If various injuries occur, one of the most popular immobilization methods is the use of plaster casts. This approach to conservative treatment has several advantages. To perform the procedure correctly, doctors of appropriate qualifications study the methodology for preparing and applying such a bandage. Its features will be discussed later.
Features of the technique
Plaster cast is applied with significant bruises, damage to the ligaments. It is also used after reduction of joints in case of dislocations, as well as with different types of fractures. If there are contraindications for the application of deaf gypsum, this method is also used. For this, a special room is allocated in the surgical departments. It has the necessary materials and equipment for the procedure.
The application of plaster casts has several advantages. It is firmly and evenly attached to the body, can be easily removed and hardens very quickly. If there are fragments correlated by a surgeon or traumatologist, the splint will hold them well.
Gypsum is calcium sulfate. It is well dried at temperatures from 100 to 130 º. Due to this, the material is well rubbed, forming a white powder. Gypsum is a hydrophilic substance. So that it is not saturated with moisture, it is stored in a well-closed container made of metal or glass.
It is best to use plaster of the M400 brand for medical purposes. It freezes in 10 minutes. at a temperature of 15 º. This period is reduced to 4 minutes if the room temperature is 40 º. The quality of the gypsum is checked using a series of samples. The powder should have a uniform and fine grinding. When mixing it with water, the smell of hydrogen sulfide should not be released.
Varieties
Plaster cast can be of two types:
- A bandage with a lining of cotton and gauze, flannel, knitwear. It has certain disadvantages. Vata or cloth can stray, putting pressure on the body. Inadequate fixation of fragments may also be observed. It is best used when applying a similar bandage to knitwear. They protect the skin from the appearance of scuffs.
- Unlined dressing. It is applied directly to the skin. She is not smeared with anything, her hair is not shaved. Protruding parts of the body are important to protect from pressure.
Overlay procedure
Arm or leg in a cast, heal correctly and on time. For this, it is important to adhere to the established methodology:
- The patient is placed or sit in a comfortable position.
- Part of the body is placed on a rack, protruding places are covered with cotton-gauze pads.
- The bandage with gypsum lead in a spiral, avoiding tension. The material is not torn off the surface so that wrinkles do not form. Layers are smoothed with a palm.
- Above the fracture site, it is required to further strengthen the bandage with rounds consisting of 6-12 layers of bandage.
- The fingers of the limbs are left open. By their appearance, they judge blood circulation.
- The edges of the bandage are trimmed, tucking them out. Gypsum paste smooths the roller.
- On the bandage is written the date of application of the cast.
- The dressing is not covered for 3 days. The patient must know how to handle the dressing until the material is completely dry. Otherwise, he can harm himself by ruining the fixation material.
Upper limbs
If damage is determined on the shoulder and shoulder joint, two Turner plaster casts are used. They are also called "crow's nest." The first part is applied from the scapula along the outside of the limb. The back bandage is from the forearm to the heads of the bones of the fingers. The second splint is superimposed on the first, and then it is distributed on the front surface. Fix the bandage with an ordinary bandage.
The elbow joint can be immobilized with one or two spindles. They are imposed from the upper third of the shoulder surface on both surfaces or only from above.
The forearm is immobilized using two plaster casts. They are imposed from the middle of the shoulder to the metacarpal bones. In this case, it is necessary to control the position of the forearm. It should be between pronation and supination. The joint should form a right angle. The brush is set in the position of the back flexion. It is checked whether the patient is comfortable in this position.
If an injury has occurred on the hand, the longuet is applied over the surface of the palm to a third of the forearm.
Lower limbs
Plaster cast in fracture of the tibia has a U-shape. Immobilization is carried out to the upper third of this part of the limb. In this case, the bandage should cover the span on the sole.
In case of a knee joint injury, two dressings are applied on the sides. They begin from a third of the thigh and follow to the lower 1/3 of the lower leg.
If you need to immobilize the forefoot, impose the back plantar bandage. It is conducted from the fingers to the lower 1/3 of the lower leg.
In some cases, special circular dressings need to be used. They are designed to immobilize different departments of the musculoskeletal system.
Some recommendations
It is necessary to prepare in advance everything necessary for applying a plaster cast. A bone and several adjacent joints are fixed. If the damage is diagnosed in one joint, it is imposed on it and a sufficient extension of the limb. It is important to give an immobilized limb a functionally advantageous position.
When applying a bandage, a part of the body must remain absolutely motionless. The patient is not allowed to move during the procedure.
Bandaging is carried out from the periphery towards the central part. The material must not be bent. If necessary, it is trimmed, changing the direction of travel, and then straightened. After each layer, the dressing is carefully modeled and rubbed. So the material is well soldered, and the bandage will exactly match the contours of the body. It is necessary to support the limb with the whole palm. It is unacceptable to use only fingers for this.
It is important that the plaster is not too tight or, conversely, loose. In order not to damage the dressing (which is especially common in children), it is covered with shellac or a solution of this material with alcohol.
Bandages are harvested in advance, guided by the length of the limb. It is folded loosely, and then soaked and smooth on weight. On bends, the material is incised and one part of the material is laid on another.