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

Below-the-Knee Application of 2-Layer Cohesive Compression
Jennifer Spector
Fri, 12/15/2023 – 12:19

Transcript

We’re going to start off with the comfort layer, which is the first layer of the Coban II. You’re going to apply the comfort layer. I would suggest that you follow the natural contour of the foot.

So again, you’re not going horizontal. You’re actually following the oblique angle of the forefoot. You’re coming around the forefoot, wrapping around the heel. And then from here,

I like to do the cut and go method. So, I actually will go ahead. and cut my bandage. And what this does is it allows me to give a better contoured fit to the patient. Maybe an extra step, but it’ll pay off in the end. We’re going to cut and stick here and kind of form that to her foot. Then we’re going to take the product and we’re going to do 50% overlap and we’re going to come around here. We’re going to maintain that 50% overlap as we go up the leg. Notice that I’m not pulling. I’m simply rolling the product on. I’m going to come up and I’m going to, again at the top, follow the natural angle of the leg and I’m going to do an oblique angle, coming a little higher on the outside, a little lower on the inside. 

So, you have your fibular head here, you’re using it as a structure that you can apply compression against. You don’t want it too tight on the inside by the popliteal fossa because that’s where people are going to be irritated. Again, by coming at it or applying the bandage with more of an angle, higher laterally, lower, medium. your patient will be more comfortable. So, you’re going to give that a little bit of a squeeze to set the product. Notice that the bottom of the foot is not covered. We want to make sure that this is pulled down to the edge, and she’s holding her foot at a 90 -degree angle. The next thing that we’re going to do is we’re going to take the second layer, which is the elastic portion of the Coban. Again, we’re going to start medially. We’re leaving ourselves a little bit above buffer room of the comfort layer.

We’re going to go around one time. We’re going to go down and catch the heel. And we’re going to do a figure eight around the ankle. A little key here, when you’re going across the anterior tip, you want to make sure do not pull and create tension across that anterior tip. You simply want to apply and press down and stick. Do not apply tension as you come across the front of the foot. We’re going to go underneath and then back around. So again, make sure that you do not pull across that anterior tip.

Simply lay the product down. making sure that you’re getting 50% overlap and from here all you’re doing is you’re rolling it on. Notice that I’m keeping the product close to the leg and by doing so I can apply full stretch of the product. An error that people will do they will roll it up, off, and then strap. They will pull down and in. And it’s going to create too much tension here. So again, you want to keep it close to the limb. Take the stretch out of the bandage, applying it at full stretch and rolling it on. Too often, people when they’re doing two layer or any kind of compression, they try to engineer in. in the compression into the product as opposed to just allowing the product to work for them.

The way a two -layer works is that once you stick it together, it becomes a rigid sleeve. And then you’re going to have that last little bit. You take the tension off of it and just stick. And you’re going to go back and give it a try. it that Coban squeeze where we set it. The product comes with an outer nylon sock, and what’s great about this, it’ll make it much easier for the patient to get their shoe on, and it also will help to maintain the integrity of the compression itself. So you put your nylon on, and you can simply tuck it in. here at the top to keep good coverage. And that’s a below the knee application.

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