Gilchrist Association

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The Gilchrist bandage, often also referred to as the Gilchrist bandage, is usually applied after injuries or operations on the shoulder or upper arm. The shoulder and arm are supported and immobilized at the same time. Here you can find out everything you need to know about the Gilchrist bandage, when to put it on and what the risks are.

What is a Gilchrist Association?

The Gilchrist Association was invented over 100 years ago by the American dermatologist Thomas C. Gilchrist. This support bandage can be put on after injuries or operations in order to immobilize the shoulder and arm in a certain position (immobilization) and to support them at the same time.

The upper arm of the injured side lies close to the side of the upper body, the elbow is bent at a right angle and the forearm rests on the front of the stomach. The easiest way to illustrate this position is to first let both arms hang down loosely and then guide the fingers on the injured side to the opposite elbow.

Once the Gilchrist bandage is in place, the weight of the arm is held in place by a loop that hangs around the patient's neck. The injured arm is suspended in the area of the wrist and elbow. Most of the Gilchrist bandages these days are pre-fabricated.

When do you put on a Gilchrist bandage?

A Gilchrist bandage is often applied after the following injuries:

Dislocation of the shoulder (shoulder dislocation)
Fracture of the humerus near the shoulder (proximal humeral fracture or humeral head fracture)
Fracture of the collarbone in the outer area (lateral clavicle fracture)
Injury to the shoulder joint (acromioclavicular joint)
Immobilization after an endoscopy of the shoulder joint (arthroscopy)

How long a Gilchrist bandage must be worn depends on the type of injury or previous surgery. The wearing time is usually two to six weeks with subsequent targeted restoration of mobility, for example as part of physiotherapy.

A less frequently used alternative to the Gilchrist Association is the Desault Association. It is a little more complicated to put on, but fixes the arm even better on the upper body and can be necessary for particularly restless patients.

What do you do at a Gilchrist Association?

In most cases, the Gilchrist bandage is already prefabricated. The doctor can make it himself with just a few materials. To do this, he needs bandage scissors, a long piece of tubular bandage, four safety pins (or an adhesive plaster) and possibly some cotton wool.

The following steps are necessary:

Measure the hose bandage: The hose is about three times the distance from the base of the neck to the fingertips.
Cut the tubular bandage two-thirds across (do not cut through) and insert the injured arm into the longer end.
The armpit can be padded if necessary (e.g. with cotton wool).
The short end (one third of the tube) is placed around the neck and fixed in the area of the wrist on the healthy side (at the area of the tube bandage there) with two safety pins.
The long end, which is still hanging down on the injured arm, is led around the torso on the back, looped around the upper arm and the rear part is also fixed with two safety pins.
Finally, the bandage is incised in the area of the fingers so that they are exposed and can be moved.

If a prefabricated Gilchrist bandage is used, the patient can put it on himself with a little practice - if it hurts to put it on yourself, it is better to get help.

You first slip your arm into the longer end (starting with the recess at a third of the total length), throw the thin strap over your neck and first fix the hand on the injured side with a Velcro fastener. Then lead the long end with the sound arm around the back and forward between the arm on the injured side and the upper body. After looping around the upper arm, lead it back to the healthy side on the back and then fix it with a Velcro fastener.

What are the risks of a Gilchrist bandage?

The use of a Gilchrist bandage is associated with risks if it is not put on correctly or worn for too short or too long. The attending physician gives precise instructions on how long it can be worn and on which occasions (e.g. when showering) it can be temporarily removed.

Resting for too short a time can delay healing. If the Gilchrist bandage is used for too long, the shoulder joint can stiffen through excessive immobilization and mobility can be restricted, which can only be restored with difficulty through physiotherapy exercises.

What do I have to consider after creating a Gilchrist bandage?

The bandage must sit comfortably and not constrict. The blood flow in the arm up to the fingers must not be restricted and all fingers should be free to move.

You should wear the bandage for as long as your doctor prescribes. You should avoid taking the bandage off for a long time - the bandage can usually be adjusted so that it fits well.

If the Gilchrist bandage is worn for several weeks, it can make sense to have a second bandage fitted for hygienic reasons and to use both in alternation.

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