Bandages, Splints, Casts 1
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. What would you like to do?
What do we use bandages for?
- protect the wound
- protect granulation tissue
- support before surgical repair
- prevent edema, seromas, hemorrhage
- immoblize wound
- support catheters
- minimize exuberant granulation tissue
- absorb wound exudates
- help debride loose tissue as bandage is changed
- prevent soiling of environment
What does a bandage protect a wound from?
- self-mutilation from the patient
What is a seroma?
pocket of fluid in tissue
What do we use bandages to immobilize a wound?
- promote healing
- less pain
- before fracture repair - less tissue damage
What are 3 types of debridements?
- own body doing it (macrophages)
Should we cast over open wounds?
What direction do we bandage?
- go from distal to proximal
- go from lateral to medial
Should we rotate the limb when bandaging?
What should we leave exposed in full length bandages, splints, or casts? Why?
leave the 2 middle toes exposed so you can check for color, warmth, and swelling
Is the appearance of the bandage important? Why?
yes, the client will judge you by what it looks like so it should be neat and clean
Why is it important to keep the bandage clean and dry?
to reduce moist dermatitis, infection, discomfort, chewing
How do we keep a patients bandage dry and clean?
- cover with stockinette
- keep patient on a rack
- walk patient often
- plastic bag on limb for walks outside
What are some signs of discomfort?
- chewing, licking
- chafing at edges
Should we give the client written home care instructions about taking care of their pets bandages?
What can excess pressure from the bandage do?
cut off circulation and cause necrosis
What are different types of excess pressure?
- pressure ring
- pressure point
What is a pressure ring?
band of pressure around the limb
What does a pressure ring cause?
edema of distal tissue
How do we prevent a pressure ring?
- apply bandage in spirl barber pole fashion
- do not pull tight
- wrap from toe to wound (not just the wounded area)
- leave 2 middle toes exposed
Where are the pressure points?
pad around prominences (elbow and carpal pad)
How do we prevent pressure points?
- may cut a hole in the wrap
- distribute pressure evenly
What can we do to help keep bandages on?
- apply to clean, dry skin or hair
- clip long hair
- apply anchor tapes
What is another name for anchor tapes?
What is the purpose of anchor tapes?
placed to prevent cast, splint, or bandage from sliding off the leg
How do we apply anchor tapes?
- Cut two lengthwise strips that extend well past the toes
- Apply loose spiral tape on the leg to hold lengthwise strips in place
- Bandage the limb
- Twist so sticky side is against bandage
What are some common problems with bandages?
- dirty, infected
- skin reaction to tape
- patient removes bandage
What are gauze sponges?
porous woven folded fabric (usually squares or rectangle shaped)
What are gauze rolls?
loose woven fabric in rolls (stretchy or not stretchy)
What is elastic gauze?
- does not adhere to patient
- different colors and sizes
- adheres to itself
What is another name for elastic gauze?
Can elastic gauze be applied too quickly?
What can happen if elastic gauze is applied too tightly?
What is adhesive tape?
- porous, permits air to get to wound
- sticks to itself and to the patient
What is elastic tape?
- elastic adhesive tape
- sticks to itself and patient
What is another name for elastic tape?
What is non-adhering sponges?
- do not adhere to wound
- do not tear away scab or granulation tissue when removed
- less painful to remove
- tends to trap in moisture
What is non-adhereing sponges usually used for?
used for primary layer of bandage over wound
What is another name for non-adhereing sponges?
What are stockinettes?
- woven tube of cloth
- elastic, comes in a roll
What do we use stockinettes for?
apply under cast padding
What is cast padding?
- small rolls of pressed cotton
- smooth or corrugated
What is cast padding used for?
- pad simple bandages
- pad casts
What is roll cotton?
- large and bulky
- major padding
Who is roll cotton usually used for?
What are the different layers of bandages?
- primary layer
- secondary layer
- tertiary layer
- supporting layer
What is the purpose of the primary layer?
in contact with the skin
What are the different types of primary layer?
When do we use adherent primary layer?
used if some debridement is needed
What can be used as a adherent primary layer?
When do we use non-adherent primary layer?
- required when healthy granulation tissue fills wound
- protects skin, not removes skin
What can be used as a non-adherent primary layer?
What is semi-occlusive primary layer?
- allow air to penetrate
- allows exudate to escape
What can be used as a semi-occlusive primary layer?
What is an occlusive primary layer?
- no air penetration
- no exudate escapes
What can we use as an occlusive primary layer?
waterproof adhesive tape
When should we not use an occlusive primary layer?
if exudate is present because it holds it in against the wound and causes maceration of wound
What is the secondary layer?
padding - cast padding, roll cotton
What can happen if the secondary layer is not done correctly?
can damage tissue and cause edema or necrosis
What is the tertiary layer?
main outer layer
What is the purpose of the tertiary layer?
- holding and protection
- holds the bandage together
What can be used for the tertiary layer?
- adhesive tape
What are some after care instructions for bandages?
- keep clean and dry
- restrict exercise
- watch for problems
- bandage changes and rechecks as indicated
How do we restrict exercise?
- house confinement
- leash walk
What is the purpose of restricting exercise?
- decreases trauma
- less opportunity to get dirty
What kind of problems does the owner need to look for after their pet has been bandaged?
- licking, chewing, odor, redness, chafing
- patient stops using leg
- observe toe color, warmth
- toenails spread means swelling
What can cause problems with bandages?
- uncomfortable and patient messes with it
- too tight - poor circulation
- fracture site breaking down
What is the general rule of thumb for bandage changes?
the more a wound is draining, the more often the bandage should be changed
At each bandage change, the wound should be...
How often should bandages, splints, and casts should be rechecked?
at least every 10 - 14 days
What should we document in the medical record about rechecks of bandages?
- document when we did the recheck
- document if the owner did not show up
- document phone calls
What would you like to do?
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