
J. Biomedical Science and Engineering, 2013, 6, 1186-1190 JBiSE
http://dx.doi.org/10.4236/jbise.2013.612148 Published Online December 2013 (http://www.scirp.org/journal/jbise/)
Geometry of the bandaging procedure and its application
while wrapping bandages for treatment of leg ulcers
Monica Puri Sikka*, Subrato Ghosh, Arunangshu Mukhopadhyay
Department of Textile Technology, National Institute of Technology, Jalandhar, India
Email: *sikkamonica@yahoo.co.in, ghoshs@nitj.ac.in, arunangshu@nitj.ac.in
Received 7 October 2013; revised 15 November 2013; accepted 28 November 2013
Copyright © 2013 Monica Puri Sikka et al. This is an open access article distributed under the Creative Commons Attribution Li-
cense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In
accordance of the Creative Commons Attribution License all Copyrights © 2013 are reserved for SCIRP and the owner of the intel-
lectual property Monica Puri Sikka et al. All Copyright © 2013 are guarded by law and by SCIRP as a guardian.
ABSTRACT
Appropriate compression bandaging is important for
compression therapeutic medical diseases. The high
compression approach employed for treating venous
leg ulcers should be used correctly so that sufficient
(but not excessive) pressure is applied. Bandages used
to treat venous disease by compression should achieve
and sustain effective levels and gradients of pressure
and minimize the risk of pressure trauma. To main-
tain graduated compression on the limb, the bandage
needs to be applied at the same tension for each layer
from the ankle to the knee. In this paper, the geome-
try for various ba ndaging procedures is used to wrap
each layer of bandage by marking the relaxed length
of the bandage. The relaxed length is calculated de-
pending on the stretch%, the average circumference
of the limb to which it is to be applied and the ban-
daging technique to be used. This paper aims at de-
veloping a scientific approach while applying the
bandage to reduce the inter operator variability in
applying the same tension on each successive layer of
bandage.
Keywords: Bandaging; Compression; Inter Operator
Variability; Graduated; Relaxed Length; Stretch
1. INTRODUCTION
Compression therapy is used for the treatment of the ve-
nous leg ulceration and for other chronic venous insuffi-
ciency [1,2]. Compression is provided by wrapping the
bandage around the limb by the application of external
force. Because of compression, the pressure is generated
at the interface between bandage and skin and this pres-
sure is called interface pressure or sub-bandage pressure.
The efficiency of the treatment depends to a great degree
on the level of interface pressure applied and sustenance
of this pressure during the course of the treatment. Pro-
vided that the right level of interface pressure does not
affect arterial flow and the right level of application
technique and materials used, the effects of compression
can be dramatic, which could reduce oedema and pain
and also could promote healing of ulcers caused by ve-
nous insufficiency [3,4]. So compression bandaging re-
quires skill, appropriate training and initial supervision
of practice [5].
The degree of compression produced by any bandage
system over a period of time is determined by complex
interactions between four principle factors—the physical
structure and elastomeric properties of the bandage, the
size and shape of the limb to which it is applied, the skill
and technique of the bandager and the nature of any
physical activity undertaken by the patient [6]. It is es-
sential that practitioners understand how application
techniques can affect the performance of the bandage
systems [7]. Inappropriate selection or application of a
bandage could lead to lack of efficacy and to adverse
effects including amputation [8]. Lee et al. [9] observed
the importance of different application techniques on the
interface pressure variations for different bandages.
Wrapping of bandage over wounded limb by different
practitioners could also influence interface pressure
variation. Dale et al. [10] observed different pressure
gradients obtained by the same bandaging system when
applied by different experienced technicians under the
same application technique.
Many attempts have been made to reduce the effects
of operator variability by marking bandages with geo-
metrical shapes that change from rectangles to squares or
from ovals to circles when a particular level of extension
has been applied [11]. Not all bandages have these geo-
metrical shapes and some manufactures ask users to ap-
*Corresponding author.
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