Bandaging And Casting Flashcards
What is the function of bandage?
Wound/incision
Secure dressings
Inhibit excessive granulation tissue
Reduce swelling, movement, edema
Support - assist in temporary stabilization of fractures
Decrease dead space
Reduce post-op hemorrhage/edema
Prevent contamination
A bandage is placed over a wound. Day 1 and 2, there is not lameness. Day 3, the patient is lame. What should you do?
A. The patient is sore from procedure, this is normal
B. Patient likely kicked the wall and is now sore, recheck tomorrow
C. Give Bute today and recheck tomorrow if not better
D. Remove bandage and evaluate wound/incision site immediately
D. Remove bandage and evaluate wound/incision site immediately
What can you cause if you wrap a bandage too tight?
Inhibit circulation
Soft tissue injury (tendon damage)
Pressure sores
How would you bandage a subsolar abscess?
Open abscess— don’t soak
Closed abscess — magna paste in diaper with duct tape and secured with elasticon
T/F: when placing a distal limb bandage, it should not extend past the coronary band
False
Bandage should extend distal to the coronary band to protect it
What are examples of primary layers?
Telfa Curasalt (hypertonic dressing) Kerlix AMD Hydrogen Calcium alginate
Examples of secondary layers?
Cotton/supporting layer
Cotton roll (pound cotton)
Sheet cotton
RediRoll/CombiRoll
Secured with brown gauze
What is the function of the secondary layer
Provide support and padding
-prevent excessive compression and protect the limb
Absorbent for exudate
Purpose of tertiary layer?
Secures previous layers
Rigidity/support to bandage
Helps protect bandage from contamination
Pay attention to where tertiary layer ends
Materials used in tertiary layer?
Vetrap/Coflex
Elastikon
Elasoplast
Placed with no tension
When would you use a full limb/stack bandage?
Large wounds
Swelling /cellulitis
Coaptation for temporary fracture stabilization
A full limb bandage extends from where to where?
Extends from below the coronary band to proximal of carpus/tarsus
How do you place a stack bandage?
Add primary layers as before.
After placing distal secondary layer (cotton sheeting), “stack another cotton roll above, covering the proximal aspect of the first cotton.
Secure with brown gauze
What is a stent bandage
Bandage suture over a wound / incision site
“Tie over”
Create suture “loops” to string umbilical tape through secure bandage
When placing a bandage, layers should be applied so tendons are pulled (laterally/medially)?
Medially
— minimizes risk of tendon injury secondary to bandage placement
Bandage should be placed from medial aspect of limb, moving cranially, then lateral and caudal
What are the uses of sweat bandages?
Decrease edema
What can be used to make a sweat bandage?
Nitrofurazone ointment (carcinogenic?)
DMSO
Epsom salts
Place on limb then cover with Saran Wrap and support bandage
Remove and wash limb daily
What type of splint is often used for phalangeal fractures in horse?
Kimzey splints
— stabilize for transprot
—reduce or eliminate flexion/extension of joints
What is the name of this bandage?
Has several layers of cotton, size should be 2x the size of the limb
Preserves blood supply and supports fractures
Extends from distal to coronary band to proximal to carpus/tarsus
Robert jones bandage
What is the most important rule for fracture stabilization?
Must immobilize a joint above and a joint below
What splint options can you use to stabilize a radial fracture?
Robert jones bandage with 2 splints
—> palmar splint from heel to elbow
—> lateral splint from hoof to withers
How would you stabilize an olecranon fracture in a horse?
Stack bandage with a palmar splint
Extend splint from heels to top of elbow
—> this locks the limb in extension so horse can bear weight (olecranon fracture causes loss of functionality of triceps)
When is a Thomas-Schroeder splint appropriate?
Radial and tibial fracture stabilization in farm animals
Or rupture of gastrocnemius
NEVER use in horses
Large ring placed around axial or groin, two rods extend cranially and caudally down limb and attach to a foot plate
Why do you want to avoid wrinkles in your bandages or casts?
Pressure sores
T/F: you should never end a cast or a splint in the middle of a long bone
True
What are indications for casting?
Immobilize for..
Laceration Fracture Transfixation pin casting Support for fracture repair Soft issue injures (flexor tendon injury)
What is the best casting material?
Fiberglass casting tape
— light weight, fully set in 5-7mins
What are complications of immobilization ?
Articular cartilage degeneration
Loss of bone density
Decreased muscle strength
What are the steps of cast application?
Drill hole in toe of hoof wall and place Gigli wire
Stockinette should be uct 2.5x the length of anticipated cast (foot must be incorporated)
Extra padding at the proximal aspect and around coronary/fetlock region
Incorporate gigli wire in Iv tubing (for cast removal later)
Overlap cast padding and casting tape 50% (no fingerprints/wrinkles in cast —> potentiates cast sores )
Place 2-3layes of casting tape with minimal tension
Elastikon to seal no and bottom of cast
PMMA (Tecnovit) bottom of cast to decrease wear-through
Why is it important to incorporate the hoof into the cast for large animals?
Ensure maximum diversion of weight from the limb and ground forces alway from the limb to the cast
Methods of cast removal?
Cast saw
Gigli wire
Cast spreaders
How do you evaluate a fracture post-cast removal?
Radiographs
—> fracture callus? Or fracture lines present?
Continued stall rest — if fracture stall rest minimum 12 weeks
Bandage placement after cast removal
Indications of cast complications or cast failure?
LAMENESS
Swelling Foul order Moisture Cracks Increased temperature at the cast
Common causes of cast failure?
Poor placement — abnormal positioning of limbs or pressure pores
Poor owner compliance
Poor animal behaviour
Subsolar abscess
Post op complications
Septic processes under cast
How often should a cast be changed?
At first sign of lameness
Adults — every 6weeks
Neonates — 7-14days
If there is significant swelling at time of 1st cast placement, change in 3-5days
