Use of a double roll as a bandage

USE OF A DOUBLE ROLL AS A BANDAGE LIEUT. MEDICAL

CORPS,

A.

ARMY

D.

JONAS

OF THE

UNITED

STATES

or irreguIarIy curved surfaces of the human body present considerabIe diffIcuIties in the appiication of

Head Dressing. The rolIs are appIied with the knot in the occipita1 region and brought forward, then they are crossed;

bandages by the usua1 methods. The use of onIy one bandage, to cite an exampIe, wiI1 not hoId secureIy a dressing for the scaIp. The loops carried over the prominent portion of the part to be bandaged have a tendency to Ioosen unIess they can be secureIy anchored. This disadvantage can be overcome by using two individual roIIs of the same size tied together at one end. One roI1 serves as the base to which the other roI1 finds a secure attachment.

roI1 A at I 80 degrees, wound in the opposite direction; roil B at 44 to go degrees, carried over the vertex to the occipital area where it is crossed by roI1 A. Then roII A is wound around the head in a horizonta1 position without changing its direction, thus serving as a base for each crossing of roI1 B. (Fig. IA and B.) In this way any area of the skuI1 can be covered with a minimum of bandage and a maximum of fixation. The pressure ex-

OUND

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366

AmericanJournalofSurgery

Jonas-DoubIe

RoII Bandage

erted on a wound is far greater than by appIication of the routine head dressing. The same principle can be used in appIy-

A

MARCH, 1946

region by roII B. (Fig. 2~ and B.) This is done five to seven times, then roII B is carried from the right tempora1 region be-

B

FIG.

ing dressings to the chin as a support for a fractured mandibIe or wounds of the IateraI portions of the face. The roIIs are again appIied with the knot in the occipita1 area and then crossed over i,n the right tempora1 region. RoII B is carried downward, across under the chin, upward, and in the Ieft tempora1 region crossed over roI1 A, which was reversed in its original direction. RoII A is wound from left to right anteriorIy and crossed on each tempora1

hind the right ear in a diagonq1 direction appearing in front beIow the Ieft ear, then carried forward to cover the chin, roI1 A is used in the same way, starting in the Ieft tempora1 region. RoII A and B cross each other on the chin, occiput and forehead. Shoulder Dressing. RoIIs are appIied with the knot in the back, two to four inches below the scapuIa and brought forward. After crossing roll B, roII A is reversed in its direction. RoII B is carried over the

VOL.

LXXI,

No.

3

Jonas-DdubIe

shouIder down the back and after being crossed by roI1 A is brought back to the origina starting point. (Fig. 3A and B.) The roIIs Dressing of Inguinal Wounds. are appIied with the knot at the IeveI of the second to third Iumbar vertebra and brought forward. RoII A is reversed in its direction in the Ieft Iower abdomina1 quadrant. RoII B is carried down to the inner aspect of the thigh. Thence in a

RoII Bandage

American

Journal of Surgery

367

horizontal direction to the area beIow the greater trochanter, from there sIanting upward to the Ieft Iower abdomina1 quadrant. Here roI1 x, running from Ieft to right anteriorly, serves as a base for roII B. (Fig. 4~ and B.) The contour of an amputation stump presents the same probIem as a head dressing. Therefore, the same procedure wiII be foIIowed. (Fig. 5~ and B.)

BLEEDING from wounds of the palm of the hand is often profuse, for not onIy is the blood suppIy generally a rich one, but is derived from several sources. With a mass of important structures in the immediate vicinity it is inadvisable to appIy artery forceps bhndly; nevertheIess, bIeeding here shouId be treated by Iocal haemostasis, and not by Iigature of the proxima1 vesseIs, i.e. radia1 and uInar, except as a Iast resort.

From “ Minor Surgery ” edited by Humphry crieff (PhiIosophicaI Library).

RoIIeston and AIan Mon-