how to self-bandage your hand(s) and arm(s) to reduce ... · pdf file2 do not self-bandage if...
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Please visit the UHN Patient Education website for more health information: www.uhnpatienteducation.ca© 2016 University Health Network. All rights reserved. This information is to be used for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider for advice about a specific medical condition. A single copy of these materials may be reprinted for non-commercial personal use only.
Author: Stephanie Phan, Sylvia Crowhurst, Pam HammondCreated: 02/2016Form: D-8605
For patients with upper body lymphedema who have had treatment for cancer (breast, melanoma, sarcoma, lymphoma) including:• Removaloflymphnodes• Radiation
This pamphlet explains:• Whatisself-bandaging• Howdoesbandaginghelpwithlymphedema• WhenshouldIwearthebandages• WhatshouldIdobeforeIbandage• Howtobandageyourfingersandarms
Disclaimer:Thispamphletisforpatientswithlympedema.Itisonlytobeusedafterthepatientand/orfamilymemberhasbeentaughthowtobandagebyaclinicianatthePrincessMargaretCancerCentreLymphedemaClinic.
Howtoself-bandageyourhand(s)andarm(s)toreducelymphedema(swelling)
PrincessMargaret
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Do not self-bandage if you have an infection in your fingers, hand, arm, trunk or chest:
Signsofinfectionmayinclude:• Rednessoftheskinthatexpandsorspreads.• Feelingofheatorwarmthintheareathatisred.• Painintheareathatisred.• Raisedskinaroundtheareathatisred.• Feverorchills.Normalbodytemperatureis:98.6°For37°• Feelingsickorunwell.
If you think you have an infection, go to • YourFamilyDoctor• WalkinClinic• Ifnowalk-inclinicisopen,gototheclosesthospitalEmergencyDepartment
Ifyoudohaveaninfection,itisimportanttogetmedicalhelprightawaybecauseinfectionscanspreadquickly.Ifyouhaveaninfectionorothermedicalconcerns,askyourhealthcareprofessionalifyoushouldkeepbandaging.
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What is the lymphatic system? • Yourlymphaticsystemremovesextrafluidandwastefromyourbody.
• Yourlymphaticsystemplaysanimportantroleinhowyourimmunesystemworks.
• Yourlymphaticsystemismadeupoflymphnodesthatarelinkedbylymphvessels.
Yourlymphnodesarebeanshapedorgansthatarefoundalloveryourbody.Largegroupsoflymphnodescanbefoundinyourneck,underyourarmsandinyourgroin(seepicturetotheright).
Lymphnodescanberemovedaspartofcancertreatment.Thiscancauseatypeofswellingthatiscalledlymphedema.
The Lymphatic SystemCirclesshowwheregroupsoflymphnodesareinyourbody.
What is self-bandaging?Self-bandagingisawaytohelptreatlymphedema(swelling).Self-bandagingisbandagingthatyoudobyyourselforwiththehelpofafamilymemberorfriend.Self-bandagingiswhenmanylayersofpaddingandbandagesarewrappedaroundtheswollenareaofyourbodytomakeasoftcast.
How does bandaging help with lymphedema?Ifyouhadlymphnodesremovedunderyourarm(s)and/orradiationtreatmentunderyourarm(s),breast,chestortrunk,theareasthatmayhaveswellingmayincludeyourfinger(s),hand(s),arm(s),breast(s),andchest.
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Wrappingtheswollenpartofyourbodywithbandages(compression),helpsmovethelymphfluidinthedirectionoftheheartandawayfromyourswollenarea.
Thegoalofbandagingisto:• helpreducetheswelling• helppreventtheswellingfromgettingworse
When should I wear the bandages?Ifyouhavelymphedema,youshould:
• Wearyourbandagesduringthedayandwhenyouexercise.
• Wearyourbandagesforafewhoursaday.Slowlyincreasetheamountoftimeyouwearthemduringtheday.Thiswillhelpyougetusedtowearingthebandages.
• Begintowearyourbandagesatnightafteryoufeelcomfortablewearingthebandagesduringtheday.Itisimportantthatthebandagesfeelcomfortablebeforeyoutrysleepinginthemallnight.
• Ifyouwearthebandagesduringthedayandnight,remembertotakeyourbandagesoffeachdaytotakecareofyourskin.Takeabathorshowerandcheckyourskinforcutsandredness.Putmoisturizer(lotion)onyourskin.Remembertoletthemoisturizersoakintoyourskincompletelybeforeyoubandage.
• Wrapthebandagesagainiftheysliporbecomeloose.Itisnormalforbandagestoslipwhenyouaremoving.
• Beawareofyourbody.Ifthebandagesbecomeuncomfortable,tryremovingthemandre-bandaging.Iftheyarestilluncomfortableafteryoure-bandage,contactthePrincessMargaretLymphedemaClinicat4169464501ext.2363.
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What should I do before I bandage?
• Cleanyourskinwithsoapandwaterandpatitdry.Makesureyoudrybetweenyourfingers.
• Checkyourskinforanycutsorredness.Ifneeded:
• Cleanthecutandapplyabandaid.Thenexttimeyoutakeyourbandagesoff,checktoseeifthecutishealingandtherearenosignsofinfections(Seepage2forthesignsofinfection).
• Ifthecutisstillred,theareamaybeinfected.Getmedicalhelp(Seepage2).
• Putskinlotiononyourskin.Thiswillkeepyourskinmoistandhelpyouavoiditchiness,irritationandblisters.
• Applyskinlotiontoyourarmandhand.
• Rubitintoyourskinsothatyourskinismoistbutnotsticky
• Pullonthestockinette(Seeimageonpage8).Itwillpreventthelotionfromrubbingoff.
Makesureyouareinacomfortablepositionwhilebandagingtoavoidanybackorshoulderdiscomfort.
Follow instructions given by the staff at the Lymphedema Clinic.
If you lose your self-bandaging instructions, contact the Lymphedema Clinic at 416-946-4501 ext. 2363. The clinic will mail or email you another copy.
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Have all your supplies ready before you begin
Bandagingsuppliesmayinclude:
• Stockinette(tubularcotton)toprotectthehandandarm
• Padding(softwhiteartiflex/castorpaddingorfoam)tohelpwithpressureofthebandages
• Gauze(white,4cmand/or6cm)bandageforyourfingersandthumb
• Short stretch bandages(beige)6cm,8cmor10cm
• Optional: Adhesive (sticky) gauzeforyourfingersandthumb(Seepage9)
Askforourbookleton“HowtoCareforYourBandages”
How to Bandage Your Fingers and ArmsTherearethreestepstofollow:Step1:BandageyourfingersStep2:WrappaddingonyourhandandarmStep3:Bandageyourhandandarm
Soft padding
Short stretchbandages
Foam padding
Gauze for fingers
Stockinette
Adhesivegauze
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Step 1. Bandage your fingers
• Putthestockinetteonyourarm.• Thestockinettewillcoveryourhandbutnotyourfingersandstopjustbelowyourunderarm(aboutthesizeof2fingerswidebelowyourunderarm).
• Cutasmallholeinthestockinetteforyourthumb
• Pullthestockinettebackoveryourhandandwristtobandageyourfingersandthumb
• Wrapeither4or6cmgauzearoundyourwrist.
• Wrapyourthumbfirst.Bringthegauzeuptowardsthebottomofyourthumbnail.
• Startfromthebottomofyourthumbnailandwraparoundyourthumbtwoorthreetimestowardsthebaseofyourthumb.
• Do not pull the gauze tightasyoubandageyourthumbandfingers.
• Wrapthegauzearoundyourwristagain
Stockinette
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• Continuewrappingeachfingerthesameway
• Afteryouhavewrappedallthefingersandthumbwithgauze,wrapthebaseofeachfingerandthumb.Youmayhaveenoughgauzelefttodothisoryoumayneedtouseanotherrollofgauze.
• Wrapthegauzearoundyourwristandbringthegauzearoundthebaseofyourthumbandbackaroundthewrist.Thisisa“figure8”pattern.
• Continuewrappingthebaseofeachfingerthesameway.Thiswillhelpsecurethefingerbandages.
• Ifyouhaveanyextragauze,wrapitoverthewristandarm.Donotcutthegauze.
• Pullthestockinettebackoveryourwristandhandandputyourthumbinthethumbholeyoucutinstep1.
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Option: FingerWrapwithAdhesive(sticky,gluebased)gauze.
Youcanuseadhesive(stickyorglue-based)gauzetobandageyoureachfingerandthumbonitsownifyouprefer.• Wrapeachfingerandyourthumbwithoutpullingthegauze
Whenyouhavefinishedyourbandagingyourfingers,checkyourbloodflowbydoingthefollowingtest:• Pressonyourfingernail.Itshouldlosesomecolourorturnpale.
• Thecolourwillreturnafterafewsecondswhenyoureleasethefinger.
• Ifthisdoesnothappenyoumayhavebandagedtootightly.Youwillneedtoremovethebandageandwrapmoreloosely.
The finger bandages should feel comfortable. You should not feel pain or discomfort.
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Step 2. Wrap padding on your hand and arm
• Youcanusethefluffyorfoampaddingforthisstep.• Withthe10cmpadding:Wraparoundyourhandbeginningatthebaseofthefingers.Youmaywanttocutasmallholeinthepaddingforyourthumbsothepaddingfitsaroundyourhandeasily.
• Wraparoundthepalmofthehandmovingclosertothewrist.Coverthewholehand.
• Overlapthepaddingbyhalfwitheachwrap.
• Continuewiththispaddingupthearminthesameway
• Continuetowrapthepaddingtojustbelowyourunderarm(abouttwofingerswidthsbelowunderarm)
• Trytosmoothoutthewrinklesinthepaddingasbestyoucan.Donotusetapeasitmaytearthepadding
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Step 3. Bandage your hand and arm
Youmayneedthreebandagesforthisstep:Bandage#1:a6cmbandage(beige)Bandage#2:a8cmbandage(beige)Bandage#3:a8cmor10cmbandage(beige)
Bandage #1 – 6 cm bandage (beige)
• Keepyourfingersspreadwhenyouwrapyourhand.Thiswillallowyourfingerstomovefreelywhenyourhandisbandaged.
• Beginwiththe6cmbandage(beige).Wraparoundyourwristoncewithout pulling.Thiswillsecurethebandage.
• Pullthebandageacrossthetopofyourhandtothebaseofyourfinger(knuckle)wraptwotothreemoretimes,pullingthebandageacrossthetopandacrossthepalmofyourhand
• Nowwrapthebandagearoundyourwristandbackaroundyourhandtwoorthreetimes.Thisis“figure8”pattern.
• Giveagentlepullonthebandageateachhalfturntokeepanevenpressure.
• Wrapthebandageclosetoyourthumboverthepalmofyourhand.
• Giveagentlepullonthebandageateachhalfturntokeepanevenpressure.
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• Makeafistwithyourhandwhenyoubeginbandagingtheforearm(wristtoelbow).Thismakesthemusclesinyourforearmtightandwillstopthebandagesfromcausingextrapressurewhenyoumoveupthispartofyourarm.
• Continuewiththesamebandageupthearm.• Overlapthebandagebyhalfwitheachwrap.• Alwaysgiveagentlepullonthebandageateachhalfturntokeepanevenpressure.
• Tapetheendofthebandagetostopitfromgettingloose.
Bandage #2 – 8 cm bandage (beige)
• Takean8cmbandage.Wrap around the wrist once without pulling.Thiswillmakeitsecure.
• Makeafistwithyourhandwhenyouwrapyourforearm.Continuetowrapthisbandageupyourforearm
• Overlapthebandagebyhalfwitheachwrap.• Giveagentlepullonthebandageateachhalfturntokeepanevenpressure.
• Continuewiththesamebandage.Whenyoureachtheelbow,bendyourelbowslightly.
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• Wrapthebandageover the elbow.• Thenwrapthebandage below the elbow.• Thenfinallywrapabove the elbowinafigure8pattern.
• Makesurethepaddingdoesnotshowthroughattheelbow.Bendyourelbowfullytocheckthatthebandagecoversthepadding.
Itisveryimportantthatthebandagecoversthepaddingcompletely.Ifthebandagedoesnotcoverthepadding,thatpartofyourarmisnotgettingcompression(pressure)andmaybecomemoreswollen.Ifyoucanseethepadding,takeoffthebandageandre-wrapitasabove.• Continuewrappingtheupperarm• Overlapthebandagebyhalfwitheachwrap.• Giveagentlepullonthebandageateachhalfturntokeepanevenpressure.
• Tapetheendofthebandagetopreventitfromgettingloose.
Bandage #3 – 8 or 10 cm bandage (beige)
• Thethirdbandagecanbe8cmor10cm.Starttowrapthisbandageatthemiddleofyourforearm.Thisbandageshouldcomeallthewayupyourarm.
• Wrap in the opposite direction to the previous bandage.
• Wrapthebandagearoundyourforearmoncewithoutpulling.Thiswillsecurethebandage.
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• Continuewrappingupyourarm.• Overlapthebandagebyhalfwitheachwrap.• Dothefigure8wrapoveryourelbow(asdescribedbefore).Thiswillhelpwithelbowmovement.
• Alwaysgiveagentlepullonthebandageateachhalfturntokeepanevenpressure.
• Continuewrappingtothetopofyourarmtojustbelowyourunderarmandtapetheendofthebandagetopreventitfromgettingloose.
Whenyoufinishbandagingyourarm,checkyourbloodflowbydoingthefollowingtest.• Pressonyourfingernail.Itshouldlosesomecolourorturnpale.
• Thecolourwillreturnafterafewsecondswhenyoureleasethefinger.
Ifthisdoesnothappenyoumayhavebandagedtootightly.Youwillneedtoremovethebandageandwrapmoreloosely.
The arm wrap should feel comfortable. You should feel no pain or discomfort.
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What should you avoid?• Donotstrainyourshoulders,neck,armorhand.• Donotwrapthebandageinawaythatcausesyoupain.• Donotcontinuetoself-bandageifitcausesyoupain.Ifyoufeelpaincallyourdoctororhealthcareteam.
• Donotself-bandageifyouhaveaninfectionintheareathathasswelling.
Follow instructions given by the staff at the Lymphedema Clinic.
Contact informationIfyouhavequestionsaboutself-bandaging,contacttheSurvivorshipClinicat416-946-4501extension2363.Asktospeakwithoneofthehealthcareteamaboutself-bandaging.
ThedevelopmentofpatienteducationresourcesissupportedbythePrincessMargaretCancerFoundation.