The Fortunate Lady and Her Mountain Man

Chapter 223: Chapter 223: Bandage

"The main purpose of a plaster cast is immobilization."

"For patients with fractures or ruptured tendons, it promotes healing and recovery better than a simple splint."

"This is especially true for open wounds. Before they’ve healed, the soft tissue shouldn’t be compressed, which makes splints unsuitable for immobilization."

"If you want to avoid further injury as much as possible, lessen the strain of movement, and prevent mobility issues, a plaster cast is the better choice."

After hearing Ji Huan’s explanation, Xin Ziqi silently put away the splint he had just taken out.

He hesitated for a moment, then pointed to the object in her hand. "Then this thing of yours..."

"This is a plaster bandage for immobilization."

A plaster bandage is essentially made from starched gauze coated with plaster of Paris. After being soaked in water and wrapped around the affected limb, it hardens and sets in a short amount of time, giving it excellent molding capabilities.

"I thought you wanted plaster powder to use as a topical poultice, or to mix into a paste."

"Calcined gypsum powder does indeed help regenerate tissue and stop bleeding, but that doesn’t conflict with using a plaster bandage. Besides, your family’s special styptic medicine is very effective. The homeless man’s bleeding has already stopped. The priority now is to immobilize his limbs."

Xin Ziqi looked at the plaster bandage in her hand, which was only slightly thicker than ordinary cotton gauze, finding it hard to imagine how it could possibly be better than a splint.

Ji Huan didn’t waste words, simply asking Ping’an to bring over a basin of warm water.

"Watch closely. This will be very useful for your orthopedics department. Besides immobilizing the injured limb and preventing further damage to tendons and blood vessels, it can also be used to correct deformities and maintain functional positioning..."

After a brief discussion, the two decided to only cast his right hand and left foot, where the tendons were completely ruptured.

Ji Huan walked over to the homeless man, who was lying flat on his back.

Since she didn’t have any cast shears, she had pre-measured the approximate length of gauze needed for each area when she brought him food last night. She only started making the plaster bandages after returning, so the sizes were quite accurate.

First, she slipped on the thin cotton sleeve she had worked overtime to sew last night, ensuring it extended three to five centimeters beyond the cast boundaries. Then she wrapped a layer of padding over it.

"What’s that for?" Xin Ziqi asked, confused.

"Plaster isn’t elastic. Without padding, it can easily cause pressure injuries. The padding both prevents those injuries and protects the skin over bony prominences from developing bedsores."

As Ji Huan answered his question, she submerged a roll of bandage into the warm water at a forty-five-degree angle.

A large number of bubbles immediately rose to the surface of the calm water.

She wrapped her hands in oilcloth, reached into the water, and squeezed the roll for two to three seconds until the continuous stream of bubbles stopped. Then she took out the bandage and gently pressed it from both ends toward the middle to wring out the excess water.

Next, she positioned the limb, making sure the fingers were semi-flexed, the thumb was in an opposable position, and the wrist was dorsiflexed at a thirty-degree angle.

Then, she held the roll of plaster bandage in her right hand and used her left to smooth the starting end onto his arm.

"You need to focus on immobilizing the joint proximal to the injury. This prevents repeated pulling on the wound when the joint flexes or extends, which would not only hinder healing but also worsen the swelling and pain."

Alternating hands, she wrapped the bandage from the proximal to the distal end of the limb in a uniform, spiral-rolling motion.

At the elbow joint, she wrapped it in a figure-eight pattern. When she reached the final layer, she folded the top edge of the cotton sleeve back over to prevent the edge of the plaster bandage from chafing the skin.

"Overlap each layer by one-third to two-thirds. This ensures it sets into a single, solid piece. You also have to make sure the tension is just right. Too loose, and the bandage won’t adhere properly; too tight, and you’ll restrict blood circulation to the limb."

Ji Huan narrated the entire process, not forgetting to smooth the bandage with her hands as she wrapped. This improved the adhesion between layers and prevented wrinkling, which was especially important for the first two layers.

Of course, if she had latex gloves, she could have wet them and molded the cast, which would have made the bond between the layers even tighter and smoother.

Once the wrapping was complete, she temporarily reinforced the outermost layer with a regular gauze bandage.

"Remember, you have to be quick, finishing in an instant if possible. Otherwise, the plaster bandage will harden and become unusable."

Xin Ziqi stared intently. In just a short while, the bandage that now encircled almost the entire arm had indeed begun to harden.

He reached out and touched it. This kind of all-around immobilization was indeed much more secure than a splint.

"So... you just soak it, and that’s it?" His tone was filled with amazement.

Ji Huan had already put the cotton sleeve on the homeless man’s left leg and was now adjusting the angle.

Seeing this, Xin Ziqi walked over to help and observe.

"There’s a technique to the soaking, too. The water temperature has to be between twenty-five and thirty... well, let’s just say you can feel it out with your hand. The soaking time is only about a dozen seconds or so, so you have to finish molding it within that working time, or both the adhesion and the molding effect will be compromised."

"Can he move afterward?"

"He can’t move it for about a quarter of an hour, until the cast has fully hardened. After that, as long as the wound isn’t painful, he can make some small movements."

"If it’s all-around immobilization, why aren’t his fingers and toes covered?"

"His fingers and toes are left exposed to make it easier to monitor the circulation in his extremities... You could also say it’s to facilitate later exercises."

"I see."

Xin Ziqi mentally noted down all the key points before turning to observe the bandage on the homeless man’s arm again.

Ji Huan felt a slight pang of regret.

’Plaster bandages have many drawbacks. In modern times, they’ve been gradually replaced by fiberglass casts and splints.’

’Fiberglass casts don’t cause the skin to feel tight and itchy after drying, nor do they cause the clamminess and discomfort from poor breathability. They’re better for the skin’s metabolism and are even waterproof.’

’Plus, they harden extremely quickly. They start to set in two to three minutes, begin to harden in three to five, and can bear weight after twenty minutes.’

’But unfortunately, all those advantages are useless now. It’s already an achievement just to be able to make a plaster bandage here.’

Ji Huan patted the homeless man’s leg, telling him to raise it as high as he could.

The homeless man was clearly weak from his recent surgery, but he still complied.

Because the Achilles tendon has the least tension—and is also shorter than normal post-surgery—the leg needed to be positioned with the knee flexed at a sixty to seventy-degree angle and the ankle in moderate plantar flexion, with the toes pointing downward.

This position for the leg and foot would ensure no tension was placed on the sutured Achilles tendon.

However, the ankle couldn’t be in excessive plantar flexion—meaning, the toes couldn’t point too far down—or it would increase the pressure on the skin and the sutured tendon, hindering recovery.

Compared to the eight layers on his right arm, she wrapped his left leg with twelve layers before stopping.

’His right leg tendon wasn’t completely ruptured and had mostly healed, but Xin Ziqi did put a few stitches in it later,’ Ji Huan mused. ’I should probably cast it too, though I can be a bit more casual with it.’

After she had finished with everything, Ji Huan found a piece of blackened charcoal and wrote the date for cast removal on the plaster.

"It needs a month?"

Ji Huan nodded. "Only for the right leg. The left leg and right hand will need more time."

Xin Ziqi had another question. "How will we change his dressings?"

"Hmm... Let’s see if we can cut a window."

Ji Huan then explained to Xin Ziqi what "cutting a window" meant.

’You can use a saw to remove the whole cast, but cutting a window is trickier. I’ll have to ask around later and see if there are any other tools available.’

Ping’an was furtively peeking in from outside.

When he saw that the two people inside had noticed him, he chuckled. "Young Master, it’s getting late. When are we heading back?"

"Tonight... we’re not going back."

Ji Huan, who was standing nearby waiting for his answer, silently let out a sigh of relief.

Visit and read more novel to help us update chapter quickly. Thank you so much!