Most of the time, nurses wrap areas of the body to hold a dressing in place or to reduce edema. Physical Therapy will wrap any joint for support after an injury.
Wrapping joints such as a knee or elbow requires enough compression to offer support but not so much as to cut off the circulation to the distal end of the limb.
Wrapping a limb to reduce edema requires enough compression to push the excess fluid in the soft tissue up the limb and back into circulation.
Sooo, generally speaking if you want to reduce edema in the lower leg, you must start the wrap just above the toes or you will cut off the circulation below the ace. That would cause swelling of the foot.
I personally don’t like using only the clips to hold an ace bandage. I will reinforce with tape over it. The ace wraps with Velcro are better but I still reinforce the end with some tape.
As with TED hose, wrinkles can cause the circulation to be impaired. Make sure the ace is on smoothly. Reusing the same ace can leave creases difficult to remove.
So when rewinding for use later, smooth the ace as you roll so it will smooth out again by time you are ready to re-use it.
Also, note, when you wrap an ankle you want the ankle to be in an "L" shape. You don't want the toes pointing down.
Wrapping a stump with an ace bandage is to shrink the new stump size as well as shape it for a prosthesis that will be built for the patient.
Therefore sufficient compression is required.
You will probably be wrapping knees after a patient has a total knee replacement.
You can use the same techniques shown on this page when using coban (disposable elastic wrap for dressings).
You will notice that the videos show people holding the roll of ace so that the end being wrapped is under the roll, not on top of the roll. Believe it or not that makes it easier to handle.
The spica wrap is literally an overlapping 3D figure eight and overlaps each layer by 1/3 to ½ each turn around.
Most of my patients are unable to properly wrap their own ace bandage, so unless you have a family member to do it for them every day, ask the doc to switch to TED hose. It may be a little easier.
Ask your patient how it feels as you wrap. Some are very sensitive and can hardly tolerate any compression which you may have to work up to a decent amount over time.
Figure you are stretching from 1 ½ to 2 times the length of the ace.
When you are done check the temperature of the toes or fingers and the capillary refill which should be < 3 seconds. (“<” means “less than”).
And, obviously, when the stretch to an ace is gone, throw it out and get a new one.