Bandaging Flashcards
Bandage Types
-Slings
-Soft-padded Bandages
-Splinted Bandages
-Casts
pros, cons, and functions of slings
- Prevent weight bearing
- Minimal Stability
- Minimal – No Padding > skin lesions
- Maintain Orientation of Bone/Joint
- Most Common Bandage**
Soft Padded Bandages
properties and functions of soft padded bandages
- Most Common Bandage**
- Protect the wound
- Control wound environment
> Debridement, protection, absorption - Minimize limb swelling
- Provide moderate immobilization for soft
tissues
indications for soft padded bandage
- Wound management
- Post-operative (fracture/scoping or soft tissue surgery)
functions of splinted bandages
- More stability/immobilization than soft- padded bandages
- Temporary fracture stabilization (en route)
> Reduces pain
> Minimize further damage
> Decrease swelling
when to use splinted bandages?
- Can be used for ligamentous injury > Sprain or strain
- Can provide additional protection to a tenuous repair (soft tissue or orthopedic)
pros and cons of casts, and when would we use them
- Provide the greatest stability***
- Adequate for ligamentous or tendinous injuries
- Definitive fixation of SOME fractures > Not as good as internal fixation
types of casts and material with properties
- Full or bivalve
- Fiberglass mesh
> Light weight
> Breathable
> Strong
Composition Of A Bandage
- Generally 3-4 layers (+ stirrups)
- Stirrups
- Contact layer
- Padding/absorbance layer
- Compressive layer (+/- splint)
- Outer layer/Cast layer
purpose of stirrups, position, possible complication
- Help to keep the bandage in place
- Reflected over the compression layer to form supportive sling
- Can be irritating long term
when do we need a contact layer for a bandage, and what should we use
- Layer that contacts the wound or incision
> Not needed if no wound or incision - Should match the effusive nature of wound:
- Telfa pad – minimally effusive
- Laparotomy sponges – effusive wounds
- Alginates (very effusive wounds), Hydrocolloids (moderately exudative), Hydrogels (dry wounds)
- Placed in sterile fashion (wound)
- Non-adherent
> Wet to dry bandages (NOT RECOMMENDED)
material and purpose of the padding layer of a bandage
- Synthetic Cotton (Cast padding)
- Wicks moisture away
- Does not saturate
thickness of padding bandage layer depends on
Thickness of layer
* Amount of stability required
* Amount of compression required
* Amount of absorption required
Should be thick enough to absorb all fluid until next bandage change
how do we put on the padding bandage layer? how many layers?
- Start at the extremity with a few turns
> MUST include toes, leave nail of digit 3+4 visible - Move up and down overlapping by 50%
- Couple of turns at the top before returning back down
> Clear defined edges
Slightly longer than the rest of the bandage
Must be snug (without ripping)
Number of layers depends on needs
> 2 for protection (4 layers with overlap)
> 4 or 5 (or more) for absorption or compression
what is the compressive layer of a bandage made of? how do we apply it?
- Made from conforming gauze (KLING)
- Strong but flexible/somewhat extensible in all directions
- Applied with circumferential tension to compact the padding layer
- Must be tight but do not overtighten
- Thicker padding = tighter it can be
where would we add a splint in a bandage?
- If splint needed – always added between two layers of conforming gauze
purpose of the outer layer of a bandage?
- Protect from contamination
- Applies compression
- Provides rigidity
>etc….vet wrap is a good material
how do we apply the outer layer of our bandage?
- Snug but do not overtighten!
- Do not under tighten (falls off)
- 1/3 to 1⁄2 of full tension (still be able to see wrinkles)
- Neat and free of folds (pressure points)
- Slightly shorter than the padding layer to avoid irritation
are bandage complications common and important?
- Very frequent
- Can be very serious
- Prevention is more effective than treatment
common complications from bandages
- limb swelling
>common, often from too tight bandage or swollen limb
>EMERGENCY; pressure causes compressions of lymphatics, veins, arteries > necrosis - pressure necrosis
- soft tissue damage
>most ischemic injuries occur 24-48 hours after bandage placements - cutaneous erosions/ulcers
>excessive pressure, abrasion, wetness - ankylosis
>very frequent, within one week
>decreased ROM can be permanent; longer immobilization more severe
>dont leave bandage on longer than necessary - bandage loosening
how to prevent cutaneous erosions/ulcers due to bandage?
Be aware of:
* Pointed areas with little covering skin
> Epicondyle, olecranon, tibial malleoli, calcaneus etc.
* Increased moisture areas
> Axillary and inguinal folds
> Between toes
- Prevention is KEY:
- Restrict activity
- Keep bandage clean and dry
- Avoid pressure points
» Increase padding AROUND, decrease padding ON TOP
why might a bandage loosen
- Decreased swelling
- Stretching of bandage material
- Incorrect placement
- Too much activity…
+ - Bandage slips = bunches + pressure below joints
+ - MUST BE REPLACED ASAP
Ehmer Sling and 90/90 Bandage purpose and when used
- Prevent use of hindlimb
- After closed reduction of dorsal hip luxation
- Sticky tape applied to the skin
- Difficult to maintain
Velpeau Sling purpose and considerations
- Prevent use of front limb/shoulder
- Scapular fractures or medial shoulder luxation
- NEVER FULLY FLEX THE JOINTS
- Cranial aspect usually the weakest
Spica Splint uses and function
- Immobilize shoulder joint and elbow
- Used for lateral shoulder luxation and elbow luxation
- Includes casting material
- Keep leg in extension/weight bearing position
Robert Jones Bandage purpose and appearance
- TEMPORARY immobilization of a DISTAL fracture
- Large amount of cotton – tightly compressed
- Outdated … similar thing achieved with simpler splint
casting uses , and what it is, and considerations
- Used to heal SOME simple fractures
- Many fractures should never be casted
- … a good bandage with hard fiberglass shell
- Application must be meticulous and perfect
when putting on a cast, what must we be sure to immobilize? what bones should we not use it on?
- Must immobilize from toes to the JOINT ABOVE the fracture
- Not for humerus or femur
- NOT FOR RADIUS/ULNA IN MINIATURE BREEDS
casting layers
- Stirrups + “Stockinette” (tubular fabric: useful but not mandatory)
- Padding (not too much ~ 2 layers)
- Conforming Gauze
- Casting material (4-6 layers)
how do we make sure our cast is applied correctly to avoid complications?
- Must be anesthetized or heavily sedated – CANNOT MOVE
- Do not create pressure points
- Fold padding/Stockinette over the edges of the cast
- Can customize with a walking bar
issues associated with casting
- Immobilization originally for suboptimal fracture repair
{
However: - Rapid loss muscle mass
- Loss of joint motion
- Loss of cartilage
- Loss of bone mass
- Complicate early post-operative rehabilitation
> Icing
> Massage
> Passive range of motion
