How to Self-Bandage Your Hand(s) and Arm(s) to Reduce Lymphedema


 

For patients with upper body lymphedema (swelling) who have had treatment for cancer (breast, melanoma, sarcoma, lymphoma) including:

 • Surgery 

• Removal of lymph nodes

 • Radiation This pamphlet explains:

 • What is self-bandaging

 • How does bandaging help with lymphedema 

• When should I wear the bandages

 • What should I do before I bandage 

• How to bandage your fingers and arms


What is the lymphatic system?

 • Your lymphatic system removes extra fluid and waste from your body.

 • Your lymphatic system plays an important role in how your immune system works. 

• Your lymphatic system is made up of lymph nodes that are linked by lymph vessels. Your lymph nodes are bean shaped organs that are found all over your body. Large groups of lymph nodes can be found in your neck, under your arms and in your groin (see picture to the right). Lymph nodes may be removed as part of cancer treatment. This can cause a type of swelling that is called lymphedema. The Lymphatic System: Circles show where groups of lymph nodes are in your body. 

What is self-bandaging?

 Self-bandaging is a way to help treat lymphedema (swelling). Self-bandaging is bandaging that you do by yourself or with the help of a family member or friend. Self-bandaging includes layers of padding and bandages that are wrapped around the swollen area of your body to make a soft cast. How does bandaging help with lymphedema? If you had lymph nodes removed under your arm(s) and/or radiation treatment under your arm(s), breast, chest or trunk, the areas that may have swelling may include your finger(s), hand(s), arm(s), breast(s), and chest.

Wrapping the swollen part of your body with bandages (compression), helps move the lymph fluid in the direction of the heart and away from  your swollen area. The goal of bandaging is to: 

• Help reduce the swelling

• Help prevent the swelling from getting worse 

• Help soften firm, swollen tissue When should I wear the bandages? If you have lymphedema, you should:

 • Wear your bandages during the day and when you exercise. 

• Wear your bandages for a few hours a day. Slowly increase the amount of time you wear them during the day. This will help you get used to wearing the bandages.

 • Begin to wear your bandages at night after you feel comfortable wearing the bandages during the day. It is important that the bandages feel comfortable before you try sleeping in them all night. 

• If you wear the bandages during the day and night, remember to take your bandages off each day to take care of your skin. Take a bath or shower and check your skin for cuts and areas of redness. Put moisturizer (lotion) on your skin. Remember to let the moisturizer soak into your skin completely before you bandage. 

• If the bandages slip down or become loose, take the bandages off and re-wrap the bandages again. It is normal for bandages to slip when you are moving. 

• Be aware of your body. If the bandages become uncomfortable, try removing them and re-bandaging. 

Bandaging supplies may include:

 Fluffy padding Foam padding Short stretch bandages

 • Stockinette (a thin tubular cotton layer) to protect the hand and arm 

• Padding (fluffy white artiflex/castor padding or foam) to help with pressure of the bandages

 • Gauze (white, 4 cm and/or 6 cm) bandage for your fingers and thumb 

• Short stretch bandages (beige) 6 cm, 8 cm or 10 cm 

• Optional: Adhesive (sticky) gauze for your fingers and thumb  


 How to Bandage Your Fingers and Arms There are 3 steps to follow: 

Step 1: Bandage your fingers 

Step 2: Wrap padding on your hand and arm

 Step 3: Bandage your hand and arm


Step 1. Bandage your fingers 



• Put the stockinette on your arm.

 • The stockinette will cover your hand but not  your fingers and stop just below your underarm  (about the size of 2 fingers wide below your  underarm). 

• Cut a small hole in the stockinette for your thumb. 

• Pull the stockinette back over your hand and  wrist to bandage your fingers and thumb. 

 • Wrap either 4 or 6 cm gauze loosley around your wrist.  

• Wrap your thumb first. Bring the gauze up  towards the bottom of your thumb nail.  

 • Start from the bottom of your thumb nail and  wrap around your thumb two or three times  towards the base of your thumb. 

• Do not pull the gauze tight as you bandage your  thumb and fingers. 

• Wrap the gauze around your wrist again.

Continue wrapping each finger the same way.  

  • After you have wrapped all the fingers and thumb with gauze, wrap the base of each finger and thumb. You may have enough gauze left to do this or you may need to use another roll of gauze.   

 • Wrap the gauze around your wrist and bring the gauze around the base of your thumb and back around the wrist. This is a “figure 8” pattern.    

• Continue wrapping the base of each finger the same way. This will help secure the finger bandages. 

• If you have any extra gauze, wrap it over the wrist and arm. Do not cut the gauze.   

 • Pull the stockinette back over your wrist and hand and put your thumb in the thumb hole you cut in step 1.


Option: Finger Wrap with Adhesive (sticky, glue based) gauze. 

You can use adhesive (sticky or glue-based) gauze to bandage your each f inger and thumb on its own if you prefer. 

• Wrap each finger and your thumb without pulling the gauze.  When you have finished your bandaging your fingers, check your blood flow by doing the following test: 

• Press on your fingernail. It should lose some colour or turn pale.

 • The colour will return after a few seconds when you release the f inger

. • If this does not happen you may have bandaged too tightly. You will need to remove the bandage and wrap more loosely.

 The finger bandages should feel comfortable. You should not feel pain or discomfort.

Step 2. 

Wrap padding on your hand and arm 

• You can use the fluffy or foam padding for  this step.

 • With the 8 cm or 10 cm fluffy or foam padding: Wrap around your hand beginning at the base of the fingers. You may want to cut a small hole in the padding for your thumb so the padding fits around your hand easily.

 • Wrap around the palm of the hand moving closer to the wrist. Cover the whole hand.

 • Overlap the padding by half with each wrap.     • Continue with this padding up the arm in the same way.       

• Continue to wrap the padding to just below  your underarm (about two fingers widths  below underarm). 

• Try to smooth out the wrinkles in the padding  as best you can. Do not use tape as it may  tear the padding.

Step 3. Bandage your hand and arm You may need three bandages for this step:

 Bandage #1:  6 cm bandage (beige) 

Bandage #2:  8 cm bandage (beige) 

Bandage #3:  8 cm or 10 cm bandage (beige)

 Bandage #1: 6 cm bandage (beige)

 • Do not pull the bandage roll away  from the area you are bandaging,  keep the bandage roll close. 

• Keep your fingers spread wide when you wrap your hand. This will allow your fingers to move freely when your hand is bandaged. 

• Begin with the 6 cm bandage (beige). Wrap around your wrist once without pulling. This will secure the bandage. 

• Pull the bandage across the top of your hand to the base of your finger (knuckle) wrap two to three more times, pulling the bandage across the top and across the  palm of your hand

 • Now wrap the bandage around your wrist and back around your hand two or three times. This is “figure 8” pattern.

 • Give a gentle pull on the bandage at each half turn to keep an even pressure. 

• Wrap the bandage close to your thumb over the palm of your hand.

 • Give a gentle pull on the bandage at each half turn to keep an even pressure.

Make a fist with your hand when you begin bandaging the forearm (wrist to elbow). This makes the muscles in your forearm tight and will stop the bandages from causing extra pressure when you move up this part of your arm. 

• Continue with the same bandage up the arm.

 • Overlap the bandage by half with each wrap. 

• Always give a gentle pull on the bandage at each half turn to keep an even pressure. 

• Tape the end of the bandage to stop it from getting loose. Bandage #2: 8 cm bandage (beige) 

• Take an 8 cm bandage. Check the area already bandaged area by squeezing the bandages and start the 8cm bandage where the bandage on your arm feels soft. 

• Make a fist with your hand when you wrap  your forearm. Continue to wrap this bandage up your forearm.

 • Overlap the bandage by half with each wrap. 

• Give a gentle pull on the bandage at each half turn to keep an even pressure.

 • Continue with the same bandage.  When you reach the elbow, bend your  elbow slightly.

• Wrap the bandage over the elbow while  keeping your elbow bent slightly. 

• Make sure the padding does not show  through at the back of the elbow. Bend your elbow fully to check that the 8 cm bandage covers all the padding. 

It is very important that the bandage covers the padding completely. If the bandage does not cover the padding, that part of your arm is not getting compression (pressure) and may become more swollen. If you can see the padding, take off the bandage and re-wrap it as above. 

• Continue wrapping the upper arm

 • Overlap the bandage by half with each wrap.

 • Give a gentle pull on the bandage at each half turn to keep an even pressure. 

• Tape the end of the bandage to prevent it from getting loose. Bandage #3: 8 cm or 10 cm bandage (beige)

 • The third bandage can be 8 cm or 10 cm. Start to wrap this bandage where the bandages feel soft. This bandage should come all the way up to the top of your arm. 

• Wrap in the opposite direction to the previous bandage.

Continue wrapping up your arm. 

• Overlap the bandage by half with each wrap. 

• If you bandage over your elbow, bend  your elbow slightly.  Wrap the bandage  over the elbow while keeping your elbow bent slightly. 

• Remember: Always give a gentle pull on  the bandage at each half turn to keep an even pressure. 

• Continue wrapping to the top of your arm  to just below your underarm and tape the end of the bandage to prevent it from getting loose. When you finish bandaging your arm, check your blood flow by doing the following test. 

• Press on your fingernail. It should lose some colour or turn pale.

 • The colour will return after a few seconds when you release the finger. 

If this does not happen you may have bandaged too tightly. You will need to remove the bandage and wrap more loosely. The arm wrap should feel comfortable. You should feel no pain  or discomfort.

What should you avoid?

 • Do not strain your shoulders, neck, arm or hand. 

• Do not wrap the bandage in a way that causes you pain. 

• Do not continue to self-bandage if it causes you pain. If you feel pain call your doctor or health care team.

 • Do not self-bandage if you have an infection in the area that has swelling. 

Follow instructions given by the staff at the Cancer Rehabilitation and Survivorship Clinic.




















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