|Application: The materials should be pre-prepared
to enable rapid application of the bandage. All the necessary materials should
be placed within reach to avoid hold-ups in the procedure.
The patient should be in a position which is comfortable to him/her and the
person applying the bandage. This may vary depending on the extent of the
injury, the diagnosis, the treatment method and the patient's condition.
Materials required: 3 x 10 cm and 1 x 7.5 cm Delta Cast Conformable polyester
support bandage and hydrogel-coated casting gloves, toweling tubular bandage,
Delta-Fix adhesive bandage, self-adhesive fleece padding, strapping, bandage
scissors, felt-tip pen.
The toweling tubular bandage is pulled over the leg to form a layer of padding
underneath. A narrow strip of fleece padding is inserted beforehand to help
with the cutting. U- or O-shaped fleece padding is used as additional padding
for the ankle bones and fibula capitulum.
To provide additional local padding a 2-layer longuette is prepared from
the 7.5 cm cast bandage and applied on the outer side of the ankle joint
and a 2-layer longuette (4 layers in the knee area) to the knee joint.
2-3 layers of cast are wrapped around using circular movements. In the area
of the previously applied longuettes, there are up to 4 to 7 layers of cast.
This produces a stable cast in the rear area whilst retaining flexibility
and therefore adjustability at the front. In order to achieve the best fit
and bonding of the layers, the cast should be applied relatively tightly
extending it by 50% to 70%. The cast is then molded for four to six minutes.
Molding at the side of the femur condyles increases the comfort for the patient.
Any folds in the cast in the thigh area can be easily smoothed out by pulling
the proximal end lengthwise.
Following the molding phase which takes approximately 4 to 6 minutes, the
cutting lines are marked with the felt-tip pen and the cast is opened along
the inserted fleece strip using bandage scissors. A notch is cut into the
cast in the thigh area in order to prevent movement of the cut edges after
re-application. Large areas of the cast are cut away in the areas of the
patella and ankle joint. This simplifies the removal and re-application of
After trimming for individual fit, the fit of cast is checked on the patient
and the cast is fixed in place with strapping taking into account the state
of swelling. Velcro tape can be used as an alternative to strapping.
An adhesive bandage is wrapped around the finished thigh cast. This makes
the cast very stable and avoids the danger of fenestra edema in the areas
of the knee and upper ankle joint.
The small number of layers means that the cast remains semi-flexible and
can be adjusted depending on the individual state of the swelling (looser
or tighter). To do this, the adhesive bandage is removed and the cast altered
for a perfect fit.