NCM 109A unit 1

• Scultetus Binder


  • Commonly known as "many-tailed binder", holds dressings in place in the abdominal region
  • Provides support, keeps dressings in place, reduces tension on wounds and suture lines
  • Can be made up of wide strip of soft muslin, strip of lightweight canvas material, elastic net binders
• Preparation before the application of a binder


  Measure the area that the binder must fit and obtain the proper size and type of binder from the central supply department
• Types of Binders


  • Straight Abdominal Binders
  • Breast Binders
  • T Binder
• Special Considerations in the Application of Binders

  1. Wrap the binder for maximum support applying even pressure across the body section

  2. Eliminate all wrinkles

  3. Avoid placing pressure over bony prominences

  4. Observe the patient closely for precipitate delivery due to extra pressure on weak abdominal muscles

  5. Be careful not to compress tubes, drains, or catheters

  6. Don't allow binder placement to interfere with elimination

  7. Use a double T-binder on a female patient after extensive surgery requiring a large dressing

  8. Use a straight or Scultetus binder as a breast binder if necessary

  9. Observe the patient and check binder placement every 8 hours

  10. Reapply the binder when needed according to practitioner's orders and observe skin for signs of irritation
• Irritation of the underlying skin can result from perspiration or friction
• Documentation for Binders


  1. Record date and time of binder application, reapplication, and removal

  2. Record binder type and location, purpose of application

  3. Record skin condition before and after application

  4. Record dressing changes or skin care

  5. Record complications

  6. Record patient's tolerance of the treatment
• Documentation data to record

  • Date and time of binder application, reapplication, and removal
  • Binder type and location; purpose of application
  • Skin condition before and after application
  • Dressing changes or skin care
  • Complications
  • Patient's tolerance of the treatment
• Scultetus Binder Application Procedure

  1. Check physician’s order from the chart

  2. Performs hand hygiene

  3. Gather equipment (Scultetus binder and safety pins)

  4. Ask the client to state his or her name

  5. Explain the procedure

  6. Close door, draw curtains and send out extra personnel

  7. Roll one side of the tails of the binder towards the center then insert the binder’s center under the patient

  8. Distribute the tails evenly on each side

  9. Bring the lowest tail straight across the patient’s abdomen while holding it snugly

  10. Alternate tails in the same manner with the next higher tail overlapping the one below it by about half its width

  11. Eliminate all wrinkles and avoid placing pressure over bony prominences

  12. Fasten binder with safety pin

  13. Assess client’s comfort

  14. Assist patient to a comfortable position

  15. Check binder placement every 8 hours including the skin for color, palpate it for warmth, check pulses, and assess for tingling or numbness

  16. Document skin condition and procedure using FDAR charting
• In surgical patient: fasten straight and the binder from the bottom upward to relieve gravitational pull on the wound. In obstetrical, fasten from the top downward to direct the uterus into the pelvis
• To determine whether the binder is fitting properly, not too tight nor too loose
• To ensure patient’s comfort
• Tight fitting binder may compromise the circulation
• Ensures continuity of care and ongoing assessment record
• binder starts from the bottom to top. rationale: for support, splinting of the cervical incision.
• some uses velcro abdominal binders on NSVD.
• purpose of sandbag: substitution for massaging, for weight to maintain firm and uterine contractions
• purpose of ice pack: vasoconstriction reduce swelling, decrease pain, prevent infection
• STRAIGHT ABDOMINAL BINDERS

  ➢ It keeps suture line intact after abdominal surgery
• BREAST BINDERS

  ➢ Reduces breast engorgement in the non-breast-feeding mother
• T BINDER

  ➢ SINGLE T BINDER

  ✓ Keeps perineal dressings in place for the female patient

  ➢ DOUBLE T BINDER

  ✓ Secures perineal dressings for the male patient requiring a bulky dressing
• Check physician’s order from the chart. Verifying the physician’s order is crucial to ensure

  that proper intervention is given to patient
• Performs hand hygiene. Hand hygiene deters the spread of microorganisms
• Gather equipment. (Scultetus binder and

  safety pins) Organization facilitates task performance.
• Ask the client to state his or her name. To determine whether we are doing the procedure to the correct patient
• Explain the procedure. Explanation relieves anxiety and facilitates

  cooperation
• Close door, draw curtains and send out

  extra personnel.

  Provides patient’s privacy and facilitates

  cooperation
• Roll one side of the tails of the binder

  towards the center then insert the binder’s

  center under the patient.

  Slide the binder under the patient’s hips and

  buttocks so that it’s top align with the waist.
• Distribute the tails evenly on each side. To ensure the fitness of the binder
• Bring the lowest tail straight across the

  patient’s abdomen while holding it snugly.

  The lowest tail crosses the extreme lower

  abdomen.
• Alternate tails in same manner with the

  next higher tail overlapping the one below

  it by about half its width.

  Provides maximum support and have even

  pressure across the body section.
• Eliminates all wrinkles and avoid placing

  pressure over bony prominences.

  Prevents skin irritation
• Fasten binder with safety pin. In surgical patient: fasten straight and the binder

  from the bottom upward to relieve gravitational

  pull on the wound.

  In obstetrical, fasten from the top downward to

  direct the uterus into the pelvis.
• Assesses client’s comfort. To determine whether the binder is fitting

  properly, not too tight nor too loose.
• Assist patient to a comfortable position. To ensure patient’s comfort.
• Check binder placement every 8 hours

  including the skin for color, palpate it for

  Tight fitting binder may compromise the

  circulation.
• Document skin condition and procedure

  using FDAR charting

  Ensures continuity of care and ongoing

  assessment record