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An Esmarch bandage is a bandage which is designed to act as a tourniquet to restrict the flow of blood into a limb in order to limit blood loss. The original version of this bandage was developed by German physician Friedrich von Esmarch in the late 1800s for use in battlefield medicine. Since then, the design of the bandage has changed considerably, as have its uses. Medical supply companies may carry Esmarch bandages in their catalogs, usually in a range of sizes.
The original version of the Esmarch bandage was a triangular strip of tough material such as linen. The bandage was designed to be large so that it could be utilized in a number of different ways, allowing people to carry one bandage to meet numerous needs. On the battlefield, this could be extremely important, because medics needed to travel light in order to provide services to as many soldiers as possible.
In the field, the Esmarch bandage was designed to provide consistent pressure to prevent blood loss so that a patient could be evacuated to a hospital for treatment. The bandage could also be used in surgery to clear blood from a limb in order to make the surgical field easier to visualize. Typically the limb would be elevated to encourage blood to flow out before applying the tourniquet. Esmarch referred to his invention as “Esmarch's bandage for surgical haemostasis,” and it quickly became known simply as an Esmarch bandage.
After the introduction of this bandage, doctors began to realize that it could lead to nerve damage if it was not applied properly. Several variants on the design were developed including more elastic bandages. Today, the Esmarch bandage can take a number of forms, ranging from a rubber tube to an elastic strip. These designs have been developed to reduce the risks associated with applying an Esmarch bandage and to make the bandage easier to use.
Although the Esmarch bandage can be used as a surgical tourniquet, most operating rooms prefer more sophisticated bandaging systems which are designed to reduce the risk of damage to the patient. These include limb protectors to minimize pinching and pulling of the skin and nerves, along with bandages which can be precisely inflated to a desired level of pressure to control blood flow to the surgical field. Numerous controlled studies have been conducted to determine the best way to use tourniquets in surgery, balancing the need for a clean surgical field with the desire to avoid injuring patients or setting up situations which may impede healing.
@anamur-- I don't believe that Esmarch bandage has more disadvantages than other medical bandages. It is also a stretch bandage and there are many varieties. Some are tubular bandages, some come in strips and carry adhesives.
You yourself said that the risk are associated with wrong use, which I also think is the main problem. When the bandage is applied, most medical professionals stretch the bandage too much which causes more than necessary amount of pressure after several layers of bandage. When used correctly, the pressure can be reduced and many of those complications you mentioned prevented.
In many surgeries, it has been proven that use of Esmarch bandages for compression reduce blood loss post-surgery. And much more than other techniques such as elevation.
@ysmina-- The reason that the Esmarch compression bandage is not preferred as much anymore is that it carries risks when used incorrectly or for too long.
If too much pressure is applied through the bandage, it can result in temporary or permanent nerve damage as the article mentioned. If it's used for more than two hours, even with the right amount of pressure, it can cause bruising, blistering and muscle problems including a rare condition called compartment syndrome which is dangerous.
I think that elastic bandages that are more flexible, durable and not to mention cheaper, are much better alternatives. They carry less risks.
I remember reading about the invention of Esmarch bandages during my first year of medical school. When this bandage first came out, it was quite a sensation on the battlefield because something like it had never been used before.
Friedrich von Esmarch worked with the German army and knew in detail the kinds of medical problems that soldiers and medical professionals had on the battlefield. He developed this bandage with soldiers's wounds in mind. And he developed it so that it could be used in many different ways and for different purposes.
He also wanted medics with little experience or the soldiers themselves to be able to use it and so had the picture directions printed on the
actual bandage! He didn't want to risk the loss of paper instructions on the battlefield.
Innovations tend to come out of need and this was definitely the case with the Esmarch bandage. It has certainly come a long way since then. Esmarch bandages of today work a lot better than the triangle shaped cloth bandage wrap that it first was.
There are actually many other kinds of bandages available for tourniquet and surgery now that are preferred over the Esmarch bandage. But I still think that this bandage paved the way for the rest.