Bandaging & Bandaging Techniques (13) Flashcards
Dr. Gilley
What are the goals of a bandage?
- protects wounds
- speeds wound healing
What are some good things bandages can do?
- provide wound cleanliness
- control wound environment
- reduce edema and hemorrhage
- eliminate dead space
- immobilize injured tissue
- minimize scar tissue
- make patient more comfortable
What are some complications with bandages?
When are bandages indicated?
- treating injuries
- used below elbow and stifle
- protecting wounds or devices
- transport
What are the characteristics of a Modified Robert Jones (soft padded) bandage?
- immobilizes limb
- decreases/limits soft tissue swelling
- absorbs wound exudate
- add splint material
What is a requirement with the modified Robert jones bandage?
fracture MUST be below the elbow/stifle
What are the three basic layers of a bandage?
- primary (contact layer)
- secondary (intermediate layer)
- tertiary (outer layer)
What is the function of the primary layer of a bandage?
Which layer?
primary layer - TELFA
What are the functions of the secondary layer?
- absorbs and stores deleterious agents
- retards bacterial growth
- pads wound from trauma
- splints wound to prevent movement
- holds primary bandage layer in place
Which bandage layer?
secondary layer
Which layer?
secondary layer
What are functions of the tertiary layer?
- holds other bandage layers in place
- protects against external bacterial colonization
- cosmetic
Which layer?
tertiary
What are the types of primary layers?
- adherent
- nonadherent
- occlusive
- semi-occlusive
What are the characteristics of an adherent primary layer?
used when wound debridement is required
may be wet or dry
What are characteristics of a non adherent primary layer?
- during repair phase or if no necrotic debris
- retains moisture to promote epithelialization and prevent dehydration
- drains excess fluid and prevents maceration
What are characteristics of an occlusive primary layer?
- 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
What are characteristics of a semi-occlusive primary layer?
- allows air to penetrate
- allows exudate to escape
- most commonly used primary layer
What should you apply before the primary layer?
tape stirrups
What should you do before you even start bandaging?
assemble bandage materials and supplies
Where do you place tape stirrups?
distal 1/3rd of the limp, medial & lateral or dorsal and palmar/plantar
prevents it from slipping
In the Modified Robert Jones / Soft Padded bandage, what should you do regarding the toes? Why?
place cotton between the toes
- decreases moisture build-up
- increases patient comfort
don’t forget the dewclaw
What is this person doing?
applying the primary layer
- contact layer, non adherent
What is this person doing?
applying the secondary layer
What are characteristics of the secondary layer?
intermediate layer, absorbent, supportive
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
How should you apply the tertiary layer?
applied toes-up, overlapping, with a firm, even pressure
How do you apply a walking pad?
applied without much pressure since elastic properties may lead to swelling
What are the characteristics of a walking pad?
very adhesive and water resistant
can use koozies
After the bandage is applied, what is the last thing you should do?
put date, initials, reminders, & warnings
What are the types of adherent bandages?
wet-to-dry
wet-to-wet
dry-to-dry
What type of bandage material is now recommended for all stages of wound healing?
non adherent
What bandages are most often used in vet med?
semi-occlusive
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
A dog has a wound in his axillary region. What type of bandage should you do?
tie-over bandage
Type of bandage?
tie-over bandage
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
Type of bandage?
pressure relief bandage
When do you use pressure relief bandages?
- usually over bony prominence
- to treat/prevent pressure sores
What is the function of a pressure bandage?
facilitates control of minor hemorrhage, edema, and excess granulation tissue
The more [convex/concave] the surface, the greater pressure exerted by dressing on tissue
convex
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
When are wet adherent bandages used?
wound has necrotic tissue, foreign matter, or viscous exudate
What are wet adherent bandages?
sterile wide mesh gauze soaked in sterile saline solution and 1:40 chlorhexadine diacetate
A wound has loose necrotic tissue and foreign material. What bandage is best to use?
dry adherent bandage
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
What are the characteristics of the Robert Jones bandage?
- very large/thick bandage
- uses rolled/sheet cotton
- wrapped with more compression
Bandage type?
Robert Jones
What are the characteristics of a soft padded (Modified Robert Jones)?
add splint material (premade, thermoplastics, fiberglass, aluminum rods
How do you bandage a proximal extremity lesion?
continue bandage up the leg around chest or abdomen & between legs to create spica type bandage
What is a paw bandage?
placed like a leg bandage except digits are covered
What is this? Is it recommended?
Schroeder-Thomas Splint
NO!!
What is this?
spica splint
What is the purpose of a spica splint?
for immobilization of the shoulder
What is this?
Ehmer sling
What is the purpose of an Ehmer sling?
“Ehmer Femur” - to prevent pelvic limb weight bearing
post-hip reduction or acetabular fractures
What is this?
velpeau slip
What is the purpose of a velpeau sling?
“Velpeau Elbow” - to prevent forelimb weight bearing
after shoulder / forelimbs procedures - medial shoulder luxations
When should you only use casts for fractures?
only injuries distal to elbow/stifle
When do you place casts for fractures?
- stable minimally displaced fractures
- unable to repair with surgical techniques
- young rapidly healing animals
T/F: You can cast open fractures
FALSE
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
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
How often should you check casts for fractures?
every 2 weeks, maybe weekly at first
What are common complications to casting?
How should you assess the bandage?
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
What is the key to success when healing regarding bandaging use?
owner compliance
