The plaster of Paris bandage was perhaps first applied by Kluge of
Berlin in 1829, but to the Dutch physicians Mathysen and Vander Loo
belongs the credit of the modern bandage.
It is imperative to give, in this chapter, a detailed and complete
description of what constitutes a properly made plaster of Paris
bandage and the application of it, in order that the general
practitioner may become familiar with its use. Even though one
cares not to treat the conditions heretofore enumerated, I have
found that for fractures of almost every bone in the body requiring
immobilization, the plaster bandage properly applied is far superior
and rather to be preferred to any other form of splints.
It has been used very little in the past in private practice because
the ordinary commercial bandage found in any supply house does not come
up to requirements, in that it is usually air slaked or the plaster has
been shaken from it by the time it is received. Then too the mesh is
too closely woven and the plaster lies on the bandage instead of in the
meshes and there is, in consequence, an excess of plaster; also as a
rule the bandages are rolled so tightly that the water does not reach
the deeper layers.
The ordinary plaster of Paris bandage made in your own office can
always be successfully applied because the right quantity of plaster
can be incorporated in the bandage and it can readily be made into
the desired widths. The plaster of Paris to be used should be of the
superior quality used by dentists and should be of the quick setting
kind. It can be procured at almost any drug store but the surest place
for quality will be your dentist.
Absolutely, the only kind of gauze to be successfully used is white
crinoline of the ordinary variety used by dressmakers and obtainable
at any dry goods store in twenty-four yard bolts. It is especially
desirable to get a kind not too rich in starch or dextrin and of a mesh
running about one hundred holes to the square inch.
The bandages should be made in six yard lengths, and of widths ranging
from three to five inches according to the part that is to be cast;
for instance the three inch widths are most suitable for casts for the
extremities, while the larger ones serve best for conditions of the
spine. After the length had been measured and cut the desired widths
can be torn the full length without trouble. The edge of the crinoline
nearly always frays out and naturally will become so entangled as to
prevent rolling in the plaster or as to hinder the free unrolling of
the bandage when applying it. To prevent this, three threads should be
plucked from each side of each strip before starting to roll in the
plaster.
A hard surface of, at least, two feet in width should be used on which
to roll in the plaster. Starting at one end, a handful of plaster of
Paris is rubbed into the crinoline with the palmar surface of the hand,
bearing down hard, so that all excessive plaster passes to either edge
of the bandage. No more plaster should be rubbed into the crinoline
than the meshes will hold, and as each successive yard is incorporated
with the necessary amount of plaster, it is loosely rolled in such
manner that in the center of the bandage there is a hollow cylinder of
the thickness of the index finger, and the concentric layers are easily
movable on one another. This manner of rolling permits of the rapid and
uniform spread of water through the bandage when it is to be applied,
and prevents parts of the bandage from being insufficiently moistened.
The general practitioner should always keep on hand about two dozen
completed bandages that he is most accustomed to using in his daily
practice. These should be corded as it were, to prevent unrolling, in
an air tight container, either of glass or tin in the bottom of which
is placed a small quantity of plaster of Paris, and should always be
kept in a dry place. I have never found either a nurse or an office
girl who could not make these bandages successfully so that in the
future there is no excuse for a practitioner not using this superior
form of splints.