DR. D.Y.

PATIL COLLEGE OF AYURVED

&RESEARCH INSTITUTE

PADMASHREE DR. D.Y.PATIL UNIVERSITY NERUL,
NAVI MUMBAI.













Project Prepared By
YUGANDHARA RAMCHANDRA DAMADE
(T.Y.B.A.M.S.2012-13)Roll No-09


Index
Serial no. Topic Page no.
1. Introduction 1-2
2. Material for bandaging 3-4
3. Types of bandages 5-14
4. Use of bandaging material
according to the condition
15-17
5. Equipments useful for
bandaging of wound
18-19
6. Procedure of bandaging a
wound
19-20
7. Dimensions of bandage 21
8. Effects of use of improper
bandage
22
9. Adverse effects of not
bandaging
23
10. Indications 24
11. Contra-indications 25-26
12. Bandaging 27-35
13. Plaster 36-44
14. Splints 45-53
15. Bibliography 54

Introduction:
yasmaacCuQyait banQaona va`Naao yaait ca maad-
vama\
raoh%yaip ca ina:Sa=\kstsmaad\ banQaao ivaQaIyato
sau.ica.1
The procedure which is carried out to cover a wound is
called as Bandhana.
When a wound is bandaged, the process of Shodhan of
wound is carried out i.e. wound remains clean, soft &
without any complications, starts to heal properly.
Aalaop AaV ]pk`ma: eYa sava-SaaofanaaM saamaanya:
p`QaanatmaSca
tM ca p`itraogaM vaxyaama: ttao banQa: p`QaanaM
tona Sauiwva`-Na raopNamaisqa sainQasqaOya- ca
sau.saU.183
The procedure in which the wound is applied with alepa
(paste of medicinal plants) or else in fractures without
applying alepa bandaging the wound (affected part) is
called as BANDHA VIDHI
Due to application of banQa (bandage), shodhan , ropan
of wound, steadiness in bones & compactness of joints is
maintained.
Bandages & Splints are applied from the point of view of:
Keeping the dressings in situ;
Immobilizing the part when managing fractures &
dislocations;
Keeping in position the fractured (displaced &
dislocated) bones &
Protecting the wound from dust, flies, insects, etc.
Now-a-days, due to availability of sticking bandages,
importance of various ancient procedures of bandaging
techniques are been forgetted to a certain extent. Then
also in the injuries caused to the bones, etc. which has
deeply sited wound, in these conditions without applying
proper bandages the patient is not provided with benefit.
Hence, information of various types of bandaging
procedures & according to the affected part of the body
of a patient having knowledge about procedure is of
utmost importance.

Material for bandaging (banQana d`vya):
At: ]Qva- va`NabanQanad`vyaaNyaupdoxyaama:,
tVqaa: xaaOmakapaosa
AaivakdukUlakaOSaoya~aoNa-caInapT\T camaa-
ntva-lklaalaabaUSaklalata
ivadlarjjautUlaflasantainakalaaOhanaIit toYaaM
vyaaiQaM kalaM caavaoxyaaopyaaoga:
p`krNatnaScaOYaamaadoSa:
sau.saU.1816
i. xaaOma - flax
ii. kapa-sa - cotton
iii. Aaivak - sheep wool
iv. dukUla - fabric (cloth)
v. kaOSaOya - silk
vi. caInapT\T - Chinese silk ( fabric )
vii. cama- - leather of animals like deer, etc
viii. Antva-lkla - inner bark of trees like
bhurjapatra, etc.
ix. AlaabaUSakla- skin of bottle gourd
x. Lata- creepers
xi. ivadla - split bamboo
xii. rjjau - ropes
xiii. tUlafla - cotton fiber of simbaal friut
xiv. santainaka - pad of cotton fibers
xv. laaOh - Metals of like gold etc.
Use of these materials for bandaging should be done
according the kala (time), condition of stage of the
disease & ?tu (season).
Now-a-days for the process of bandaging; Linen, Flannel,
Muslin or Cotton is used.

Types of bandages (banQana p`kar):
A] Aakaranausaar Baod
t~ kaoSadamasvaistkanauvaoillatmau p`
taolaImaNDmasqaigaka
yamak#aT\vaacaInaivabanQaivatanagaaofNaa:
pHcaa=\gaI caoit catud-Sa banQaivaSaoYaa
sau.saU.1817
Acharya sushruta has described 14 types of banQa -i. e.
]%saMga banQa hence, there are total 15 types of
banQa.
o Kosha bandha (sheath of sleeve bandage) - it is
clear from the word kosha that the shape of the
bandage is in such way that the distal part of fingers
or any peripheral part can be kept in it. It is prepared
from leather & it is it is same as that of the cover of
the sword. It is kept or worn on fingers & then tied
with thread.
Site thumb, fingers, toes & wounds of knee joints.
o Dama bandha (four tailed bandage) use of this type
of bandage is done in such parts of body where
bandaging is unable to be done.
For example: in Axakaisqa in middle of this bandage
there is a wide cloth & to the four corners of this cloth
long bandage are present. The wide cloth is on the
wounded part & the four long bandages are whirled
across the body part & then tied to the bandage present
in front or tied to the opposite long bandages.
Site- vaMxaNa sainQa ga`Ivaa etc.
o Swastika bandha ( cross or figure of eight bandage)
from the name of the bandage is clear that the shape
of it is like the svaistk symbol of Hindu religion or
the English numerical (8)
Site joints, ankle , between two eyebrows , mammary
glands , inter mammary region , palms & soles.
Acc. to Arunadutta it should also be tied to eyes,
forehead, ears, etc.

o Anuvellita bandha (spiral bandage ) this bandage is
done like a creeper which grows around the all four
sides of the branches.
This type of bandage is tied around the peripheral body
parts according to their diameter & then it is tied
around in a such a manner that the new whirl cover half
of portion of previous whirl of bandage.
It is described that initiation of this type of bandaging
should be done from the part having lesser width then
gradually reaching upto the part having more width &
then tied properly.
Site extremities i.e. upper limbs & lower limbs

o Pratoli / Mutoli bandha (circular bandage) - it is a
loosely woven bandage (like net ) & tied loosely
accordingly.
During using this bandage the netted part is kept on the
affected part & the two long bandage attached to it are
tied with each other. In this way the part gets support
& the bandage is not pressurized.
With this bandage, patient can easily urinate or
defecate.
Site penis, neck, palatal region. In females wounds of
the breast region.

o Mandala bandha (Abdominal binders, etc) - The
shape of this bandage is circular. This bandage is tied
on buttocks, abdominal region, back region &
axillary region.
During tying the bandage, it is whirled in circular
manner only.

o Sthagika bandha the shape of this bandage is like
sqaigak i.e. half portion is having more width or
broad surface & other portion is having narrower
surface ( lesser width ). It is used on the terminal
parts of fingers , toes & penis.
Acharya Sushruta has described its use after the
draining of fluid in maU~ vaRiw disorder.
It is also an alternative of kaoSa banQa, hence it is
also tied on scrotum & stump region.

o Yamaka bandha (bandage for two wounds ) - i.e.
Twin bandage when two wound are situated at a
small distance from each other then one wound is
bandaged & without tying the knot other wound is
also bandaged. Then, when the second wound is
bandaged. Then, when the second wound is bandaged
properly knot is tied. In this way, by one bandage
only two wounds are bandaged which are situated
near , this method is yamaka bandhan.

o Khatva bandha (four tailed bandaged) Haran
Chandra has described it as catuYpad, as it has a
wide cloth in middle with four long strips of bandage
one present in each corner.
It is same like dama banQa but used in smaller
regions (parts of body).
Site mandible, temple & cheeks.

o China bandha (many tailed bandage for eye ) this
bandage is made from the soft cloth imported from
china.
The shape of this bandage is same like that of #aT\va
banQa as this use only on eyes. Hence a round piece or a
piece of cloth having the width as much as it can covers
eyes is taken & long bandages are attached to it, this
bandages are tied behind the head.
Site - eyes outer canthus (eye surgeries).

o Gophana bandha (T bandage ) the shape of this
bandage is same like that of #aT\vaa banQa. The
specific difference is that the middle piece of the cloth
is having certain depth so that body part can be kept
in it.
Use of it is in done for chin, nose, lips, shoulder & pubic
region bandaging. It is also used for bandaging of
scrotum region.
According to the site, the center part or piece of clot is
taken smaller or bigger in size.

o Vitna bandha (cephalic bandage) this bandha is tied
on head & the cloth to be used should be having the
width that can cover the head from all sides. Due to
covering the head from all sides it is called iva%tana
banQa as it looks like cape.
When the cloth is having four sides then the two ends
should be tied on forehead & other two ends should be
tied behind the head.
When there is triangular bandage, the broad part is
kept on the forehead & the two opposite ends are taken
behind the head passing through temporal region the
third end is placed below the knot then the third point
is taken over the knot & tied with safety pin.

o Vibandha bandha ( many tailed bandage ) in this
type, the center piece of cloth is four sided & at two
end of this there in presence of 6 to 8 long strips of
bandages. From these 5 strips are present upper,
lower & horizontal direction & then the two strips
present on other two corners are tied behind the
neck.
Site back, abdomen & chest.

o Panchangi bandha the shape of this bandha is same
like that of #aT\vaa banQa. In this the long bandage
strips present on all four sides with one extra
bandage strip present on one corner. Hence due to
presence of five strip bandages it is called as
pHcaa=\gaI banQa.
Site head, mouth region, joints of chin & also on supra
clavicular region.

o Utsanga bandha (sling bandage) due to the fracture,
the bandage which gives support to the slinging body
part is called as ]%saMga banQa.
Nowadays for this type of banQa use of triangular
bandage is done. Two ends of this of triangular bandage
are tied together & placed behind the neck. Then hand
is placed in the broad piece of cloth & the third end is
whirl around elbow joint & brought in front from
behind the hand & then it is tied with safety pin to the
main strip of bandage.

B] sqaanaanausaar Baod
t~
va`NaayatnaivaSaoYaadbanQaivaSaoYais~ivaQa
ao Bavait gaaZ: sama: iSaiqala [it
sau.saU.1822
On the basis of the site of wound the bandaging method
is of three types gaaZ sama iSaiqala.
pIDyanna$jaao gaaZ: saaocC\vaasa iSaiqala: smart:

naOva gaaZao na iSaiqala: samaao banQa: p`kIit-t:

sau.saU.1823
1. gaaZ banQa ( Tight bandage )
t~ isfkkuixakxaava=\xaNaao$iSar: sau gaaZ:
sau.saU.1823
The bandage which when pressurized does not cause
pain & the body part is properly tied is called as gaaZ
banQa.
Use of this bandage is done buttocks, abdomen, axillary
region, inguinal region, thighs & head.

2. sama banQa (in between loose & tight bandage )
t~ Saa#aa vadnakNa- kNzmaoZ/maYkpRYz
paSvaao-draor: sau sama:
sau.saU.1823
The bandage which is neither too tight nor too loose is
called as sama banQa.
This bandage is applied over extremities, mouth, ears,
throat, penis, scrotum, back, flanks, abdomen and chest.
It is an ideal bandage.

3. iSaiqala banQa (loose bandage )
t~ AxaNaao: sainQaYa ca iSaiqala [it
sau.saU.1823
The bandage which stretches on inspiration ( breathing )
& which is loose is called as iSaiqala banQa.
It is applied over eyes & joints.

Use of bandaging material according to
the condition (banQana d`vyaaoM ka
Avasqaanausaar p`yaaoga):
A] daoYaanausaar
t~ pOitkM gaaZsqaano samaM baQnaIyaat\
samasqaanao iSaiqalaM iSaiqalasqaanao naOva
evaM SaaoiNarduYTM ca SlaOiYmakM
iSaiqalasqaanao samaMsamasqaanao gaaZo
gaaZsqaanao gaaZtrM evaM vaatduYTM ca
sau.saU.1825
Normally where gaaZ bandage is applied on the body
parts in that part:
In paittika wound, sama banQa should be applied.
On the place of sama banQa iSaiqala banQa
should be applied.
And where iSaiqala banQa is applied there no
bandaging should be done.

In shleshmika wound, on the place of iSaiqala
banQa instead sama banQa should be applied

Instead of sama banQa gaaZ banQa should be
applied &

On the place of tight bandage more tight bandage is
to be applied.


In vatika wound ,as per the shleshmika wound
application of wound should be done. Because due to
application of this type of bandage there is palliation
of the hot Vata & Kapha produced in this bandha.

In the rakta dushita wounds bandaging should be
same as that of paittika wound.

B] kalaanausaar
t~ pOi<akM Sarid ga`IYmao iWrh\naao baQnaIyaat\
r@taop d`utmaPyaova SlaOiYmakM homant
vasantyaaos~yahat\ vaataop d`utmaPyaovama\
evamaByaU)ya banQaivapya-yaM ca kuyaa-t\
sau.saU.1826
In paittika wound, in sharad & grishma rutu
bandaging should be done twice a day.

In rakta dushita wound, also bandaging should be
done same as that in paittika wound i.e. twice a day.


In shleshmika wound, in the hemant as well as
vasant rutu bandage should be changed after 3 days.

In this way, a physician should think about the
bandaging method.

Equipments useful for bandaging of
wound (va`Na banQana p`yaaojya
]pkrNa):
1] kvailaka Cotton-pad
"iWgauNa catugau-Na maRdupT\T ivaricata kvailaka
"
"bahuvas~ KNDmaud ivavait-ta kvailaka "
To protect the wound from external injuries, a soft cloth
tied by keeping two or four layers on the wound it is
called as kavalika.
Acharya Sushruta explained usage of thick, dense cotton
pad on a wound.
Now-a-days instead of kavalika, cotton is used.

2]ivakoiSaka medicated gauze piece
"klk maQauGaRtaByau> vas~sya saU~sya vaa vait-
ivakoiSaka "
A cloth or piece of sutra, etc on which kalka, ghruta, etc.
medicines are applied & kept on wound is called as
vikeshika.

"saUpitmaasaM saao%saMgasagait pUyagaiBa-
Nama\
va`Na ivaSaaoQayaot\ SaIGa`M isqata (ntiva-
koiSaka "
By keeping vikeshika on the wound, the wound having
pUitmaaMsa kaoTr & pus formation internally, heals
quickly & makes the wound clean (SaaoQana).
Now-a-days also medicine is applied on gauze & packing
is done in sinus cavity.

3] ipcau (Swab)
"ipcau sqaUla kvailaka "
It is quite similar to but it is mode of thick material.
This is kept in yoni by applying medicated oil or ghruta
on it.

4] Plaaot (Swab or pack)
A piece of cloth which is used with water or kashaya to
clean the wound is called as Plaaot.

Procedure of bandaging a wound (va`Na
banQana ivaQaI):
When there is wound in any part of the body, then
bandaging is done there.
Acharya Sushruta, has described the process of mandala
bandha
t~ GanaaM kvailakaM d%vaa
vaamahstpirxaopmaRjaumanaa ibawmasaMkuicatM
maRdu pT\T inavaoSya baQnaIyaat\ na ca
va`Nasyaaopir kuyaa-d\ ga`inqamaabaaQakrM ca

sau.saU.1820
i. Medicated gauze piece which is not too oily or too
dry should be kept on wound on that thick kavalika
(cotton pad) is kept & with the left hand the
bandage is held & it is spreaded over kavalika with
right hand & is bandaged in circular direction.
ii. It should be in such a way that each new round of
bandage cover the half of the portion of the previous
round of bandage.
iii. By this way, that bandage can be removed easily & is
tied on the body part in such a manner that each
round of bandage stabilizes (keeps in place) the
previous round of bandage.
iv. During the bandaging it should be remembered that
the bandage is straight & placed on body part
wrinkle free & vikeshika & kavalika should not have
been moved from their site.
v. After appropriate bandaging is done, during the time
of tying the knot it should be taken care that the
knot is not present on the wound or around it or else
on upper or lower side should be tied but not near to
the wound.
vi. In this way, the patient doesnt feel pain or
uncomfortable while sitting or lying down due to the
position or placement of knot.

Dimensions of bandage (banQana
Anaah):
0.75 inches of bandage fingers, toes, iSaSna.
1 inches of bandage on hands.
2.5 inches of bandage on head region, groin region &
breast.
3-4 inches of bandage on flanks, chest & abdomen.

Effects of use of improper bandage
(yan~Na pirvat-na sao haina):
t~ samaiSaiqalasqaanaoYau gaaZM baQdo
ivakoiSakaOYaQanaOrqa-@yaM Saaofvaodnaa
p`aduBaa-vaSca gaaZsamasqaanaoYau iSaiqalaM
baQdoM ivakoiSakaOYaQaptnaM p+nao
saHcaarad\ va`Nava%maa-vaGaYa-Naimait
gaaZiSaiqalasqaanaoYau samaM baQdo
gauNaaBaava [it
sau.saU.1827
If instead of sama or shithila bandha, gadha bandha is tied
then the medicine in vikeshika will become useless
causing oedema & pain.
If instead of gadha or sama bandh, shithila bandha is tied
then the medicine on vikeshika will fall down & outer
part of wound will become scratched due to movement.
If instead if gadha or shithila bandha, sama bandha is tied
then it will not affect anything.
AivaprItbanQao vaodnaaOpSaaintrsaR@p`saadao
maad-vaM ca
sau.saU.1828
Due to proper bandaging alleviation or cessation of
pain, purification of blood and softness is produced.
Adverse effects of not bandaging:
AbaQyamaanaaO
dMSamaSaktRNakaYzaoplamaaMSauSaIt vaatatp
p`BaRitiBaiva-SaoYaOriBahnyatova`Na:
ivaivaQavaodnaaopd`utSca duYTtamaupOit
AalaopnaadIina caasya ivaSaaoYamaupyaaint
sau.saU.1826
A] Due to not covering the wound it can get infected due
to the following:
Bite (dMSa)
Mosquito
Harmful particles
Wood
Stone
Dust
Cold
Smoke
air
B] Due to various analgesics, various complication & due
to drying of the alepa applied on wound.

Indications:
caUiNatM maiqatM BagnaM ivaiSlaYTmaitpaittma\
AisqasnaayauisaraicCnnamaaSau banQaona raohit

sau#amaovaM va`Naao Saoto sau#aM gacCit itYzit

sau#aM Sayyaasanasqasya ixap`M saMraohit
va`Naa:
sau.saU.183031
The wound or diseased condition in which bandaging
helps in healing quickly are:
caUiNat fracture causing small pieces.
maiqat
Bagna fracture of bone
ivaiSlaYT joints are affected
Aitpaitt hanging or suspended from its site.
AisqaicCnna
snaayauicCnna
isaraicCnna, etc.
Due to bandaging the patient gets sound sleep, walks,
comfortably lies down, sits & rapid healing of wound.

Contra-indications:
AbanQyaa: ip<ar>aiBaGaativaYainaima<aa yada
Saaofdah pakragataod vaodnaaiBaBaUta
xaaraignadgQaa: pakat\ p`kuiqatp`SaINa-
maaMsaaSca Bavaint
sau.saU.1832
Bandaging should not be done in wounds of:
ip<ajanya
r>janya
AiBaGaatjanya
ivaYajanya
With presence of Saaoqa (oedema), dah (burning
sensatoin), pak, laailamaa, taod, vaodnaa(pain), etc.
When the wound occurs due to alkali or burning due to
the fire, causes wasting of muscle tissues hence bandage
should not be applied.
In kushtha patients
Persons burned with fire
Person having Diabetes
And in rat poisoning cases,
Bandage should not be applied on wound & also in
karnika, toxic wound & mamsapaka & gudapaka.

BANDAGING
Introduction:
The proper bandage properly applied can aid materially in the recovery of a patient. A
carelessly or improperly applied bandage can cause discomfort to the patient. In many
instances it may expose the wound to danger of infection; it may even imperil the life of
the patient. It is essential, therefore, that bandages should be applied properly.

Uses:
A bandage is used to hold a dressing in place over a wound.
To create pressure over a bleeding wound for control of hemorrhage.
To secure a splint to an injured part of the body.
To provide support to an injured part.

Principles of Bandaging:
A bandage should never be applied directly over a Wound.
It should be used only to hold in place the dressing which covers a wound.
A bandage should be applied firmly and fastened securely.
It should not be applied so tightly that it stops circulation or so loosely that it
allows the dressing to slip.
If bandages work themselves loose or become unfastened, Wounds may bleed, they
may become infected, and broken bones may become further displaced.
It is essential, therefore, that bandages be properly applied and well secured.

Material used for bandaging:
Bandages are made from different types of material such as gauze, muslin, flannel,
crinoline, rubber, and elastic webbing.
The materials most commonly used are gauze and muslin.

a. Gauze bandages are widely used because they are light, soft, thin, and porous, and
may be easily adjusted and applied.
b. Muslin is strong, inexpensive, and readily obtainable; and can be easily torn into
strips of the desired Width. Before being made into bandages, muslin should be
soaked in water and dried to cause shrinkage and then ironed to remove wrinkles.
Muslin bandages are excellent for bandage practice, since they can be used repeatedly
without fraying and can be easily rerolled.
c. Flannel, being soft and elastic, may be applied smoothly and evenly, and is useful
for conditions requiring bandages which absorb moisture and maintain body heat.
d. Crinoline, rather than ordinary gauze, is used in making plaster of Paris
bandages, since the mesh of crinoline retains the plaster more satisfactorily than
that of gauze.
e. Rubber and elastic webbing are used to afford support to a part. Webbing is preferable
to pure rubber, since it permits the evaporation of moisture.

Types of Bandages:
The three general types of bandages are:
1. Triangular bandages
2. Roller bandages
3. Tailed bandages.

TRIANGULAR AND CRAVAT BANDAGES
The temporary bandage is used for the temporary or permanent bandaging of
wounds, the immobilization of factures and dislocations and as a sling for the
support of an injured part of the body.
It is valuable in emergency bandaging since it is quickly and easily applied, stays
on well, and can be improvised from a piece of shirt, an old sheet, a large
handkerchief, or any other pliable material of suitable size.
Unbleached muslin is generally used in making triangular bandages, although
linen, wool, or silk may be used satisfactorily.
Procedure- In making the triangular bandages a square of material about 3 by 3
feet, or slightly more, is folded diagonally to make one bandage, or may be cut
along the fold to make two. The long side of the triangle is called the base, the
point opposite the base is called the apex, and the points at each end of the base are
called the ends or extremities.
This bandage may be used either as a triangle or as a cravat, the latter being made
from the triangle by bringing the apex to the base and folding it upon itself a
sufficient number of times to obtain the desired width.
The names of the triangular and cravat bandages indicate the part of the body to
which the bandage is applied.

Triangle of Forehead or Scalp

The triangle of forehead or scalp (fronto-occipital) is used to hold dressings on the forehead
or scalp.
i. Place middle of base of triangle so that edge is just above the eyebrows and bring
apex backward, allowing it to drop over back of head (occiput). Bring ends of
triangle backward above ears.
ii. Cross ends over apex at occiput, carry ends around forehead, and tie them in a
square knot.
iii. Turn up apex of bandage toward top of head. Pin with safety pin or tuck in behind
crossed part of bandage.

Triangular Arm Sling

The triangular arm sling (brachio-cervical triangle) is used for the support of fractures or
injuries of hand, wrist, and forearm.
Two versions of this sling are discussed below.
1. Method of applying the sling, in which the forearm is supported from both shoulders
by the sling.

Bend the arm at elbow so that little finger is about a hand breadth above level of
elbow.
Place one end of triangle over shoulder on injured side & let bandage hang down
over chest with base toward hand and apex toward elbow
Slip bandage between body and arm.
Carry lower end up over shoulder on uninjured side.
Tie the two ends, by square knot, at the neck. Knot should be on either side of
neck
2. Method in which it is desirable to support the forearm without pressure on the
collarbone or shoulder of injured side.

Triangular of chest or back
This bandage is used to hold dressings or burns or wounds of chest or back.



Triangular of shoulder
o The triangle of shoulder is used to hold dressings on wounds of the shoulder.
o Two bandages require one triangle and the other a cravat, roller bandage or belt.






Cravat of Palm of Hand


ROLLER BANDAGES
The roller bandages is used to hold dressings in place, to support an
injured part, to create pressure for control of hemorrhage, and to secure a
splint to an injured part in order to immobilize it.
Roller bandages are made from gauze, flannel, muslin, rubber or elastic
webbing, the width & length depending upon the part to be bandaged.

The size most frequently used are:
o 2 inches wide & 6 yards long for hand, finger, toe and head bandages
o 3 inches wide and 10 yards for extremities
o 4 inches wide and 10 yards long for thigh, groin & trunk.

For convenience & ease of application, the strip of material is rolled into
the form of cylinder.
Each bandage of this type should consist only one piece, free from
wrinkles, seams, selvage and any imperfections that may cause discomfort
to the patient.


TAILED BANDAGES
Tailed bandages consist of T-bandage, the double bandage, the four tailed bandage
& many tailed bandage.
These bandages are used to secure dressings to parts which do not lend themselves
to roller bandage application.
a. The T-bandage is a T-shaped bandage consisting of a vertical strip of
material sewn or pinned to the centre of horizontal strip this bandage
may be used as a scalp, ear, eye or perineum bandage.
b. The double T-bandage may be made by sewing two vertical strips of material
to the centre of horizontal strip and about inches apart. The double T-
bandage may be used to hold dressing on the chest, back or perineum.
c. The four tailed bandage is a piece of material 4 to 6 inches wide & about
30 inches long with each end about 12 or 14 inches down in the middle,
leaving the centre piece about 12 or 14 inches in length. The four tailed
bandage is used to hold the dressing on jaw, nose, forehead & back of head.
d. The many tailed bandage is similar construction to the four tailed
bandage except that the ends are cut into desire number of tails about 16
inches in length and the uncut portion about 20 inches in length.

Plaster
A medicated or protective dressing that consists of a film (as of cloth or plastic) spread
with a usually medicated substance is called as Plaster.
Different kinds of plaster cast:
There are several different kinds of plaster casting material available. The choice depends on
the particular injury.
-In a Stable fracture the cast is often only needed to protect the bone from further injury
and limit movement a little at the fracture site. (A little movement stimulates healing; too
much movement slows it down.) Hence the molding and fit is not as critical. It is also
possible to make a removable cast or use pre made splints.
-In an Unstable fracture treated just with a cast, the plaster cast is critical in holding the
bone ends in a good position and hence the fit and molding is very important.

Backslab
Plaster of paris
Synthetic cast (hard and soft cast)
Swimming cast

Backslab
In an acute fracture swelling, which can be a problem a "Backslab" is used; this does not
have to go on the back of the limb.
Made up of- an underlayer of orthopaedic wool, with a slab of usually old fashioned white
plaster of paris.
It does not encircle the limb, usually covering half or 3/4
th
of the circumference of the limb.
A bandage is applied to keep it well applied to the limb.

The "cut away" completed by the bandage allows for swelling. "Backslabs" are usually
temporary, used for a few days. They usually do not last longer than 2 weeks.

Plaster of Paris (Gypsum)
Plaster of paris is often used in acute, fresh fractures. The reason for the use of Plaster of
paris (Gypsum) is, because it is a lot easier to mould to get a snug fit without creating
any pressure areas. It is heavier and not as resilient as synthetic casts. The casting
material for fractures requires a snug fit and "molding" over the fracture to keep the bones
in a good position. Patient should not get plaster of paris wet once the cast has set.

Synthetic casts
It is often called as Fibreglass casts.
Not all synthetic casts are made of fibreglass, some are made of polyester.
TYPES:
There are two main synthetic casting groups.
1. Synthetic (soft)-
2. Standard synthetic casts (hard)

1) Softcast these are used mostly for support or stable fractures in kids.
Benefits- the ability to remove by unwrapping or cutting off the cast without the need
for a plaster saw.
It is also possible to manufacture a "swimming cast" using softcast.

2) Synthetic casts (hard)- it will normally not fall apart if cast gets wet or splashed.
But the padding or underlay remains wet for a long time and the skin may
macerate. Hence, hard synthetic cast which gets moist or wet, should be dried out
with a hairdryer.
Swimming cast
Plaster of paris (Gypsum) should not be placed in water it softens the cast and it will
disintegrate.
Commercially cast covers (eg. Limbo) are available. They are very good in keeping the limb
watertight and enabling showering, bathing and swimming on the surface of a pool eg.
Hydrotherapy.
It is possible to manufacture a truly swimming cast with softcast and a thin terry cloth
underlay; this is only suitable for stable fractures.
Cast

A cast holds a broken bone in place as it heals.
Casts also help to prevent or decrease muscle contractions.
They are effective at providing immobilization, especially after surgery.
Casts immobilize the joint above and the joint below the area that is to be kept
straight and without motion.

Material used for cast:
The outside or hard part of the cast is made from two different kinds of casting materials.
i. Plaster - white in color.
ii. Fiberglass - comes in a variety of colors, patterns, and designs.

Cotton and other synthetic materials are used to line the inside of the cast to make it soft
and to provide padding around bony areas such as the wrist or elbow.
Special waterproof cast liners may be used under a fiberglass cast, allowing the child to get
the cast wet.

Different types of casts:


Type of Cast Location Uses
Short arm cast Below the elbow to the
hand.
Forearm or wrist fractures. Also used to hold the
forearm or wrist muscles and tendons in place after
surgery.
Long arm cast Applied from the upper
arm to the hand.
Upper arm, elbow, or forearm fractures. Also used to
hold the arm or elbow muscles and tendons in place
after surgery.
Arm cylinder
cast
Applied from the upper
arm to the wrist.
To hold the elbow muscles and tendons in place after
a dislocation or surgery.

Type of Cast Location Uses
Shoulder spica
cast
Around the trunk of the
body to the shoulder,
arm, and hand.
Shoulder dislocations or after surgery on the
shoulder area.
Minerva cast Around the neck and
trunk of the body.
After surgery on the neck or upper back area.
Short leg cast To the area below the
knee to the foot.
Lower leg fractures, severe ankle sprains/strains or
fractures. Also used to hold the leg or foot muscles
and tendons in place after surgery to allow
healing.
Leg cylinder cast Applied from the upper
thigh to the ankle.
Knee or lower leg fractures, knee dislocations or
after surgery on the leg or knee area.

Type of Cast Location Uses
Unilateral hip
spica cast
Applied from the chest to the foot on
one leg.
Thigh fractures, to hold the hip or
thigh muscles and tendons in
place after surgery to allow
healing.
One and one-half
hip spica cast
Applied from the chest to the foot on
one leg to the knee of the other leg. A
bar is placed between both legs to keep
the hips and legs immobilized.
Thigh fracture, to hold the hip or
thigh muscles and tendons in
place after surgery to allow
healing.
Bilateral long leg
hip spica cast
Applied from the chest to the feet. A bar
is placed between both legs to keep the
hips and legs immobilized.
Pelvis, hip or thigh fractures, to
hold the hip or thigh muscles and
tendons in place after surgery to
allow healing


Type of Cast Location Uses
Short leg hip
spica cast
Applied from the chest to
the thighs or knees.
To hold the hip muscles and tendons in place
after surgery to allow healing.


Type of Cast Location Uses
Abduction boot cast Applied from the upper
thighs to the feet. A bar
is placed between both
legs to keep the hips and
legs immobilized.
To hold the hip muscles and tendons in
place after surgery to allow healing.


Splints

A Splint is a device used to support or immobilization of limbs or the spine.

They play a major role in the management of musculo-skeletal injuries involving
extremity fractures & joint dislocations.
Immobilization of the extremities through splinting decreases pain & bleeding.
Splinting may provide definitive treatment for some injuries.
Compared to casts, splints permit swelling and may prevent neuromuscular
compromise.

Material used for cast:

Most splints are made from plaster or fiberglass.
1. Plaster splints-
They are made from gauze

Impregnated with POP (plaster of Paris) powdered form of gypsum water

Gypsum recrystallizes & hardens (heat-releasing action)
Advantages:
Plaster splint takes 2 to 8 min. to set.
Plaster splints are easy to mold & are less expensive than fiberglass splints.
Disadvantages:
They are more difficult to apply & become soggy when wet.

2. Fiberglass splints & other synthetic splints (eg. Orthoglass, OCL & Velcro splints)
are usually prepared & easy to apply.
Advantages:
They set more quickly & are lighter, longer-wearing and water-resistant.
Disadvantages:
They are more expensive and do not mold as well, as plaster splints.

Types of splints:

Upper extremity splints

I. Figure of eight splint: used in Medial clavicle fractures.

II. Sling and swathe: used in Shoulder and humeral injuries.
III. Velpeau bandage: used in Shoulder and humeral injuries.

IV. Sugar tong proximal splints: used in humeral fractures.

V. Sugar tong distal splints: used in wrist fractures, distal forearm fractures.
VI. Sugar tong double splints: used in elbow fractures, forearm fractures.
VII. Sugar tong reverse splints: used in distal forearm fractures.

VIII. Posterior arm splint: used to stable elbow and forearm injuries.
IX. Colles splint: used in distal forearm and wrist injuries.

X. Dorsal or volar splint: used in wrist fractures /injuries, fractures of 2
nd
to 5
th

metacarpals, soft tissues injuries of hand.

XI. Gutter splint: used in phalangeal and metacarpal fractures.

XII. Thumb spica splint: used in scaphoid fractures, extra articular fractures of the
thumb metacarpal, ulnar collateral ligament injuries.

XIII. Volar finger splint: used in fractures of distal phalanges and interphalangeal
joints.

XIV. Bulky hand compression: used in closed hand fractures.

Lower extremity splints

I. Knee splint: used in knee injuries.
II. Jones compression: used in knee and calf injuries.

III. Posterior ankle splint: used in distal leg, ankle, tarsal and metatarsal fractures as
well as in reduced dislocations, severe sprains.

IV. Stirrup splint: used in ankle fractures.
V. Bulky foot compression dressing: used in calcaneal fractures, foot injuries.

VI. Buddy tapping: used in phalangeal fractures of the toes.




Name of book Author
Shalya vidnyan (part 1) Surendra Kumar Sharma
Shalya vidnyan Dr. K. K Thakral
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