PARAFFIN WAX

INTRODUCTION
Therapeutic wax bath is one of the forms of heating conduction by wax. Wax baths are available in many variations of size and shape. The melted wax need to be maintained at a temperature of 40- 44degree . So thermostatic control is essential.

Apparatus
Wax

bath tank. Stainless steel. Height adjustable. Thermostat control. Temperature :- 40-44 degrees. Liquid paraffin (natural oil) + wax. Ratio is 6:1 or 7:1.

Mode of Action

Water at 45 temp is uncomfortable and can cause damage. Specific heat of water :- 4.2 kj/kg/degree c. Specific heat of wax :-2.7 kj/kg/degree c. Therefore , the energy released by wax is 1 degree c cooler than that of water. The wax transmits its latent heat to tissues by giving up its energy as it solidifies.

TECHNIQUES OF APPLICATION:Dip and wrap method Dip and re-immersion method Painting or brushing method Bandaging and toweling method Direct pouring method or bath method

Dip and Wrap Method.

Extremity is dipped for few minutes and taken out. Repeated 7-12 times. Wrap with a insulator sheet of plastic. Site fingers, wrist, toes, ankle.

Dip and Reimmersion Method

Part is dipped and taken out to solidify, a white coat will form. Again re-immerse. Repeat 10-12 layers. Wrap with plastic sheet for 15-20 minutes. Site- fingers, thumb, wrist, foot, ankle.

Painting and brushing method

Use painting brush. Make 6-8 layers of wax. Site- arm, elbow, forearm, wrist, thigh, knee, shinbone, ankle.

Bandaging and Towel Method

4-6gauge bandage is used. A two folded length one feet is chosen , it is immersed in paraffin wax bath tub then taken out and applied over the area after releasing the extra wax. Site:- shoulder, greater trochenter.

Direct Pouring or Bath Method

Melted wax of tolerable temperature is directly poured over the area with cup or mug drop by drop. 10-12 layers. Wrap in plastic sheet. Site: elbow, forearm, knee, shinbone, ankle.

METHODS OF APPLICATION

Preparation of Patient

Clean the part to be treated. Check for cuts, rashes, infection, blisters etc. Position the patient accordingly and comfortably. Explain about the nature of treatment. Examine the sensation of the patient. Remove clothing and jewellery etc. Heat should be warm within comfortable limits. Stay near the patient.

Preparation of the Apparatus

Wax should be melted. Temperature : 45 degree. Do not touch the tub. Check the temperature before Rx.

Important Points
Time o f Rx:- 20 minutes ( 15-30 minutes) Coating:- 2 mm-3 mm per layer; total 9-14 mm thickness.

Termination

Remove the towel, plastic sheet, wax. Do not drop wax on the floor. Inspect and dry the part. Put all the used wax into the tub at the end of day. Clean the part with dry cotton.

Follow up
Inspect for erythema, skin colour, burn. Warn the patient not to apply ice or cold water till 2 or 3 hrs after the Rx.

Indications
1. 2. 3.

4.
5. 6.

7.
8.

Pain. Spasm. Contracted deformity. Adhesive scar. Stiffness. Arthritic joints Post-op #. Mobilization of joints.

Contraindications

Open wounds--delays healing. Allergic rash Skin conditions. Defective arterial blood supply--DVT ,varicose veins. Impaired skin sensation. Fever. Malignancy. Acute injury.

Advantages

Risk of burns is less ( low specific heat.) Risk of overheating is less. ( low thermal conductivity) Best for irregular areas as melted heat is used. Oil add moisture. Comfortable. Cheap.

Dis-advantages
For

distal extremities No method of temperature control ones wax is applied. Heating last only for 20 minutes . Exercises may not be performed simultaneously.

EFFECTS

Circulatory Effects

Stimulate capillaries and arterioles thus cause local hyperemia and reflex vasodilatation.

Metabolic Reaction
Is

increased. Increases energy expenditure. Increases protein denaturation.

Vascular effect
Axon

reflex Release of chemical mediators Local spinal cord reflex.

Neuro Muscular Effect Sedation

Analgesia. Decrease

pain. Decrease spasm.

Effect on the Skin

Make

the skin Pliable and soft. Soften the scars and adhesions.

Connective Tissue

Effect

Temperature elevation and stretch can alter visco elastic properties of connective tissue. Plastic elongation.

THANK YOU
Pomila Chopra