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Surgery 2 > Bandaging > Flashcards

Bandaging Flashcards

1
Q

Bandage Types

A

-Slings
-Soft-padded Bandages
-Splinted Bandages
-Casts

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2
Q

pros, cons, and functions of slings

A
  • Prevent weight bearing
  • Minimal Stability
  • Minimal – No Padding > skin lesions
  • Maintain Orientation of Bone/Joint
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3
Q
  • Most Common Bandage**
A

Soft Padded Bandages

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4
Q

properties and functions of soft padded bandages

A
  • Most Common Bandage**
  • Protect the wound
  • Control wound environment
    > Debridement, protection, absorption
  • Minimize limb swelling
  • Provide moderate immobilization for soft
    tissues
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5
Q

indications for soft padded bandage

A
  • Wound management
  • Post-operative (fracture/scoping or soft tissue surgery)
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6
Q

functions of splinted bandages

A
  • More stability/immobilization than soft- padded bandages
  • Temporary fracture stabilization (en route)
    > Reduces pain
    > Minimize further damage
    > Decrease swelling
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7
Q

when to use splinted bandages?

A
  • Can be used for ligamentous injury > Sprain or strain
  • Can provide additional protection to a tenuous repair (soft tissue or orthopedic)
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8
Q

pros and cons of casts, and when would we use them

A
  • Provide the greatest stability***
  • Adequate for ligamentous or tendinous injuries
  • Definitive fixation of SOME fractures > Not as good as internal fixation
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9
Q

types of casts and material with properties

A
  • Full or bivalve
  • Fiberglass mesh
    > Light weight
    > Breathable
    > Strong
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10
Q

Composition Of A Bandage

A
  • Generally 3-4 layers (+ stirrups)
  • Stirrups
  • Contact layer
  • Padding/absorbance layer
  • Compressive layer (+/- splint)
  • Outer layer/Cast layer
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11
Q

purpose of stirrups, position, possible complication

A
  • Help to keep the bandage in place
  • Reflected over the compression layer to form supportive sling
  • Can be irritating long term
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12
Q

when do we need a contact layer for a bandage, and what should we use

A
  • 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)
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13
Q

material and purpose of the padding layer of a bandage

A
  • Synthetic Cotton (Cast padding)
  • Wicks moisture away
  • Does not saturate
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14
Q

thickness of padding bandage layer depends on

A

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

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15
Q

how do we put on the padding bandage layer? how many layers?

A
  • 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

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16
Q

what is the compressive layer of a bandage made of? how do we apply it?

A
  • 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
17
Q

where would we add a splint in a bandage?

A
  • If splint needed – always added between two layers of conforming gauze
18
Q

purpose of the outer layer of a bandage?

A
  • Protect from contamination
  • Applies compression
  • Provides rigidity
    >etc….vet wrap is a good material
19
Q

how do we apply the outer layer of our bandage?

A
  • 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
20
Q

are bandage complications common and important?

A
  • Very frequent
  • Can be very serious
  • Prevention is more effective than treatment
21
Q

common complications from bandages

A
  • 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
22
Q

how to prevent cutaneous erosions/ulcers due to bandage?

A

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
23
Q

why might a bandage loosen

A
  • Decreased swelling
  • Stretching of bandage material
  • Incorrect placement
  • Too much activity…
    +
  • Bandage slips = bunches + pressure below joints
    +
  • MUST BE REPLACED ASAP
24
Q

Ehmer Sling and 90/90 Bandage purpose and when used

A
  • Prevent use of hindlimb
  • After closed reduction of dorsal hip luxation
  • Sticky tape applied to the skin
  • Difficult to maintain
25
Q

Velpeau Sling purpose and considerations

A
  • Prevent use of front limb/shoulder
  • Scapular fractures or medial shoulder luxation
  • NEVER FULLY FLEX THE JOINTS
  • Cranial aspect usually the weakest
26
Q

Spica Splint uses and function

A
  • Immobilize shoulder joint and elbow
  • Used for lateral shoulder luxation and elbow luxation
  • Includes casting material
  • Keep leg in extension/weight bearing position
27
Q

Robert Jones Bandage purpose and appearance

A
  • TEMPORARY immobilization of a DISTAL fracture
  • Large amount of cotton – tightly compressed
  • Outdated … similar thing achieved with simpler splint
28
Q

casting uses , and what it is, and considerations

A
  • 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
29
Q

when putting on a cast, what must we be sure to immobilize? what bones should we not use it on?

A
  • Must immobilize from toes to the JOINT ABOVE the fracture
  • Not for humerus or femur
  • NOT FOR RADIUS/ULNA IN MINIATURE BREEDS
30
Q

casting layers

A
  • Stirrups + “Stockinette” (tubular fabric: useful but not mandatory)
  • Padding (not too much ~ 2 layers)
  • Conforming Gauze
  • Casting material (4-6 layers)
31
Q

how do we make sure our cast is applied correctly to avoid complications?

A
  • 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
32
Q

issues associated with casting

A
  • 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

Surgery 2 (7 decks)

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