaw, double oblique of, 50

oblique of, 49
Joint, acromioclavicular, 90

Kiwisch, figurerof-8 of breasts, 38
Knee, 98

triangle, 79

Laced adhesive, 92

Leg, 98

figure-of-8 of, 22-25

short loop method, 22
long loop method, 25
method-3, 25

INDEX

123

Lip, upper, and nose, four-tailed

bandage of, 60

Liquid glass, sodium silicate, 119
Lower extremity, plaster spica of,

115-118

Many tailed bandages (Scultetus),

Martin's rubber bandage, 80
Mayor's bandage, 76

modification of, 75
Method of holding bandages, 4
of removing a plaster cast,

106-108

Miscellaneous bandages* 55~79
Modification of Mayor's bandage,

Modified Barton, 48

Velpeau (Dulles), 46
Monocle or crossed bandage of

one eye, 53
Montgomery strap, taped adhesive,

Neck and head, figure-of-8 of, 47

quadrangle bandage of, 61
Nose and upper lip, four-tailed
bandage of, 60

Oblique of jaw, 49
double, 50

Occipitofrontal triangle, 66
Occiput, quadrangle bandage of,
61

Pelvic, anterior, triangle, 76

binder, 101

posterior, triangle, 76
Perineal bandage (Cunningham),
56

" T " bandage, 55
Plaster, adhesive, De La Cour's,

casts, applications of, 103-100
method of removing, 106-

108

isinglass, 84
jacket, 113-115
Janus adhesive, 83
shoulder cap, 118
spica of lower extremity, 115-

118

splints, IIO-H2
surgeon's adhesive, 83
" ZO " adhesive, 83

Plaster-of-Paris or gypsum band-
ages, 102-120
Posterior figure-of-8 of shoulders

and back, 33
pelvic triangle, 76
triangle of shoulders, 70

Quadrangle bandage of neck, 61
of occiput, 61
of vertex, 61
or sling of arm and fore-
arm, 62
of shoulder, 61

Recurrent of scalp, 51
transverse, 52
with double roller, 52
Requisites of bandage, 5
Roller bandages, 1-54

double, recurrent of scalp

with, 52
Rose binder, 87
Rubber bandage, Martin's, 80

Sayre dressing, shoulder, 88

modified, 89
Scalp, recurrent of, 51

with double roller, 52

" T " bandage of, 57

transverse recurrent of, 52
Scrotal hammock, 76

square, 78

triangle, 78
Scultetus, many tailed bandages,

Segmented or bracket casts, no
Shoulder cap, plaster, 118

quadrangle bandage or sling

of, 61

Sayre dressing, 88
triangle, 75
Shoulders, posterior triangle of,

Silicate, sodium (liquid glass), 119
Sling, tibiocervical, 78
Sodium silicate (liquid glass), 119
Spica of foot, 21
of groin, 25-29
of lower extremity, plaster,

115-118

of shoulder, 16
of thumb, ascending, 13, 15
descending, 13, 15

124

INDEX

Spiral of foot covering heel, 19,

20
reverse of upper extremity, 14,

15
of lower extremity, 17, 18,

Splint, Bavarian, 112
Splints, 93

plaster, 110-112
Square cap of head, 68-70

scrotal, 78

Starch bandage, 119, 120
Starting bandages, 5
Stirrup extension strap (Buck's

extension), 94

Strap (Buck's extension), 94
dumb-bell adhesive, 92
Montgomery, taped adhesive,

Straps, catheter, 92
Surgeon's adhesive plaster, 83
Suspensory, adhesive, 100
of breast, 34, 36
of both breasts, 37
triangle, of breasts, 71
Swathes, 63-65

Tailed bandages, 55

Taped adhesive (Montgomery

strap), 92
" T " bandage of buttock, 59

of ear, 58

of eye, 57

of groin, 59

of scalp, 57
Testicles, 100

Thoracicohumeral triangle, 71
Thoracicoscapular triangle, 70
Tibiocervical sling, 78
Tourniquet, 79, 81
Transverse recurrent of scalp, 52
Triangle, anterior pelvic, 76
auriculo-occipital, 67
bitemporal, 66

Triangle, brachiocervical (a and

b), 71, 72
brachioscapular (a and b), 73,

x 74

foot, 79

fronto-occipital, 66

gluteal, 78

hand, 76

of head, 67

inguinal, 78

knee, 79

occipitofrontal, 66

posterior pelvic, 76

scrotal, 78

shoulder, 75

of shoulders, posterior, 70

suspensory of breasts, 71

thoracicohumeral, 71

thoracicoscapular, 70

verticomental, 66
Tube or tourniquet, Esmarch, 81
Turns, circular, 9, 16, 17, 19, 21,

25, 28, 29, 34, 35, 37, 42, 46
Turns, figure-of-8, 9, 15, 16, 17,
25, 36, 38, 47

fundamental, 6

horizontal, 31, 35, 37, 43, 44

oblique, 35

recurrent, 9

spiral, 38, 39

or spiral reverse, 19

vertical, 43, 44

Umbilicus, 87

Unna's dressing, 81, 82

Velpeau (modified), 42-46

Dulles, 46

Vertex, quadrangle bandage of, 61
Verticomental triangle, 66

Webbing, elastic, 81

" ZO " adhesive plaster, 83

THIS BOOK IS DUE ON THE LAST DATE
STAMPED BELOW

AN INITIAL FINE OF 25 CENTS

WILL BE ASSESSED FOR FAILURE TO RETURN
THIS BOOK ON THE DATE DUE. THE PENALTY
WILL INCREASE TO SO CENTS ON THE FOURTH
DAY AND TO $1.OO ON THE SEVENTH DAY
OVERDUE.

BIOLOGY LIBRARY

-P 30

EEB 1 1 1942

^Stf H 191M8

DEC 86

LD 21-10m-7,'39(402s)

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