A wound compression bandage consists of bandaging material which exerts pressure inside the wound to control bleeding from a damaged blood vessel.
A hard object, about the size of the wound, is pressed into the wound using non-elastic, high tensile strength roller bandaging. Circular turns are used to apply the bandage with force around the object and the part of the body. These turns around the wound should be alternated with circular turns that pass proximally and distally to the wound. These proximal and distal turns should cover half the width of those layers above the site of the wound.
By only tightening the bandage when it passes over the wound, the greatest pressure will be over the wound. The pressure should decrease towards the edge of the bandage, so that the bandage does not cut into the skin.
Materials
The wound compression bandage should consist of the following layers:
- A wound dressing layer: Sterile absorbent gauze, emergency bandage or an absorbent wound dressing.
- Absorbent layer: White cotton wool wadding or cellulose. This is not necessary if an emergency bandage or absorbent wound dressing layer is used.
- Compression layer: Small hard object, such as a roll of bandage, a small stone or non-absorbent cotton wool.
- Fixing layer: Non-elastic bandage, preferably cambric, 6 cm wide.
Procedure
- Cover the wound with the dressing material.
- If possible, place the absorbent layer on top of the dressing layer.
- Place the hard object precisely above the wound.
- Fold up non-absorbent cotton wool or a handkerchief to form a small plug [Figure 80].
Figure 80
- Fix the bandage layers by applying the bandage with two circular turns around the body part at the site of the wound [Figure 81].
Figure 81
- Make one further circular turn over the previous two turns, pulling tightly [Figure 82].
Figure 82
- Make one circular turn distal to the wound site, but ensure that the turn covers half the width of the previous three circular turns [Figure 83].
Figure 83
- Apply a tight circular turn over the wound.
- Subsequently make one circular turn proximal to the wound site, ensuring that this covers half the width of the circular turns that pass over the wound [Figure 84].
Figure 84
- Repeat these circular turns across and next to the wound a number of times.
- Between each proximal and distal turn, make one circular turn across the wound.
- Only pull the bandage tight for the turn that passes over the wound, so that the pressure is greatest on the wound and decreases towards the edges of the bandage.
- Finish the bandage with a circular turn over the wound [Figure 85].
Figure 85
For arterial bleeds, while the wound compression bandage is being applied, pressure should be exerted on the supply artery, proximal to the site of bleeding.
This indirect manual compression can be stopped once the wound compression bandage has been properly applied.