BINDER – Purpose, Types, Equipment, Preparation, Arm Sling, Abdominal Binder and Breast Binder
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A binder bandage is designed for a specific body part for example; the triangular binder (sling) fits the arm. Binders are used to support large areas of the body, such as the abdomen, arm or chest.
Binders are special wide bandages used for supporting specific parts of body and large dressings.
Binder (abdominal) is also called many tailed bandage. It is a rectangular piece of strong cloth with many tails attached to either sides of its. It is commonly used as abdominal binder for the support of the abdominal musculature
PURPOSE
It is applied after paracentesis and childbirths in order to maintain the intra-abdominal pressure and to prevent shock and collapse
- To hold dressing in place
- To support abdomen and prevent would dehiscence following abdominal surgery
TYPES
T-binders: they are used to secure dressing on the rectum and perineum and in the groin. The single T-binder is used for female patients and the double T-binder is used for male patients. Select the appropriate binder according to the patient’s gender. Place it underneath the patient smoothly, with the waistband at waist level and the tails pointing down the midline of the back. Bring the waist tails around the patient and overlap. Bring the center tail or tails up between the patient’s legs and over perineal dressings. Make sure the two tails of the double T-binder are on either side of the scrotum and penis.
Sling: a sling is used to support and arm. Most healthcare agencies use commercial strap slings or sleeve slings.
Straight binders: a straight binder is a straight piece of material, usually about 15-20 cm (6-8 inches) wide and long enough to more than circle the torso. It is used for the chest and the abdomen.
Breast binder: to provide pressure on the breast (e.g. when drying up the milk flow after childbirth) or to support the breasts (e.g. after surgery)
EQUIPMENT
- Tape measure
- Binder of appropriate size
- Safety pin/clips
- Gloves, if necessary
- Dressing materials
Commercial elastic binders are now commonly used instead of standard cotton straight and Scultetus binders that require pins. Disposable T-binders are available, and scrotal supports typically replace binders for male patients, except after abdominal-perineal resection.
PREPARATION
- Check the doctor’s order
- Perform hand hygiene and put on gloves, as needed
- Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy
- Provide privacy and explain the procedure to the patient
- Raise the patient’s bed to a comfortable working height to avoid muscle strain when applying the binder
- Position the patient in a supine position, with his head slightly elevated and his knees slightly flexed to decrease tension on the abdomen
- Assess the patient’s condition
- Remove the dressing and inspect the wound or suture line, if appropriate
- Redress the wound and then remove and discard your gloves
ARM SLING
To make an arm sling from muslin, fold of cut a 36-ich square of fabric diagonally. Slings are applied in two ways:
Method 1: with the patient facing you, place one end of the triangle over the unaffected shoulder and the long straight border under the hand of the injured side. Loop upward, positioning the other ends of the triangle over the affected shoulder. Tie or pin the ends to one side of the neck, using a square not, or pin smoothly, using a safety pin. Do not secure a sling at the back of the neck because this could exert pressure. Fold the corner flat and neatly at the elbow, and pin.
Method 2: with the patient facing you, place the sling across the body and underneath the arms. Bring the corner of the sling that is under the unaffected arm to the back. Bring the lower corner up over the affected shoulder to the back, and tie. Fold the sling neatly at the elbow, and pin.
ABDOMINAL BINDER
An abdominal binder is a wide compression belt that encircles your abdomen. Abdominal binders come in many sizes and widths. Most are made from elastic and have Velcro or hook and loop closures. Some abdominal binders offer secondary lumbar support. Others have straps that hold surgical drainage tubes in place. An abdominal binder may be used to speed-up the recovery process after abdominal surgery. Your doctor may recommend that you wear an abdominal binder after:
- Cesarean section
- Bariatric surgery
- Exploratory laparotomy
- Hysterectomy
- Tummy tuck
- Spinal surgery
Uses
A carefully-positioned abdominal binder may be used in people with spinal cord injury to help:
- Support the abdomen
- Maintain abdominal pressure
- Improve respiratory function
An abdominal binder is an important surgical body garment used in the early postoperative phase of surgeries like an abdominoplasty (tummy tuck) or an abdominal liposuction. An abdominal binder serves many important functions, especially in the early postoperative stages of an abdominal surgical procedure. An abdominal binder provides compression and support to both the upper and lower abdomen. It helps improve blood circulation and oxygen levels at the operative site, increases healing and reduces swelling. With all these improvements, the patient is able to get out of bed sooner and walk around more easily. This further improves breathing and promotes the healing process and a speedy recovery.
Other Uses
An abdominal binder may be indicated and prescribed in other surgical procedures and situations, such as during pregnancy in certain situations, after the delivery of a baby and to support weak abdominal muscles due to aging. It may also be used for obesity or paralysis. Abdominal binders come in sizes from extra-small to small and medium, large and extra large and extra-extra large.
How to Use
An abdominal binder is usually applied in the operating room immediately after surgery. The physician prescribes instruction as to the length of time it should be worn. Usually for the first two weeks, it is worn constantly, after which it may only be removed for showers and then replaced. After three weeks, it may need to be worn only in the daytime. The physician will give instructions based on your progress. Having two abdominal binders is highly recommended so they can be interchanged when one is being laundered.
Types
Straight abdominal binder: place the patient in a supine position. Ask the patient to lift upward, using the legs, or roll the patient onto the binder. It should be smooth so that wrinkles do not cause pressure on the patient’s skin. Overlap the edges of the binder snugly over the abdomen. Holding it in place, fasten the binder with safety pins or Velcro.
Scultetus abdominal binder: place the binder underneath the supine patient, being careful to check for underlying wrinkles. Lace the lower tail in a slightly oblique direction up the abdomen. Lace the tail on the opposite side in a similar way. Continue lacing in this interlocking fashion until all the tails have been neatly and securely placed.
Elastic net binder: elastic net binders are used to hold dressings in place and not for support. These binders come in a variety of circumferences. Begin by gathering the net in your hands, stretch it and slip it upward over the feet and legs to the position around the abdomen.
How to Measure
The proper measurement of the abdominal binder for a comfortable fit that applies the right amount of compression is important. The measurements and sizing must be done prior to having the surgical procedures. Measurements are taken next to the skin without clothing. A stage 1 garment is worn for the first two weeks postoperatively. It is bigger and less tight to accommodate any initial swelling. A second stage garment is worn 2-8 weeks postoperatively or longer; it is a smaller and tighter binder.
Precautions
Individuals who are allergic to latex should use a latex-free abdominal binder. This will prevent an allergic reaction, which can include a rash, itching or swelling of the face, tongue and throat, and shortness of breath and difficulty breathing. This is a medical emergency. Immediate medical care must be administered if any of these symptoms occur.
BREAST BINDER
- Wash and thoroughly dry under pendulous breasts. Place 4” multiply 4” gauze pads under breasts, as necessary, to prevent skin irritation.
- Slip the binder under the patient’s chest so that its lower edge aligns with the waist
- Straighten the binder to distribute it evenly on either side
- Place the binder so that the patient’s nipples are centered in the breast tissue. This position ensures proper breast alignment and support and produces faster tissue involution.
CONCLUSION
Bandages and binders protect an underlying wound or dressing, provide pressure, warmth, support, or immobilization. Most bandages are of a gauze material; binders are often made of muslin. Bandages or binders need not be sterile when there are underlying sterile dressings to protect the wound.
Avoid bandaging over wrinkled dressings, which can produce pressure on the wound or skin. Also do not apply bandage or binder over a dressing that appears soiled because this can lead to infection. Approximately after you applied bandage or binder, check the patient for comfort. A bandage or binder that is too tight can interfere with circulation, causing swelling, numbness, tingling, or color changes in the distal are. Bandages are applied on parts from distal to proximal, to facilitate venous return.
