Capline bandaging procedure

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I now have comprehensive information from Pye's Surgical Handicraft plus the head bandage illustration. Here is the full answer:

Capeline Bandage - Procedure

Definition

The capeline bandage (from French capeline, meaning a cap or hood) is a roller bandage technique that covers the head or an amputation stump like a cap. It combines horizontal (circular) anchor turns with alternating recurrent (front-to-back) turns that progressively cover the entire surface.

Types of Application

Head capeline - for scalp wounds, post-neurosurgical dressings, or head injuries
Stump capeline - for the end of an amputated limb

HEAD CAPELINE BANDAGE

Equipment Required

5-10 cm (2-4 in) cotton or crepe bandage
Cotton wool (for padding behind ears)
Safety pin or adhesive strapping to secure
An assistant (to hold recurrent turns in place, unless the patient is co-operative)

Pre-procedural Steps

Assess the wound; ensure any dressing is clean and in position
Insert cottonwool padding behind the ears to protect them
Position the patient comfortably, preferably seated
Face the patient while applying the bandage

Procedure - Step by Step

Step 1 - Anchor turns (circular/horizontal):

Begin at the right ear with a horizontal circular turn
Carry the bandage backwards, low over the occiput (back of head)
Bring it forward over the left ear, across the forehead and back to the starting point
Repeat this horizontal turn to anchor firmly (2 circular turns total)

Step 2 - First recurrent (central) turn:

Over the starting point, make a reverse turn (fold the bandage)
Guide the bandage over the centre of the head to the left ear

Optional extended central turn: The central bandage may be continued down the left side of the head, under the chin, up the right side, over the right ear, up and over the head to one side of the first turn, then to the left ear - this adds better coverage of the sides.

Step 3 - Alternating recurrent turns:

At the left ear, reverse the bandage again
Guide it back over the head, to one side of the central bandage, to the right ear
Continue passing turns to and fro over the head - first one side, then the other side of the central bandage
Each successive turn should overlap the previous by 2/3 of the bandage width
Continue until the entire scalp is covered

Step 4 - Finish:

Complete with two horizontal circular turns around the head
Secure in front with a safety pin or adhesive strapping
Ensure the pin/knot is away from the wound

Completed head capeline bandage covering the scalp

Completed capeline/head bandage - note the horizontal anchoring turns at the forehead, with recurrent turns covering the crown (Pye's Surgical Handicraft, 22nd Ed., Fig. 6.2)

STUMP CAPELINE BANDAGE

Purpose

Applied to condition the amputated stump for prosthetic limb wearing. Goals:

Prevent terminal oedema of the stump
Encourage healthy venous return
Tone up flabby residual tissue
Prevent formation of an adductor roll of flesh (which would cause discomfort with a prosthesis)

Equipment

Rayon and elastic (crepe/elastic) bandage - size depends on stump location
Must be applied from the time of amputation onwards

Procedure (General Principle)

Step 1: Make 2 circular turns to anchor the bandage around the limb above the stump end

Step 2: Carry the bandage over the centre of the stump to the same level behind, holding the turns front and back with the thumb and finger of the other hand

Step 3: Fix the loop with a straight turn around the stump

Step 4: Continue with figure-of-eight turns around the limb until the dressing is completely covered

Step 5: The degree of pressure must be tolerable but firm - apply from distal to proximal (tighter distally, looser proximally) to aid venous return

Site-Specific Notes

Stump	Technique
Below-knee	Figure-of-eight turns starting above the lateral tibial condyle, diagonally across the front to the medial distal corner, then firmly up the posterior aspect; fixing turns above the joint only, leaving the patella exposed
Above-knee / through-knee	Figure-of-eight and recurrent turns covering the stump; an Elset 'S' elastic bandage (by Seton Products) is recommended for this level

Incorrect stump bandaging is one of the major causes of delayed rehabilitation following amputation. If uncertain, consult the Limb Fitting Service.

Post-procedural Assessment

Check that the bandage is not too tight (assess circulation - capillary refill, skin colour, warmth distally)
Ask the patient about pain or discomfort - investigate immediately if present
Ensure pins/ties are away from the wound
Document: procedure, site bandaged, skin/wound condition, type of bandage, time of application, patient's comfort level

Bandage Width Guide

Body Part	Bandage Width
Fingers	1 inch (2.5 cm)
Head, arm, eye, ear	2-2.5 inches (5-6 cm)
Lower limbs, shoulder	3-3.5 inches (7.5-9 cm)
Trunk, groin	4-6 inches (10-15 cm)

Source: Pye's Surgical Handicraft, 22nd Edition - Chapter 6: Bandaging (Head bandage, p.72; Bandaging an amputation stump, p.77)

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