Catheters are often inserted into a wrist artery for procedures like angiography. When done, entry zone must be tightly sealed for about 48 hours to prevent blood under pressure from leaking out while entry closes. Normally, an adhesive bandage 'compression wrap' is tightly wound round the wrist at puncture site and clamped at end to prevent unraveling. The tightness will be uncomfortable and even slightly painful, but unavoidable. At removal time, upon reaching the wrist the nurse must pull it off the hair (if unshaved or unless cut individually) and skin. The pain can be quite high, and the skin is bruised, often resulting in bleeding. Some may be reained as in-patient for wounds to heal sufficiently without infection.
Solvents and lubricants like olive oil are being used to facilitate separation. Not only do these procedures follow the 'shot-gun' approach and take patience and time on the part of nurse and patient, but also can leave a mess or further problems.
Proposal is simply to interpose a non-adhesive barrier between adhesive bandage and wrist. The purpose of the adhesive wrap is to tightly compress the wrist, and adhesion to skin is simply collateral damage. No special preparation is necessary. Normal caution on use of the wrist will apply. There will be no pain at all during removal.
Clinical trials will be easy because incentive of pain reduction will be high value. Constant monitoring by CCTV or nurse will be imperative during early tests. Proposed barrier during trials may be any porous non-stick material, cut to width of bandage and long enough to go around the (largest) wrist a little more than once, say 25-30 cm.
After successful trials, adhesive bandage manufacturers may be approached to incorporate a starting length of a non-adhesive material to wrap around wrist before the adhesive starts to take over, as in Fig 1. There are already on the market, narrower bands of plaster with non-sticky patches for wounds, which may be expanded in size for wrist bandage.
– No special training needed for nurse or patient.
– No removal discomfort;
– No fuss or mess or time delay during removal.
WARNING AND FIXES:
– With bony hands, there may be some chance of bandage slipping away from site.
Possible Solutions against slippage:
(1) Place regular 1-2 cm wide strips of regular adhesive plaster around wrist at top and bottom edges of bandage, binding it to the wrist directly. Removal of this should be much less painful than pulling off the wide bandage from the skin. (Fig. 2.1)
(2) Attach a strip of some material running from the top of bandage over and around the middle finger or in the gap between the second and third fingers of the hand, to the top on the other side. This would be much preferable to the first option. (Fig. 2.2)