Application of Binders

 Binders
o Bandages made of large pieces of material specially designed to fit a specific body part
o Used to support large areas of the body such as abdomen, arm or chest
o The most binders are made of elastic, cotton, muslin or flannel

Binders are bandages that are made of large pieces of material to fit a specific body part. Most
binders is made up of elastic, cotton, muslin, or flannel. According to the size and shape of the
bandages they are classified as—roller bandages, many tailed bandage, T-bandages, tubular gauzes
etc.

Binder Application

 Also known as self-closures, binders are lengths of cloth or elasticized material that encircle
the chest, abdomen, or groin to provide support, keep dressing in place (especially for patients
allergic to tape), and reduce edema, tension on wounds and suture lines, and breast
engorgement in mothers who aren’t breast-feeding. Binders also promote patient comfort and
the healing process. Typically, cloth binders are fastened with safety pins, and elasticized
binders are fastened with Velcro

Equipment

 Tape measure
 Binder of appropriate size and type
 Safety pins
 Gloves, if necessary
 Dressing materials

Indications

 Creating pressure over the body part (to promote homeostasis or minimize edema)
 Immobilizing a body part (joint, extremity)
 Supporting a wound
 Reducing or preventing edema
 Securing a splint
 Securing dressing
 Protecting wound against infection
 Maintaining the position of special equipment for application traction
 Enabling the patient to participate in effective respiratory function

Assessing before applying binders

 Inspect and palpate the area for swelling

 Inspect for the presence of and status of wound
 Note the presence of any discharge (amount, color, odor, viscosity)
 Inspect and palpate for adequacy of circulation—skin temperature, color, sensation, sign of
impaired circulation - pale or cyanotic skin, cool temperature, tingling, numbness
 Ask the patient about any pain experienced—location, intensity, onset, quality
  Assess the capabilities of the patient to cooperate, to hold bandaged part of the body in
needed position
 Assess the capabilities of the patient regarding activities of daily living and assess the
assistance required during the convalescence period.

Implementation

 Check the doctor’s order

 Perform hand hygiene and put on gloves, as needed
 Confirm the patient’s identity using at least two patient identifiers according to your facility’s
policy
 Provide privacy and explain the procedure to the patient
 Raise the patient’s bed to a comfortable working height to avoid muscle strain when applying
the binder
 Position the patient in a supine position, with his head slightly elevated and his knees slightly
flexed to decrease tension on the abdomen
 Assess the patient’s condition
 Remove the dressing and inspect the wound or suture line, if appropriate
 Redress the wound and the remove and discard your gloves

Applying Abdominal Binder

 Accordion-fold half of the binder, slip it under the patient, and pull it through from the other
side. Make sure the binder is straight, free of wrinkles, and evenly distributed under the
patient. It’s lower edge should extend well below the hips.
 Overlap one side snugly onto the other.
 Starting at the lower edge, close the Velcro closure.
 Make darts in the binder, as needed. Avoid making the binder too tight around the diaphragm
because it may interfere with breathing. The insert one finger under the binder’s edge to
ensure a snug fit that’s still loose enough to avoid impaired circulation and patient discomfort.

For maximum support, wrap the binder so that it applies even pressure across the body section.
Eliminate all wrinkles, and avoid placing pressure over bony prominence (as shown below)
Nursing Responsibility

 1. Inspection of the skin for abrasions, edema, discoloration, or exposed wound edges.
 2. Exposed wounds or open abrasions should be covered with sterile dressing.
 3. Inspect the underlying dressing and if soiled it must be changed.
 4. Skin integrity of the underlying body parts and the parts that are distal to the bandages are
assessed for signs of circulation impairment (e.g. pallor or cyanosis, decreased or absent
pulse, swelling, coolness, numbness and tingling)