Paste Bandages
Indications
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Management of leg ulcers.
Some are also indicated for use in the
management of chronic eczema / dermatitis.
Seen used to protect legs from
incontinence.
They have mild astringent and antiseptic
properties.
Contraindications:
◦ Occasional sensitivity / allergy to ingredients
Types
Zinc paste bandage (Viscopaste PB7,
Steripaste)
 Zinc paste and ichthammol (Ichthopaste)
 Zinc paste and calamine
 Zinc paste and coal tar bandage
 Zinc paste impregnated stocking (Zipzoc)
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How could they work?
Array of properties that can enhance the healing of
wounds.
 Zinc ions stay within the wound bed for an extended
period of time, ensuring a constant tissue zinc level.
 Zinc:
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◦ increases the degradation of collagen in necrotic tissues,
◦ promotes epitheliazation and
◦ increases the expression of insulin-like growth factor,
essential for the production of granulation
◦ also required for collagen and protein synthesis, cellular
growth and replication, reduction in free radical activity
and inhibition of bacterial growth.
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Bandaging also promotes venous return
Application Methods
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Various suggested:
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cutting and overlap
pleating
applying the bandages in strips (can be layered)
cutting to form stirrups
applying in a series of loose folds rather than a continuous spiral
No controlled trials support one best method of application
 A 2007 paper recommend that zinc paste bandages should
be applied loosely and lightly with a pleat at each turn to
accommodate for oedema and the primary bandage covered
by compression bandaging or retention bandages as
tolerated by the patient.
 Instruction leaflets for viscopaste and icthopaste both state
that it can be applied in a spiral or with a pleat at the front
on every turn.
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Evidence
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Meyer et al (2002) used zinc paste bandages as a primary dressing in their
study of 112 patients. They could not rule if zinc oxide paste affected the
rate of healing achieved.
Strömberg and Agren (1984) performed a randomized trial where patients
were treated with either a gauze compress medicated with zinc oxide or
with an identical compress without zinc oxide. Patients treated with a zinc
oxide compress responded significantly better (83% success rate)
compared with the placebo group (42% success rate). Limitations of the
study included a small sample size, mixed aetiology and outcome
measurement at only 8 weeks.
Bradley et al (1999) reported significant increase in ulcers healed with zinc
oxide impregnated bandages at 58% compared with alginate at 35%.
Lack of evidence concerning best practice bandaging technique.
A Cochrane review (O’Meara et al 2010) on antibiotics and topical
antiseptics for venous leg ulcers makes no mention of paste bandages in
this context.
Paste bandages are mentioned in a review on compression for venous leg
ulcers (O’Meara et al 2009) but it states that the relative effects of 4 layer
compression and paste bandage systems are unclear.