Bandaging & Bandaging Techniques (13) Flashcards
Dr. Gilley
1
Q
What are the goals of a bandage?
A
- protects wounds
- speeds wound healing
2
Q
What are some good things bandages can do?
A
- provide wound cleanliness
- control wound environment
- reduce edema and hemorrhage
- eliminate dead space
- immobilize injured tissue
- minimize scar tissue
- make patient more comfortable
3
Q
What are some complications with bandages?
A
4
Q
When are bandages indicated?
A
- treating injuries
- used below elbow and stifle
- protecting wounds or devices
- transport
5
Q
What are the characteristics of a Modified Robert Jones (soft padded) bandage?
A
- immobilizes limb
- decreases/limits soft tissue swelling
- absorbs wound exudate
- add splint material
6
Q
What is a requirement with the modified Robert jones bandage?
A
fracture MUST be below the elbow/stifle
7
Q
What are the three basic layers of a bandage?
A
- primary (contact layer)
- secondary (intermediate layer)
- tertiary (outer layer)
8
Q
What is the function of the primary layer of a bandage?
A
9
Q
Which layer?
A
primary layer - TELFA
10
Q
What are the functions of the secondary layer?
A
- absorbs and stores deleterious agents
- retards bacterial growth
- pads wound from trauma
- splints wound to prevent movement
- holds primary bandage layer in place
11
Q
Which bandage layer?
A
secondary layer
12
Q
Which layer?
A
secondary layer
13
Q
What are functions of the tertiary layer?
A
- holds other bandage layers in place
- protects against external bacterial colonization
- cosmetic
14
Q
Which layer?
A
tertiary
15
Q
What are the types of primary layers?
A
- adherent
- nonadherent
- occlusive
- semi-occlusive
16
Q
What are the characteristics of an adherent primary layer?
A
used when wound debridement is required
may be wet or dry
17
Q
What are characteristics of a non adherent primary layer?
A
- during repair phase or if no necrotic debris
- retains moisture to promote epithelialization and prevent dehydration
- drains excess fluid and prevents maceration
18
Q
What are characteristics of an occlusive primary layer?
A
- impermeable to air
- use on nonexudative wounds to keep moist
- speeds rate and quality of healing compared to dressings allowing desiccation
- use in partial thickness wounds without necrosis or infection
waterproof bandage basically
19
Q
What are characteristics of a semi-occlusive primary layer?
A
- allows air to penetrate
- allows exudate to escape
- most commonly used primary layer
20
Q
What should you apply before the primary layer?
A
tape stirrups
21
Q
What should you do before you even start bandaging?
A
assemble bandage materials and supplies
22
Q
Where do you place tape stirrups?
A
distal 1/3rd of the limp, medial & lateral or dorsal and palmar/plantar
prevents it from slipping
23
Q
In the Modified Robert Jones / Soft Padded bandage, what should you do regarding the toes? Why?
A
place cotton between the toes
- decreases moisture build-up
- increases patient comfort
don’t forget the dewclaw
24
Q
What is this person doing?
A
applying the primary layer
- contact layer, non adherent
25
What is this person doing?
applying the secondary layer
26
What are characteristics of the secondary layer?
intermediate layer, absorbent, supportive
27
Once you apply the secondary layer, what should you do?
separate the tape stirrups and rotate then proximally while twisting 180 degree
secure stirrups to underlying wrap to prevent distal slipping
28
How should you apply the tertiary layer?
applied toes-up, overlapping, with a firm, even pressure
29
How do you apply a walking pad?
applied without much pressure since elastic properties may lead to swelling
30
What are the characteristics of a walking pad?
very adhesive and water resistant
can use koozies
31
After the bandage is applied, what is the last thing you should do?
put date, initials, reminders, & warnings
32
What are the types of adherent bandages?
wet-to-dry
**wet-to-wet**
dry-to-dry
33
What type of bandage material is now recommended for **all** stages of wound healing?
non adherent
34
What bandages are most often used in vet med?
semi-occlusive
35
What is a tie-over bandage?
when a wound is in an area inaccessible to standard bandaging techniques
contact and absorbent layers held in place with tie-over bandage
36
A dog has a wound in his axillary region. What type of bandage should you do?
tie-over bandage
37
Type of bandage?
tie-over bandage
38
How do you apply a tie-over bandage?
- apply several sutures or skin staples with loose loops around periphery of wound
- apply primary & secondary bandage layers
- hold tertiary layer by lacing umbilical tape or heavy suture through loose skin sutures or staples
39
Type of bandage?
pressure relief bandage
40
When do you use pressure relief bandages?
- usually over bony prominence
- to treat/prevent pressure sores
41
What is the function of a pressure bandage?
facilitates control of minor hemorrhage, edema, and excess granulation tissue
42
The more [convex/concave] the surface, the greater pressure exerted by dressing on tissue
convex
43
A wound has necrotic tissue, foreign matter, and viscous exudate. What type of bandage should you use? Why?
wet adherent bandage
necrotic tissue and foreign material adhere to gauze and are removed with the bandage
44
When are wet adherent bandages used?
wound has necrotic tissue, foreign matter, or viscous exudate
45
What are wet adherent bandages?
sterile wide mesh gauze soaked in sterile saline solution and **1:40** chlorhexadine diacetate
46
A wound has loose necrotic tissue and foreign material. What bandage is best to use?
dry adherent bandage
47
When are dry adherent bandages most likely used?
when wound has large quantity of low-viscosity exudate that does not aggregate
has loose necrotic tissue and foreign material
48
What are the characteristics of the Robert Jones bandage?
- very large/thick bandage
- uses rolled/sheet cotton
- wrapped with more compression
49
Bandage type?
Robert Jones
50
What are the characteristics of a soft padded (Modified Robert Jones)?
add splint material (premade, thermoplastics, fiberglass, aluminum rods
51
How do you bandage a proximal extremity lesion?
continue bandage up the leg around chest or abdomen & between legs to create spica type bandage
52
What is a paw bandage?
placed like a leg bandage except **digits are covered**
53
What is this? Is it recommended?
Schroeder-Thomas Splint
NO!!
54
What is this?
spica splint
55
What is the purpose of a spica splint?
for immobilization of the shoulder
56
What is this?
Ehmer sling
57
What is the purpose of an Ehmer sling?
"Ehmer Femur" - to prevent pelvic limb weight bearing
post-hip reduction or acetabular fractures
58
What is this?
velpeau slip
59
What is the purpose of a velpeau sling?
"Velpeau Elbow" - to prevent forelimb weight bearing
after shoulder / forelimbs procedures - medial shoulder luxations
60
When should you only use casts for fractures?
**only injuries distal to elbow/stifle**
61
When do you place casts for fractures?
- stable minimally displaced fractures
- unable to repair with surgical techniques
- young rapidly healing animals
62
T/F: You can cast open fractures
FALSE
63
What should you always do after casting and why?
radiograph after casting
must have >50% overlap of fracture ends in each of 2 radiographic views
64
Should you place a cast standing up or sitting down?
standing position to encourage use when walking, limit muscle atrophy and joint stiffness, and shorten recovery period
65
How often should you check casts for fractures?
every 2 weeks, maybe weekly at first
66
What are common complications to casting?
67
How should you assess the bandage?
68
What should you remember when bandaging?
- leave middle two toes exposed when possible
- bandages start at **toes** and **go up** to avoid swelling
- keep limb in physiologic position
- overlap 1/3 to 1/2 the width of your wrap
- apply firm, even pressure
69
What is the key to success when healing regarding bandaging use?
owner compliance
