Wet wrap bandaging

Dermatology

Stop the itch and scratch cycle

Used in the acute stage of eczema along with moisturisers (emollients) and topical steroids, the wet wrap technique moistens the skin and increases topical steroid absorption. The wraps cool the skin as the water evaporates soothing the skin.

Wet wraps should be used day and night in the acute phase of eczema but can also be used once or twice a week with moisturisers (emollients) during the chronic phase.

1. Prepare lengths of tubifast tubular bandages: two lengths for each arm and legs, two vests. Do this by measuring from shoulder to fingers and hips to toes and add 7.5cm. For the vest measure from the top of the neck to base of bottom, cut a 5cm slit 7.5 to 10 cms from the top to form the armholes.
2. Place two arm, two legs and one vest length in warm water.
3. Bath in the usual way, with bath oils and using soap substitute for example, aqueous cream.
4. Apply topical steroids first to the eczematous areas leave for at least three minutes and then apply moisturiser (emollients) liberally, all over the body. Weaker steroids can usually be used as they are soaked up better using wet wraps.
5. Squeeze out the tubifast bandages and apply still warm and wet to the body, followed by the second dry layer.
6. Cut holes in the bandages at the top of the arms and legs and outer shoulder and outer thighs of the vest (both layers).
7. Tie limbs to vest using 2.5cm strips of tubifast to keep body suit in place.
8. Pants or nappy should be put on over the ties to allow easy removal.
9. Holes can be made for the thumb to prevent the bandaging from being pulled up.
10. For babies a double length bandage can be used, half should be wetted, applied to the limb, then twisted at the toes or hands. The dry half is applied by pulling back up over the wet layer. Always ensure there is enough room for movement of the fingers and toes.
11. Put clothing on as normal.

Useful tips

If the bandages dry out, remove the top layer by undoing the ties, and wet the lower layer using a plant water spray filled with warm water, or a wet sponge dabbed on the lower layer. Reapply top layer.

Tubifast can be washed and used again by putting in a pillowcase, to prevent the ends from fraying in the wash.

After washing give clothes an extra rinse by putting washing machine on rinse cycle, this will ensure all washing powder has been washed away.

Colours of tubifast

• Red: Arms and legs, baby
• Green: Arms and legs, under 5 years
• Blue: Legs, over 5 years
• Yellow: Vest, small body
• Beige: Vest, large body

Green, blue and yellow line are available from your G.P in 1m, 3m and 5m lengths. Red and beige line are only available in 1m lengths.

Moisturisers (emollients)

Moisturiser is the more popular name for an emollient, which is a cream or ointment to be used frequently and liberally on the skin to stop it drying out. Many moisturisers are available; it is worth trying several to find one that suits you. Moisturisers are generally very safe and should be used at least twice a day and as often as you can, especially when the skin feels dry.

The Eczema Society, 11 Murray Street, London NW1 9RE.
Telephone: 020 7281 3553 or visit the eczema website

Patient experience

South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.

This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.

To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.

T: 01642 835964
E: [email protected]

The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW.
Telephone: 01642 850850 Extension: 54722

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