STRAPPING.
Strapping is a method of supporting weak or swollen joints and other
parts. Sheets of calico, wash-leather, or white buckskin, spread with
lead or soap plaster, are prepared for this purpose. A sheet should
be rubbed with a dry cloth before using, to remove adherent dust,
&c. It is then cut into strips varying in width between ¾ inch and
2 inches, according to the evenness of the surface to be covered:
narrow strips fit best over joints and irregular surfaces. When
applied to a limb, the strips should be about one-third longer than
its circumference. Each strip or strap is first warmed by holding it
to a fire, or by applying its _unplastered side_ to a can of boiling
water; when hot, the strip is then drawn tightly and evenly over the
part. If the surface to be strapped be irregular, it is best to dip
each strip of plaster in hot water before applying it, being thus
quite supple the strap fits the limb more exactly. When the limb is
thickly beset with hairs, it is a good plan to shave the part where
the plaster will lie before putting on the straps.
=Strapping the Breast.=—Strapping is put on the breast in the same
way as the bandage (page 8). The straps should be not more than 2
inches wide, and long enough to pass forward under the axilla and
breast from the lower angle of the scapula on the same side as the
injured breast, across the chest as far as the spine of the other
scapula. The strips are then warmed and laid on alternately over the
breast and across the chest, until the former is fairly supported.
Strapping has this advantage over a bandage—its circular strips do
not pass round the chest completely and thereby hamper the breathing
as the roller does.
=To strap the Testicle.=
_Apparatus._—1. Strips of soap plaster spread on calico, or better,
on wash-leather, ½ inch wide and 12 inches long.
2. A can of boiling water.
3. Razor and soap.
[Illustration: Fig. 20.—Strapping the Testis.]
First, shave the scrotum; then tighten the skin over the testis
with the left thumb and forefinger passed above it; take a strip of
plaster 6 inches long and ½ inch wide, and encircle the cord tightly
with it; next pass another strap of the same width, 9 or 10 inches
long, from the back of this ring, over the testicle to the front,
drawing it tight also (see fig. 20). The strapping is continued by
laying fresh straps over each other until the whole testis is covered
in. Lastly, take a strip 15 or 20 inches long, and, beginning at
the ring above, wind it round and round the testicle until all the
vertical strips are confined in place by this spiral strip.
The strapping should be re-applied the second or third day, as the
testicle by that time will have shrunk within its case.
[Illustration: Fig. 21.—Strapping an Ulcer.]
[Illustration: Fig. 22.—Strapping the Ankle.]
=Strapping Ulcers and Joints.=—Cut strips of plaster one-third
longer than the circumference of the part to be strapped; if that is
irregular, as the ankle or wrist, they must be narrow: commonly the
width varies between ¾ inch and 1½ inch. The strips are warmed, the
middle passed behind the limb, the ends crossed in front (see fig.
21) and drawn tight, but with sufficient obliquity for the margins of
the strip to lie evenly. The strapping is begun as low down the limb
as requisite, and continued upwards by laying on more strips, each
overlapping about two-thirds of the preceding strap. When the process
is finished, the ends should meet along the same line, and all the
uppermost ones be on the same side.
_The ankle_ is strapped differently. Strips are prepared about ¾ inch
wide; one is carried behind the heel and its ends brought forward
till they meet on the dorsum of the foot; a second, encircling the
foot at the toes, secures the first; a third is again carried behind
the heel above the first, and is fixed by a fourth round the foot.
This is continued until the foot and ankle are firmly supported (see
fig 22).
=Strapping a Joint with Mercurial Ointment.=
(_Scott’s Bandage._)
_Apparatus._—1. Mercurial ointment.
2. Diachylon plaster.
3. Lint.
4. Spirit of camphor.
5. Cotton wool.
6. Freshly scalded starch, or solution of gum.
7. Binder’s millboard.
Spread the ointment on a piece of lint large enough to cover the
joint, and to extend four or six inches above and below it; then
wash the joint with warm water and soap and dry it carefully; next
sponge it well with the spirit of camphor for five minutes. Tear the
lint into strips and wrap it round the joint; then strap the part
firmly from below upwards over the lint with strips of diachylon
plaster, each overlapping the preceding. Lastly, envelope the joint
in a thin layer of cotton wool, and roll a bandage soaked in starch
over all. If the patient wears no other kind of splint the bandage
may be strengthened by laying a piece of millboard well softened in
boiling water along each side of the joint before the starch bandage
is applied. As the enlargement of the joint shrinks, this application
must be renewed, usually every fortnight is often enough.