PREPRATION, ASSISTING AND AFTER

CARE OF PATIENT WITH SKIN

TRACTION

LAXMI SINGH RAJPUT

BSC(N) 2ND BATCH
CON GIMS
OUTLINE
 INTODUCTION
 PURPOSE
 DEFINATION
 MANAGEMENT
ACUTE MANAGEMENT
PAIN RELIEF MEDICATION
EDUCATION
APPLICATION OF TRACTION
NURSING MANAGEMENT
 REFRENCES
 TRACTION

Traction is the application of a pulling force for

medical purposes to treat muscle or skeletal
disorder
for eg;- to reduce fracture, maintain bone
alignment, relieve pain, or prevent spinal
injury
purpose
 To relieve pain caused by muscle spasm.
 To reduce and immobilize fracture.
 To restore and maintain proper alignment of

the injured bones.

 To treat dislocations and spinal cord

compressions due to prolapsed inter

vertebral disc.
 To prevent and correct defoemities.
 SKIN TRACTION

Skin traction is attached directly to the patient’s skin

to immobilize a body part continuously or
intermittently over a short or extended period. The
direct application of a pulling force to the patients
skin and soft tissues may be accomplished by
using adhesive or non adhesive traction tape or
other skin traction devices such as a cast, a boot or
a belt
(SCHOEN 2000)
MANAGEMENT
ACUTE MANAGEMENT
 Ensure order for skin traction is documented by the
orthopaedic team ( including wt to be applied)
 Preparation of equipment;
hospital traction bed with bar
Traction kit (foam stirrup with rope and bandage)
Overhead traction frame
Pulley
Traction weight bag
water
high strength waterproof adhesive tape
Cont…
PAIN RELIEF MEDICATIONS
 a femoralnerve block is the preferred pain
management and should be administered in the
emergency department prior to being admitted to
the ward.
 Diazepam, paracetamol should always be charted
and used in conjunction with the femoral nerve
block.
EDUCATION;-
 Explain the procedure to the patient and
patient before commencing.
APPLICATION OF TRACTION;-
PREPRATION:-
 Minimum two nurse require
 Assess patient’s skin and neurovascular
observations and document appropriately.
 Ensure all the equipment is ready at the bedside
and the patient had adequate analgesia
 Ensure the correct amount of water has been added
to the traction weight bas as per order
 Before starting tie the rope to the bottom of stirrup
ensuring a strong knot has been tied.
APPLY TRACTION:-
 Discuss procedure with family.
 Prepare client by having them lay flat on the
traction bed.
 Put foam stirrup around the arch of foot on the
patients affected limb, and is even on both the
side.
 The second nurse will assist by lifting the patient’s
leg off the bed to allow for easier application of the
crepe bandage. While doing this the nurse will need
to support the limb in natural alignment and apply
gentle manual traction to the affected limb.
Cont…
 The first nurse is to start to apply the crepe
bandage starting at the patient’s ankle and working
the way up the lower leg using a figure of 8
technique.
 Ensure the bandage and stirrup are free of wrinkles
that could cause pressure.
 Place rope over the pulley and attach traction
weight bag is suspended in the air and does not
rest on the floor.
 Rope must always be in pulley system ensuring it is
taut and in vertical line with the patient’s limb.
NURSING MANAGEMENT:-
MINIMIZING THE EFFECT OF IMMOBILITY
 Encourage active exercise of uninvolved
muscles and joints.
 Encourage deep breathing and coughing.
 Auscultate lung fields twice per day
 Encourage fluid intake of 2000-2,500ml per

day.
 Prevent pressure on calf.
 Check traction apparatus at repeated

intervals.
MAINTAIN SKIN INTEGRITY:-
 Examine bony prominences frequently for
evidence of pressure of friction irritation.
 Observe for skin irritation around the traction

bandage.
 Report complaint of burning sensation under

traction.
 Relieve pressure without disrupting traction

affectivenesss.
PROMOTING TISSUE PERFUSION:-
 Assess motor and sensory function of specific
nerves that might be compromised.

 Determine adequacy of circulation ( eg-

colour, temperature, motion, capillary refill of
peripheral fingers or toes).

 Report promptly if change in neurovascular

status is identified.
 Summary
 Femoral fractures are often managed using
skin traction prior to their definitive surgical
management. Some require short term
traction i.e. 24 hours whereas others require
it for a number of weeks i.e. 6 weeks.
Traction limits movement and reduces the
fracture to help decrease pain, spasms and
swelling. The purpose of traction is to restore
and maintain straight alignment and length
of bones following fractures
REFRENCES:-
 Kumari MJ, Medical Surgical Nursing-I, pg
547-53,jaypee brothers medical publishers.

 Gitesh amrohit(2012) the pocketbook for

physiotherapists, 2nd ed, Pg-317, jaypee
brothers medical publishers.

 John ebnezar(2011) essentials of

orthopaedics for physiotherapists. 2nd ed. Pg
34, jaypee brothers.