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Surgery 1 (SAB) > Lecture 13: Bandaging & Bandaging Tech - SA > Flashcards

Lecture 13: Bandaging & Bandaging Tech - SA Flashcards

1
Q

What are the goals of a bandage

A
  • Protects wounds
  • Speed wound healing
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2
Q

What can happen if there are complications w/ a bandage

A
  • Result in limb amputation
  • Kill the px
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3
Q

List the good things a bandage can do

A
  • Provide wound cleanliness
  • Control wound environment
  • Reduce edema & hemorrhage
  • Eliminate dead space
  • Immobilize injured tissue
  • Min scar tissue
  • Make the px more comfy
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4
Q

List complications w/ bandages

A
  • Patient discomfort
  • Px mutilation of bandage & wound
  • Bacterial colonization of wound
  • Ischemic injury
  • Damage to healing tissues
  • Become a GI foreign body obstruction
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5
Q

What are indications for bandages

A
  • Used below the elbow & stifle
  • Treating injuries to reduce pain, swelling, & local tissue damage
  • Protecting wounds or devices
  • For transport
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6
Q

Describe the soft padded bandage (Modified robert jones)

A
  • Immobilizes limb
  • decreases/ limits soft tissue swelling
  • Absorbs wound exudate
  • Add splint material
  • Fracture must be below the elbow/stifle
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7
Q

What are the three layers of a bandage

A
  1. Primary (contact layer)
  2. Secondary (Intermediate layer)
  3. Tertiary (out layer)
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8
Q

What is the functions of the primary layer

A
  • Debrides tissue
  • Delivers medication
  • Transfers wound exudate
  • Forms an occlusive seal
  • Min pain
  • Prevents excessive loss of body fluids
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9
Q

What are the functions of the secondary layer

A
  • Absorbs & stores deleterious agents
  • Retards bacterial growth
  • Pads wound from trauma
  • Splints wound to prevent movement
  • Holds primary bandage layer in place
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10
Q

What are the fxns of the tertiary layer

A
  • Holds other bandage layers in place
  • Protects against external bacterial colonization
  • Cosmesis
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11
Q

What are the types of primary layers

A
  • Adherent
  • Nonadherent
  • Occlusive
  • Semi-occlusive
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12
Q

What needs to be considered when selecting a primary layer

A
  • Phase of wound healing
  • Amount of exudate
  • Wound location & depth
  • Presence or absence of eschar
  • Amount of necrosis or infection
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13
Q

Describe Adherent primary layers

A
  • Used when wound debridement required
  • May be wet or dry
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14
Q

Describe nonadherent primary layers

A
  • During repair phase or if no necrotic debris
  • Retains moisture to promote epithelialization & prevent dehydration
  • Drains excess fluid & prevents maceration
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15
Q

Describe occlusive primary layer

A
  • Impermeable to aire
  • Use on nonexudative wounds to keep moist
  • Speeds rate & quality of healing compared to dressings allowing desiccation
  • Use in partial thickness wounds w/o necrosis or infection
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16
Q

Describe semi-occlusive primary layer

A
  • Allows air to penetrate
  • Allows exudate to escape
  • Most commonly used primary layer
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17
Q

List the steps of applying a soft padded bandage

A
  1. Assemble bandage materials & supplies
  2. Tape stirrups
  3. primary layer
  4. Secondary layer
  5. Tertiary layer
  6. Labeling
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18
Q

How are tape stirrups applied

A
  • Distal 1/3 of limb
  • On the medial & lateral or dorsal & plant/palmar sides
  • Tabbed ends or tongue depressor to help w/ seperation
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19
Q

What is a tip for the modified robert jones bandage

A

place cotton btw/ the toes to decrease moisture build-up, increases px comfort, & don’t forget the dewclaw

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20
Q

Describe applying the primary layer

A
  • Contact layer
  • nonadherent
  • +/- meds
  • usually sterile
  • Wicking
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21
Q

Describe applying secondary layers

A
  • Intermediate layer
  • Absorbent
  • Supportive
  • +/- rigid support
  • Applied from the toes up, 50% overlap, & firm even pressure
  • Separate the tape stirrups
  • Rotate the stirrups proximally while twisting 180 degrees
  • Secure stirrups to the underlying wrap (this prevents distal slipping)
22
Q

Describe applying tertiary layer

A
  • Outer layer
  • applied - toes up, 50% overlap, & firm even pressure
  • This is what the clients see
23
Q

Describe applying a walking pad

A
  • Elastikon or durable material
  • Very adhesive
  • Water resistant
  • Applied w/o much pressure since the elastic properties might lead to swelling
  • Can use a Koozie
24
Q

What need to be on the label of the bandages

A
  • Date
  • Initials
  • Reminders
  • Warnings
25
Q

What adherent bandage layers are no longer recommended

A
  • Wet to dry
  • Dry to dry
26
Q

T/F: nonadherent bandage types or recommended for all stages of wound healing

A

True

27
Q

What bandage type is most often used in vet me

A

Semi occlusive

28
Q

When should a tie over bandage be used

A

When the wound is in an area inaccessible by standard bandaging tech

29
Q

What is this

A

Tie over bandage

30
Q

Describe a tie over bandage

A
  • Apply several sutures or skin staples w/ loose loops around the periphery of the wound
  • Apply primary & secondary bandage layers
  • Hold tertiary layer by lacing umbilical tape or heavy suture through loose skin sutures or staples
31
Q

When are pressure relief bandages used

A
  • Usually over bony prominence
  • To treat/prevent pressure sores
32
Q

What does pressure bandage do

A
  • Facilitates control of minor hemorrhage, edema, & excess granulation ( direct application of corticosteroid ointment to the wound helps control excess granulation tissue)
  • Them more convex the surface the greater the pressure exerted by the dressing on tissue
33
Q

When to use adherent bandages & why

A
  • Wound surface has necrotic tissue, foreign matter, or viscous exuate
  • Necrotic tissue & foreign material adhere to gauze & are removed w/ the bandage
34
Q

When to use dry adherent bandages

A
  • When wound surface has loose necrotic tissue & foreign material
  • When wound has large quantity of low viscosity exudate that doesn’t aggregate
35
Q

What does the robert jones bandage do

A
  • Immobilize
  • Decreases/limits soft tissue swelling
  • Absorbs wound exudate
36
Q

Describe the robert jones bandage

A
  • Very large/thick bandage
  • Uses rolled/sheet cotton
  • Wrapped w/ more compression
37
Q

How should proximal extremity lesions be bandaged

A

Continue the bandage up the leg, around the chest or abdomen, & btw/ the legs to create spica type bandage

38
Q

How should a paw bandage be place

A
  • Placed like the leg except the digits are covered
  • After placing the stirrups & contact layer reflect the casting pad over digits from dorsal to ventral then ventral to dorsal
  • Wrap padding around the distal limb
  • Conform bandage to limb w/ elastic gauze
  • Secure bandage w/ elastic tape in similar fashion
39
Q

Name a traction splint and the cons

A
  • Schroeder-Thomas splint
  • Labor intensive
  • Soft tissue complications
  • Lacks predictability
40
Q

What is a spica splint used for

A

Immobilization of the shoulder

41
Q

What is the ehmer sling

A
  • “Ehmer Femur”
  • To prevent pelvic limb weight bearing
  • Post hip reduction or acetabular fractures
42
Q

What is a velpeau sling

A
  • “Velpeau elbow”
  • To prevent forelimb weight bearing
  • After shoulder/forelimb procedures
43
Q

When to casts for fractures

A
  • Stable min displaced fractures
  • Young rapidly healing animals
  • Only injuries distal to the elbow/stifle
  • Unable to repair w/ surgical tech
  • Discuss expense w/ owner
  • Swelling reduced prior to cast
  • Green stick may not need sedation
  • Displaced fractures = general anesthesia
  • Check @ least every 2 W
44
Q

T/F: Cast open fractures

A

False

45
Q

When should you radiograph during casting & what should be seen on the Xray

A
  • After casting
  • Must have >50% of fracture ends (in ea of 2 radiographic views)
46
Q

What limb position should the cast be placed

A
  • Standing position
  • Encourages use when walking
  • Limits muscle atrophy & joint stiffness
  • Shortens recovery period after removal
47
Q

What are common complications

A
  • Slipping/loosening
  • Water or urine soaked
  • Joint stiffness & muscle atrophy
  • pressure sores
  • More padding = less well immobilized
48
Q

What about checking & changing

A
  • Require high degree of client compliance
  • Discharge should include verbal, written, & visual instructions for clients
  • Check freq
49
Q

What does changing frequency depend on

A
  • Age
  • Activity
  • Cleanliness
  • Associated wounds
  • Swelling
50
Q

What should be assessed when checking bandages

A
  • Clean
  • Dry
  • Comfort (chewing? Lameness increase?)
51
Q

When should a bandage be removed

A
  • Signs of oder
  • Swelling
  • Toe temperature (compared to other foot)
  • Nail bed cyanosis
52
Q

What are some rules to remember when bandaging

A
  • Sedation or anesthesia may be req
  • Leave middle 2 toes (claws) exposed when possible
  • Bandages start @ toes & go up limb to avoid swelling
  • Keep limb in physiologic position (Not standing & do not apply w/ limb in full extension)
  • Overlap 1/3 to 1/2 the width of you wrap
  • Apply firm even pressuring application (proportional to amount of padding & size of px)
  • Owner compliance
  • No single dressing produces optimum microenvironment for all wounds or all stages of wound healing of a single wound
  • Identify underlying structures

Surgery 1 (SAB) (16 decks)

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