Editing How to Apply a Skin Traction

= How to Apply a Skin Traction =

Here is a comprehensive explanation on how to apply skin traction:

== What is Skin Traction? ==

Skin traction is a non-invasive method of applying pulling force to a limb or body part using adhesive or non-adhesive materials applied to the skin. It is commonly used for temporary immobilization and alignment of fractures, particularly in the lower extremities1<ref name="ref4">4</ref>.

== Purpose of Skin Traction ==

The main goals of applying skin traction are:

- To control pain from muscle spasms
- To reduce and maintain alignment of fractures 
- To prevent and correct deformities
- To provide temporary stabilization before definitive treatment[4]

== Types of Skin Traction ==

There are two main types of skin traction:

1. Adhesive skin traction - Uses adhesive tape or strapping applied directly to the skin
2. Non-adhesive skin traction - Uses foam boots or wraps that do not adhere to the skin1<ref name="ref6">6</ref>

== Equipment Needed ==

To apply skin traction, you will need:

- Skin traction kit (adhesive or non-adhesive)
- Crepe bandages 
- Padding material
- Scissors
- Traction cord and pulleys
- Weights (typically 5-7 lbs)
- Spreader bar
- Traction frame or Balkan beam1<ref name="ref2">2</ref>

== Application Procedure  ==

=== Preparation ===

1. Explain the procedure to the patient and obtain consent
2. Position the patient supine on the bed
3. Perform and document baseline neurovascular assessment of the affected limb
4. Gather all necessary equipment1<ref name="ref3">3</ref>

=== Applying the Traction ===

1. With an assistant providing manual traction to the limb, apply the skin traction:

   For adhesive traction:
   - Clean and dry the skin 
   - Apply adhesive spray or friar's balsam to improve adhesion
   - Apply the adhesive straps from just above the malleoli to the upper thigh, leaving the knee exposed
   - Place padding over bony prominences like the malleoli

   For non-adhesive traction:
   - Apply the foam boot or wrap from above the ankle to the upper thigh1<ref name="ref2">2</ref>[6]

2. Wrap crepe bandages spirally over the traction material, overlapping by half
3. Leave approximately 10-15 cm of space between the sole of the foot and the end of the traction to allow ankle movement
4. Attach the spreader bar to the end of the traction material1<ref name="ref2">2</ref>

=== Setting Up the Traction System ===

1. Attach the traction cord to the spreader bar
2. Run the cord through the pulley system on the traction frame
3. Attach the prescribed weight (usually 5-7 lbs for skin traction)
4. Ensure the weight hangs freely without touching the floor
5. Position the limb with slight flexion at the knee and hip
6. For balanced traction, place a padded sling under the knee2<ref name="ref4">4</ref>

== Aftercare and Monitoring ==

- Perform regular neurovascular checks of the limb (every 2-4 hours initially)
- Assess skin integrity, especially over bony prominences 
- Monitor for pain, swelling, or changes in sensation
- Ensure weights remain hanging freely
- Reapply or adjust traction as needed (at least every 24 hours)
- Encourage range of motion exercises for unaffected joints
- Provide patient education on mobility restrictions and care1<ref name="ref3">3</ref>[6]

== Potential Complications ==

- Skin breakdown or pressure injuries
- Blistering 
- Neurovascular compromise
- Muscle atrophy
- Joint stiffness
- Malunion of fracture4<ref name="ref6">6</ref>

== Contraindications ==

- Open wounds or skin infections in the traction area
- Severe peripheral vascular disease
- Certain types of unstable fractures[6]

By following these steps and guidelines, healthcare professionals can safely and effectively apply skin traction to patients requiring this intervention. Regular monitoring and adjustment are crucial to prevent complications and ensure optimal outcomes.

== References ==
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