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Kim et al. Pressures secondary to circumferential digital dressings

facilitate the identification of deep tissue injuries and Adult finger model
foreign bodies. After the repair of hand lacerations, the In the adult finger model, the pressures were measured
[2]
wound dressing is usually covered with compression according to the total length of the bandages without
bandages that are applied circumferentially around the tightening, different tightness using 2 wraps, roll-up
digit. Often, dependable tapes are used. However, with states and different dressing materials. According to
very little manipulation, these bandages can be lifted the total length of the bandages without tightening, the
and rolled up the digit distally, creating a tourniquet self-adherent bandage was wound 1 (1C-T0), 2 (2C-
effect. Vascular insufficiency from an occlusive T0), or 3 times (3C-T0) around the finger model with
dressing is an iatrogenic and avoidable complication, 1 (7 cm), 2 (14 cm), or 3 (21 cm) times the length of
and therefore circumferential digital dressings should its circumference. For the different tightness, the self-
be applied correctly. [3] adherent bandage was wound employing 2 wraps
around the finger model with twice (14 cm, 0% tightened,
To prevent the dressing from rolling up and creating 2C-T0) the length of its circumference, 91.4% (12.8 cm,
a tourniquet effect, Hart et al. suggested that the 9.4% tightened, 2C-T1), 83.6% (11.7 cm, 19.7% tightened,
[4]
dressing should be brought down from the finger, to 2C-T2), 75% (10.5 cm, 33.3% tightened, 2C-T3),
include the hand and wrist. Despite the importance of or at 66.4% (9.3 cm, 50.5% tightened, 2C-T4) the
preventing finger necrosis, [5,6] the pressures generated length of its circumference [Figure 1]. The pressures
by circumferential dressings have not yet been studied. were measured in both unrolled (NR) and rolled up (R)
The aim of this study was to elucidate the pressures states. The width of the rolled up portion of the bandage
occurring secondary to self-adherent bandages was 6 cm. Pressures were also measured according to
applied circumferentially around the fingers. the dressing materials, Peha-haft (Ph) or Coban (Co).

METHODS Child finger model
Making a clay finger model In the child finger model, the same experiments as
With clay, finger models of 7 cm (adult) and 4 cm (child) with adult finger model were done except the different
tightness using two wraps. The width of the rolled up
in circumference at the level of the proximal phalanx portion of the bandage was three cm.
level were made. Biscuit firing was performed. The
pressure of each self-adherent bandage was measured Live adult finger
using live adult finger models (7 cm circumference). A
6 cm width Peha-haft (Hartmann USA, Inc, Rock hill, In the live adult finger, the same experiments as with
SC) and a Coban (3M Co, St. Paul, MN) were used as child finger model were repeated. The width of the
self-adherent bandages. Experiments were performed rolled up portion of the bandage was six cm.
with the following variable for each model: dressing
materials, wraps, tightness and roll-up states. Measurements using a pressure sensor
Pressures were measured using a FlexiForce B201-M
Applying methods pressure sensor, ELFTM system (Tekscan, Inc., South
According to the length
The pressures were measured according to the total 14 cm
length of the elastic dressings: T0 6 cm
1C: elastic dressing was wound 1 lap around a finger
model with the same length as its circumference (7 cm). 12.8 cm
2C: elastic dressing was wound 2 laps around a finger T1 6 cm
model with 2 times the length of its circumference (14 cm).
3C: eastic dressing was wound 3 laps around a finger
model with 3 times the length of its circumference (21 cm). T2 6 cm 11.7 cm

According to the tightness
The pressures were measured according to the 10.5 cm
tightness of the elastic dressings: T3 6 cm
T0: 0% tightened.
T1: 9.4% tightened. 9.3 cm
T2: 19.7% tightened. T4 6 cm
T3: 33.3% tightened.
T4: 50.5% tightened. Figure 1: Size of the self-adherent bandages for different tightness

42 Plastic and Aesthetic Research ¦ Volume 4 ¦ March 22, 2017