In cases which require the bandage to remain in place from sixteen to twenty hours each day, it will be necessary to first apply a soft flannel bandage underneath the rubber one in order to prevent pressure necrosis.
Frequently changing the location of the bandage up and down the extremity, and treating the skin with alcohol rubs, will also be helpful to patients with a tender skin. The elastic bandage must always be placed upon a healthy area, proximal to the diseased part. All dressings should be removed while the compressing bandage is on, in order that the part may become hyperemic.
Wounds or sinuses are covered with sterile gauze and kept in place with a towel, fastened with a few safety pins.
In acute inflammation, septic wounds and phlegmons, the increased inflammation is apt to frighten the beginner, but this is a desired phase of the treatment.
As a prophylatic against infection, it cleanses the wound, produces a local immunization and reaction before the infection has a chance to work; the earlier the bandage is applied the more remarkable is the effect.
For incised wounds of the foot with division of the muscles and tendons, if the tissues are not too seriously injured, the muscles and tendons should be united and the skin closed with interrupted sutures sufficiently far apart to allow free excretion. No drainage is employed and a slight compressing dressing is applied. The elastic bandage is applied very lightly, producing only a slight venous engorgement and the bandage should remain on from ten to eighteen hours a day.
As soon us the symptoms of acute inflammation subside, the time of application of the bandage is reduced. If signs of suppuration are present, the wound should be promptly opened and the pus evacuated. The knife takes care of the pus; hyperemic treatment fights the infection.
In gonorrhoeal arthritis of acute or chronic nature, and in cases of tuberculosis of the bones and joints, the passive form of hyperemia is especially indicated.
The use of cupping glasses is limited to abscesses, furuncles and sinuses.
Active Hyperemia, or arterial hyperemia, is produced by means of hot-air boxes such as the Tyrnauer electric apparatus, or the gas apparatus of Betz.