|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 Delta Cast Conformable polyester support bandage
and hydrogel-coated casting gloves, adhesive bandage, tubular bandage, Delta
Rol S padded wadding or toweling tubular bandage, bandage scissors, felt-tip
In order to achieve maximum stability in the knee joint area, a 2-layer longuette
(4 layers in the knee area) is prepared from a cast bandage and applied to
the outer side. A toweling tubular bandage is applied beforehand or, as shown
here, padding with synthetic elastic wadding (Delta-rol S) over a tubular
bandage. In compression therapy, this special padded wadding can be applied
underneath the cast bandage. This allows treatment of swollen soft parts
and at the same time acts as thrombosis prophylaxis.
Starting at the distal end, 2 to 3 layers of cast are applied using circular
movements. It should be applied relatively tightly (extending it by about
50 to 70%). This improves the bonding of the layers and the fit of the tutor.
Fears that this will make the tutor too tight are unfounded because the cast
becomes looser after opening. The use of the longuette makes the cast very
stable in the rear knee area (7 to 8 layers) whilst retaining flexibility
in the front knee area (2 to 3 layers).
The cast is molded for approximately 4-6 minutes. In order to prevent the
tutor from slipping later, particular care is taken with the molding of the
femur condyles. Any folds occurring in the thigh area can be easily smoothed
out by pulling the proximal end of the cast.
Following the molding phase (4 to 6 minutes) the cutting lines are marked
and the cast opened. It is then trimmed for individual fit using bandage
scissors. Two notches are cut in the cast to avoid movement of the cut surfaces
after re-application. A large part of the cast is cut away in the knee joint
area. This simplifies the removal and re-application of the cast during check-ups
and any examinations of the injury or cold therapies.
The fit of the cast on the patient is then checked. If necessary, the cast
can be loosened by bending open or made tighter by cutting out a strip of
about 1 to 2 cm. The cast is put in place on the patient using an adhesive
bandage, taking into account the state of the swelling.
The tutor dressing is completed after pulling on the tubular bandage left
at the distal end. The tutor can be changed into a knee brace by shortening
the cast at the distal and proximal ends using bandage scissors. The dressing
can be held in place using velcro tape if required.
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. Re-application is carried out as described above.
This procedure can be repeated throughout the duration of treatment.