i8o OPERATIVE TECHNIQUE. 



applied it is temporarily fixed in position b\- the index finger or thumb 

 of the left hand until the next turn overlaps and fixes it in position. 

 The first circular turn should be double to give greater security ; those 

 following take a gradual upward spiral course. On regions of conical 

 section like the forearm, or such as are not truly cylindrical, spiral 

 bandaging can only be successfully carried out by using very elastic 

 cotton bandages, otherwise the lower edges of the bandage always 

 project. This, however, can be avoided by reversing the bandage at 

 each turn as shown in Fig. 202, the upper and lower edges changing 

 places. The bandage, held in the hollow of the right hand, is drawn 

 tight, rotated, and the folded point fixed with the thumb or index finger 

 of the left hand. The bandage is then rapidly passed round the limb, 

 and again drawn tight, the thumb of the free hand keeping the fold fiat 

 meanwhile. These precautions, however, are scarceh- necessary when 

 using knitted, elastic, or calico bandages, especially where the latter 

 are moist. To maintain pressure on a joint like the fetlock the figure- 

 of-8 shown in Fig. 203 is useful. The bandage is passed once or twice 

 around the pastern, thence obliquely upwards over the anterior surface 

 of the fetlock, behind the joint and then forwards and downwards in a 

 direction opposite to that of the previous turn. The position of each 

 succeeding figure-of-8 should be slightly varied so that the entire 

 surface of the joint is covered. To secure the degree of tension required 

 to keep the bandage in place without causing undue pressure at any 

 point requires some practice. Until this knowledge is acquired it is 

 better to err on the side of slackness. 



When moist applications are needed it is often best to soak the 

 bandage before use, otherwise it contracts when wetted and may cause 

 greater pressure on the diseased part than is intended. For the same 

 reason moist bandages, which will afterwards be allowed to dry in 

 position, may be drawn rather tighter than if they had been applied 

 dry, the pressure diminishing as the moisture evaporates. It is not 

 possible to fix dressings in all positions with bandages. In many 

 cases considerable ingenuity is required to secure the desired fit, and 

 the following illustrations (redrawn from Bourgelat) are intended to 

 assist operators in this task. In the illustrations (Fig. 204 et seq.) 

 indications are given of where a fold or a gusset is needed and where a 

 portion of the cloth is to be reinforced with lining. In many places, 

 however, even these applications do not meet all the requirements of 

 antiseptic wound treatment. Thus after removal of the large growths 

 which occasionally form in the shoulder region in consequence of 

 collar pressure Bayer prefers the following device : — He first inserts 

 sutures of relaxation, using drainage-tubes of large size. The sutures 



