Above-the-Knee Application of 2-Layer Cohesive Compression

Above-the-Knee Application of 2-Layer Cohesive Compression
Jennifer Spector
Thu, 12/14/2023 – 13:28

Transcript

What we’re doing now is we’re going to show an application of an above-the-knee bandage. If you have a patient and they’re having thigh swelling, you need to apply compression all the way up. The two-layer product on the mark currently that you can do a full leg with is Coban2.

They actually make a larger thigh that helps to do a better job at covering the thigh, again because of the larger circumference. So there’s the six inch. So I’ve applied my below the knee bandage already. I’m simply going to start with my six inch. I’m going to do about a 50% overlap here where I ended up. And we’re going to come around. It’s as if you were just continuing up as you go. The patient has the knee with just a little bit of knee flexion and we’re going to just roll again 50% overlap as we come up with this product. Again, not applying with any tension. We’re just taking the slack out of the product. Don’t worry if you have a little bit of gapping. It’s fine, because what’s going to happen when we come back with that second layer, it’ll stick down. So we’re going to come around. And you’re going to follow the natural contour of the leg. So just as we did for below the knee, on the top, you’re going to want to come at that oblique angle following the natural line of the body. Sometimes I tell my patients that we’re going to follow the natural line of like a panty line. So coming down low in the groin immediately, but high laterally. So again, following the seam of a panty. Don’t worry about the gapping.

We’re going to catch it as we come back around. So I’ve come up to where I want it to be. I’m just going to come around an anchor right here. And as you get to the end of the roll, it gets a little sticky. So again, you’re going to stick. You’re going to take a minute to kind of set your product. So we’ll come to the end of the roll. Whatever you don’t need, you can trim, and if you’ll take a minute and just seam your edges, that should stick for you. Okay. So that’s the comfort layer. You’re going to take the cohesive layer, and this product is going to be applied just like you applied the comfort layer.

So again, I’m just going to start just like I started previously. 50 % overlap as we go. So notice again that I’m keeping it close to the body. Do not take the bandage way out here. If you do, you’re going to find out that it’s going to be too much pressure. It’s going to dig. Your patient’s going to complain of pain. Keep the bandage close.

Take the stretch out of the product as you roll. 50% overlap as you come up.

And again, you’re going to follow the natural contour of the limb, which means that you’re going to come a little higher up. If the bandage is really sticky, you can roll off.

But again, pay attention to make sure that you’re just taking the stretch out and not strapping with the bandage. If you need to change your angle, you can fold a bit and stick.

Now I can go down and again follow the natural contour of the limb. and come up on the outside leaving yourself just a little bit of grace of the comfort layer on top.

Again if you’ve got gapping here that’s fine you can take it and stick it because again when it’s sticks it’s cohesive. You’re gonna give it that little bit of a squeeze. A

nd then you can cut and trim right here. I would encourage you that you want to– just like the bottom half of the bandage,

we covered with a nylon. The top half of the bandage also needs to be covered with something, so you could use any kind of elastic circular gauze.

This material is sticky. Sticky, so you have the potential when the patient is pulling their pants up and down that it may drag the bandage down, but if you cover it with a stockinette of some kind,

we have even taken from the dollar store, queen-sized pantyhose, and cut off the panty portion and just covered the limb with that non-compressive nylon.

It helps with pulling the bandage down. 

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