GOVERNMENT COLLEGE OF

NURSING CUDDALORE
MEDICAL SURGICAL NURSING
CLINICAL TEACHING
ON
CARE OF PATIENT WITH SKIN TRACTION
SUBMITTED TO SUBMITTED BY
Dr.B. SIVAGAMY MSc[N], Ph.D ROHINI.P
LECURER MSc[N] II YEAR
MEDICAL SURGICAL MEDICAL SURGICAL
NURSING DEPT NURSING
GCON CUDDALORE GCON CUDDALORE
 STUDENT TEACHER PROFILE

• Program - MSc Nursing II year

• Subject - MEDICAL SURGICAL NURSING-II

• Topic - CARE OF PATIENT WITH SKIN TRACTION

• Group - BSC NURSING II&III YEAR

• Date and Time - 12.7.24 at 10 am

• Venue - MICU

• AV aids - Power point presentation.

• Name of the Evaluator- Dr.B.Sivagamy MSC[N], Ph.D

 General Objectives:
The students are able to understand and gain knowledge regarding “Care of patient with skin
traction” and develop desirable attitude and skills to provide care to the patient in clinical setting.
Specific Objectives:
Students will be able to,
 Define traction,

 explain the purposes of skin traction,

 specify the principles of effective traction,

 list out the types of traction,

 describe the nursing intervention of skin traction,

 enlist the contraindication of skin traction,

 specify the complication of skin traction.

SL TIME SPECIFIC CONTENT AV TEACHER EVALUATION
NO OBJECTIVES AIDS LEARNER
ACTIVITY
1. 2min The students are TRACTION:
able to define Traction uses a pulling force to promote and maintain Power The students What is meant
traction alignment to an injured part of the body. point are listening by traction?
Brunner & suddarth. and teacher
explaining
2. 2 min The students are PURPOSES OF TRACTION:
able to explain the  To reduce a fracture and realign bone fragments Power The students What are the
purposes of skin by overcoming muscle spasms. point are listening purpose of
traction.  To maintain skeletal length and alignment. and teacher traction?
 To reduce and treat dislocation. explaining
 To immobilize and to prevent further issues
damage.
 To relieve muscle spasm that occur as a reaction
to musculoskeletal trauma

3. 2 min The students are able PRINCIPLES OF EFFECTIVE TRACTION: Handout The students What are the
 Skeletal traction is never interrupted. are listening principle of
 to specify the and teacher traction?
 Weights are not removed unless intermittent explaining
principles of
traction is prescribed.
effective traction,
 Any factor that might reduce the effective pull or
alter its resultant line of pull must be eliminated.
 The patient must be in good body alignment in
the center of the bed when traction is applied.
 Ropes must be unobstructed.
 Weights must hang freely and not rest on the bed
or floor.
 Knots in the rope or the footplate must not touch
the pulley or the foot of the bed.

4. 2 min The students are TYPES OF TRACTION:

The use of traction has decreased significantly Power The students What are the
able to list out the
due to advances in the surgical reduction of fractures, point are listening types of
types of traction
shortened lengths of hospital stay, and research that and teacher traction?
queries the effectiveness of its use. explaining
However, a basic working knowledge of the use
of traction is necessary, because some orthopedic
surgeons still prescribe traction for their patients.
Straight or running traction:
Applies the pulling force in a straight line with
the body part resting on the bed. The countertraction is
provided by the patient's body and movement can alter
the traction provided.
Buck's extension traction is an example of
straight traction. Balanced suspension traction supports
the affected extremity off the bed and allows for some
patient movement without disruption of the line of pull.
With this traction, the countertraction is produced by
devices such as slings or splints.
Traction may be applied to the skin (skin
traction) or directly to the bony skeleton (skeletal
traction). The mode of application is determined by the
purpose of the traction. Traction can be applied with the
hands (manual traction). This is temporary traction
that may be used when applying a cast, giving skin
care under a Buck's extension foam boot, or adjusting
the traction apparatus. SKIN TRACTION:
Skin traction may be prescribed for short-term use to
stabilize a fractured leg, control muscle spasms, and
immobilize an area before surgery.
 The pulling force is applied by weights that are
attached to the client with Velcro, tape, straps,
boots, or cuffs.
 The amount of weight applied must not exceed
the tolerance of the skin. No more than 2 to 3.5
kg of traction can be used on an extremity.
 Pelvic traction is usually limited to 4.5 to 9 kg,
depending on the weight of the patient.
TYPES OF SKIN TRACTION:
 Buck's extension traction (applied to the lower
leg) (described next),
 The chin halter strap (occasionally used to treat
chronic neck pain), and
 The pelvic belt (sometimes used to treat lower
back pain).
Buck's Extension Traction:
Buck's extension traction (unilateral or
bilateral) is skin traction to the lower leg. The pull is
exerted in one plane when partial or temporary
immobilization is desired.
 It is used as a temporary measure to
overcome muscle spasms and promote immobilization of
hip fractures in adult patients waiting for more definitive
treatment such as surgery.
Before the traction is applied, the nurse
inspects the skin for abrasions and circulatory
disturbances. The skin and circulation must be in healthy
condition to tolerate the traction. The extremity should
be clean and dry before the foam boot or traction tape is
applied.
To apply Buck's traction, the extremity is
elevated and supported under the patient's heel and knee
while the foam boot is placed under the leg, with the
patient's heel in the heel of the boot. Next, the Velcro
straps are secured around the leg.
Traction tape that is overwrapped with an
elastic bandage in a spiral fashion may be used instead of
the boot. Excessive pressure is avoided over the
malleolus and proximal fibula during application to
prevent pressure ulcers and nerve damage.
The rope is then affixed to the spreader or
footplate over a pulley fastened to the end of the bed and
attaches the prescribed weight-usually 2.3 to 3.6 kg to
the rope.
The weight should hang freely, not touching
the bed or the floor as this compromises the efficiency of
the traction system.

The chin halter strap:

Halter traction is used for short term cervical
traction. Uses include minor neck injuries without
obvious fractures e.g. Whiplash injury, neck muscle
spasm, conservative treatment of cervical disk lesions.
The pelvic belt traction:
A traction halter to hold the pelvic area and
pulls the sacral, lumbar and thoracic areas of the
vertebral column. The technical design ensures the
maximum traction effect is felt at the spine and not at the
lateral sides of the pelvis.
5. 4 min The students are NURSING INTERVENTION:
Ensuring Effective Skin Traction:
able to describe the
Power
 To ensure effective skin traction, it is important The students
point
nursing intervention
to avoid wrinkling and slipping of the traction are listening
of skin traction bandage and to maintain countertraction. and teacher
 Proper positioning must be maintained to keep explaining
the leg in a neutral position.
 To prevent bony fragments from moving against
one another, the patient should not turn from side
to side; however, the patient may shift position
slightly with assistance.
Monitoring and Managing Potential Complications:
Skin Breakdown:
The nurse also inspects the skin area that is in contact
with tape, foam, or shearing forces, at least every 8
hours, for signs of irritation or inflammation. The nurse
performs the following procedures to monitor and
prevent skin breakdown:
 Palpates the area of the traction tapes daily to
detect underlying tenderness.
 Provides frequent repositioning to alleviate
 pressure and discomfort, because the patient who
must remain in a supine position is at increased
risk for development of a pressure ulcer.
 Uses advanced static mattresses or overlays rather
than standard hospital foam or
alternating-air/low- air-loss mattresses to reduce
the risk of pressure ulcer formation.
Nerve damage:
 Pressure at this point can cause footdrop. The
nurse regularly questions the patient about
sensation and asks the patient to move the toes
and foot.
 The nurse should immediately investigate any
complaint of a burning sensation under the
traction bandage or boot.
 Dorsiflexion of the foot demonstrates function of
the peroneal nerve.
Circulatory Impairment:
After skin traction is applied, the nurse
assesses circulation of the foot within 15 to 30 minutes
and then
every 1 to 2 hours.
  Circulatory assessment consists of Peripheral
pulses, color, capillary refill, and temperature of
the fingers or toes.
 Manifestations of deep vein thrombosis (DVT),
which include unilateral calf tenderness, warmth,
redness, and swelling.
The nurse also encourages the patient to perform active
foot exercises every hour when awake.

6. 2 min The students are CONTRAINDICATION:

 Abrasion and laceration Power The students What are the
able to enlist the
 Impairment of circulation – Varicose vein, point are listening contraindication
contraindication of
impending gangrene. and teacher od skin traction?
skin traction  Dermatitis explaining

7.. 4 min The students are COMPLICATION:

 Erythema Power The students
able to specify the
 Allergic reaction point are listening
complication of skin
 Muscular atrophy and teacher
traction  Paralysis explaining
 Foot drop
 Edema
  Excoriation or torn

SUMMARY:
So far we have discussed traction, purposes, principles, types of skin traction, nurses intervention, contraindication, complication of skin
traction.
CONCLUSION:
Traction is a directional pull on the trunk or on an extremity. The aim is to immobilise and reduce fractures, correct deformities, and for
elevation of extremities for the management of soft tissue injuries. This is also effective pain relief.
EVALUATION:
5×2=10 marks
1. Define traction?
2. What are the types of skin traction?
3. List out the effective principles of traction?
4. What are the complication of traction?
5. Define Buck’s Extension Traction?
BIBLIOGRAPHY:
1. Brunner and Suddarths (2011) Textbook Of Medical Surgical Nursing 12 edition, Volume 2, Walter Clover India New Delhi page
number 1610.
2. https://www.slideshare.net/slideshow/presentation-for-skin-traction-cmrc.