Pütter Association

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The term Pütter-Verband designates an application technique of short-stretch bandages for compression therapy in patients with venous diseases. The Pütter bandage supports the decongestion of edema in the legs and thus promotes the healing of existing wounds . This system technology for compression bandages goes back to the founder of the drug manufacturer Medice , Gustav Pütter (1907–1977) and is widespread in Germany.

Short stretch bandages

development

Gustav Pütter, born on July 30, 1907 near Iserlohn , fell ill with tuberculosis as a child , which solidified his interest in medicine. Later he took up the profession of naturopath and founded the company Medice in Iserlohn in 1949 . He sold the Pütter Association presented in 1952 in cooperation with Paul Hartmann AG. This type of compression therapy represents a further development of the so-called Fischer Association , which was presented in 1910 by the German doctor Heinrich Fischer (1857–1928). Fischer's dressing technique used a combination of zinc glue and short-stretch bandages and was significantly more rigid in comparison. Pütter's innovation, on the other hand, enabled patients to be more mobile.

Plant engineering

For a putter bandage , 6, 8, 10 or 12 cm wide short-stretch bandages are used , depending on the size of the foot and the length and circumference of the calf - usually two bandages are sufficient. A padding cotton or foam bandage, which is wrapped without tension from the toe to the knee, protects the skin of the leg from lacerations, pressure damage or allergic reactions to the material of the short-stretch bandages. The first short-stretch bandage is applied to the ankle, from here, partially exposing the heel, is brought up to the toes and then up to the knee. The second bandage attaches to the instep, closes the heel and is wound up the calf in the opposite direction to the first bandage.

variants

A common variant of the Pütter bandage begins at the metatarsophalangeal joint. The bandages are looped around the foot and ankle several times - the heel in particular is carefully circled - and then wound up on the lower leg relatively steeply to the knee. A second bandage is attached to the ankle and is passed over the first bandage in the opposite direction. As a variant, the second bandage is first brought up to the toes, back over the foot and only then up the calf . In a further version, the first bandage on the back of the foot is to be led from the inside out, while the second bandage, which also starts on the back of the foot, is to be wrapped over it from the outside to the inside. In addition, the first bandage is wrapped back down from the knee , with the second bandage not generally starting at the ankle but where the first one ends.

The basic principle of every system "according to Pütter" is always the opposite direction of the binding cycles, in which the binding layers cross each other, which is why the Pütter association is also called "counter winding technology".

additional

There are numerous other application techniques for creating compression bandages, most of which are named after their developers. In addition to the fishermen's association mentioned above, there are also associations according to Altenkämper or Schneider . The Karl Siggs investment method, to which the Sigvaris compression stocking brand goes back, is widespread in Switzerland . In Germany, on the other hand, the Pütter technique - with its variants - is so widespread that the activity of applying a compression bandage is synonymous with “puttering”. The Paul Hartmann AG sells today Kurzzugbindensets under the name "Pütterbinden".

Individual evidence

  1. ↑ Kerstin Protz et al .: Compression bandages with and without padding: A controlled observational study on compression pressure and comfort . In: dermatologist. 2018 Aug; 69 (8): 653-661. doi : 10.1007 / s00105-018-4167-9 .
  2. ↑ Stefanie Reich-Schupke , Markus Stücker : Modern Compression Therapy A Practical Guide . Viavital Verlag, Cologne 2013, ISBN 978-3-934371-50-7 , p. 68.
  3. ↑ Phlebological Compression Association in Altmeyer's Encyclopedia of Dermatology , Springer Verlag, accessed on October 3, 2018.

literature

Kerstin Protz, Joachim Dissemond, Knut Kröger: Compression Therapy An Overview for Practice , Springer, Heidelberg 2016, ISBN 978-3-662-49743-2