Wet wraps2017-06-21T22:50:44+00:00

Wet wraps

Atopic eczema is a common, chronic, itchy skin rash that tends to affect people with other allergies like hayfever and asthma. Wet wraps or wet dressing is used to treat severe atopic eczema or severe flares. Wet wraps can be easily applied at home after you have been taught how to use them.

  • Use aqueous cream or an emollient as a soap substitute
  • Use an emollient every day … as often as is possible, to keep the skin moist
  • Steroid ointments must be used when there is a flare.  During a flare the skin is being damaged by the eczema and the steroid ointment will prevent that damage
  • Once a flare is under control a lower strength ointment should be used and then slowly reduced until it can be stopped and just the emollient continued
  • Wet wraps can be done with steroid ointments and emollients during a flare and with the emollient alone when the skin is not flaring

Wet wraps can be done with commercially available cotton clothes, or with home-made wraps made from stockinette bandage.

Prepare

If stockinette is used, make sure the right size is chosen for your child. Cut strips for the arms, legs, body and head

  • Arms: Measure from the ear to the longest finger on the hand. Add 10 centimeters and double. Then cut. Cut two of these and tie a knot in the middle
  • Legs: Measure from the hip till the toes. Add 10 centimeters and double. Allow a bit extra if the thighs are fat. Then cut. Cut two of these, fold in half and mark the half with a pen
  • Body: Measure from the ears till below the knee. Cut two of these. Put the two pieces on top of one another and fold in 3. Cut holes in the top thirds corners for the arms
  • Head: Estimate the size you need for your child head. Double it. And cut

Put half the arm’s length, half the legs length, one vest and half the length for the head in warm water.

Now undress your child and fill the bath with luke warm water.

  1. Wash your hands
  2. Rub aqueous cream on the child’s body
  3. Wash the child’s body with your hands
  4. Once all the aqueous cream is removed, take the child out of the bath and pat the child dry with a soft towel
  5. The child’s skin should still be a bit clammy
  6. Apply the steroid ointment on all the rash areas on the body using the fingertip method
  7. Now apply the emulsifying ointment on the whole body
  8. Put on the wet bandages. First the arms. Once you have covered both arms make tiny holes at the top and tie with the string made from the bandage behind the child’s back. Now put on the vest. First the wet one then the dry one. Tie the two together behind the child’s back. Now cover the legs. Roll the bandage till the mark you have made. Put it on the child. Now roll the dry part up till just before you get to the toes. Twist and pull it up the child’s leg. Tie the wet part of the stocking to the wet vest and the dry part to the dry vest. Do this with both legs
  9. Now dress the child completely
  10. Once the child is dressed. Apply the steroid ointment on the face and scalp. If you are going to cover the face put the wet part of the mask on first, then the dry part. Tie it behind the child’s head but not too tight. You should be able to put your fingers underneath it. Now cut holes for the eyes and mouth. If the face is not to be covered just apply the ointment and no mask

The Procedure is now done.

Remember: wraps should be done every night for 7 nights in a row.

Children going to school can remove the wraps when going to school and re apply them at night before going to bed. Do NOT forget to use your ointments and moisturise all the time, even when the wet wraps are not on.

  1. They improve skin hydration by the cooling effect of water
  2. The emollient under the wrap penetrates the skin better
  3. Helps the steroid ointment work better
  4. Stops the child from scratching
  5. Improves sleep
  6. Reduces the long term use of steroids

 

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