How to apply:
Before applying the first bandage:
- Check the ABPI (Ankle Brachial Pressure Index) to determine if arterial disease is present. If the ABPI is less than 0.8 do not apply the FourPress®.
- Measure the ankle circumference. If ankle circumference is less than 18 cm (7 1/8"), pad the ankle and bony prominences completely to protect against excessive sub-bandage compression which can cause tissue necrosis. Urge the patient to seek medical attention if numbness or pain in the toes or feet occurs and/or if the bandages become uncomfortable or irritating.
- Apply an appropriate non-adhesive primary dressing to cleansed wound before applying FourPress®.
Layer One - Padding Bandage:
- In a spiral fashion, wrap the padding bandage from the base of the toes up the leg to just below the knee.
- Cut or tear off any excess padding.
- Use any excess to pad bony prominences such as the tibial crest.
- This is especially important when the leg is thin and bony.
- While wrapping, overlap each layer of the bandage by one-half the width.
- Smooth after each turn.
- To hold the bandage in place, secure the end with one of the three strips of tape supplied in the kit.
- When applying a compression system to the leg, it is important to enclose the heel with all layers of the System.
Layer Two - Crepe Bandage:
- Use the same spiral bandaging technique as for layer one.
- Wrap the bandage from the base of the toes up the leg to just below the knee.
- While wrapping, overlap each layer of the bandage by one-half the width.
- Smooth after each turn.
- To hold the bandage in place, secure the end with the second of the three strips of tape.
Layer Three - Compression Bandage:
- Using a Figure 8 bandaging technique, wrap the bandage from the base of the toes to just below the knee.
- Use the yellow line as a guide to determine one-half of the width of the bandage.
- While wrapping, stretch the bandage to 50% of its relaxed length.
- At the base of the knee, cut off any excess bandage and secure the end with the third tape strip.
Layer Four - Cohesive Bandage:
- Caution: As you unroll the cohesive bandage, be sure to unroll enough of the bandage (e.g., 18"-24") from the roll to complete one full turn around the leg. Allow the unrolled portion to relax then stretch it 50% and apply it around the leg. Unroll another 18"-24" and repeat the relaxing, stretching and applying sequence until you have wrapped to just below the knee.
- Wrap the bandage in a spiral manner from the base of the toes up the leg to just below the knee.
- Stretch the bandage to 50% of its relaxed length.
- Overlap each layer of the bandage by one-half the width.
- At the base of the knee, tear or cut off any excess bandage.
- The cohesive bandage will adhere to itself securing all the bandages in place.
- To ensure that the cohesive bandage adheres firmly, let the last 6" to 8" of the bandage relax before adhering it to the underlying layer.
- Mold and squeeze the bandaged leg to increase the cohesiveness of the outer layer.
