Bandaging And Casting Flashcards by Colin Proctor

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

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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

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What can you cause if you wrap a bandage too tight?

Inhibit circulation

Soft tissue injury (tendon damage)
Pressure sores

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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

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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

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What are examples of primary layers?

Telfa 
Curasalt (hypertonic dressing) 
Kerlix AMD 
Hydrogen 
Calcium alginate

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Examples of secondary layers?

Cotton/supporting layer
Cotton roll (pound cotton)
Sheet cotton
RediRoll/CombiRoll

Secured with brown gauze

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What is the function of the secondary layer

Provide support and padding
-prevent excessive compression and protect the limb

Absorbent for exudate

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Purpose of tertiary layer?

Secures previous layers

Rigidity/support to bandage

Helps protect bandage from contamination

Pay attention to where tertiary layer ends

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Materials used in tertiary layer?

Vetrap/Coflex
Elastikon
Elasoplast

Placed with no tension

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When would you use a full limb/stack bandage?

Large wounds
Swelling /cellulitis

Coaptation for temporary fracture stabilization

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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

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What is a stent bandage

Bandage suture over a wound / incision site
“Tie over”

Create suture “loops” to string umbilical tape through secure bandage

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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

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What are the uses of sweat bandages?

Decrease edema

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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