What is the purpose of bandaging?
Protect the wound from additional trauma, contaimination, desication, “dead space” like hematoma or seroma, and to immobilize part of the body without disrupting healing.
What are the other purposes of bandaging wounds?
To lower edema and/or get ride of it, lower ‘proud flesh” or excess granulation tissue on the equine.
Bandaging if applied properly is to absorb the exudate. Maintain proper environment like acid that highers the oxygen availability. Proper temperature, if temperature of wound is lukewarm it wont heal properly
What are the layers of bandaging ?
Primary layer- wound contact and dressing
Secondary- padding forms to the wound and conforms to it
Tertiary - securing all bandage together to protect it
What are the types of primary layers?
Adhering
Debridement- wet-to-dry, dry-to-dry
Early wound care-inflammation and debridement
Disadvantages- delay repair, painful, cellular injury, maceration, and strike through bandage
What are the non-adhering primary bandage types?
Maintain moist environment in the wound, semi-occlusive and occlusive.
All phases of wound healing and proper bandaging helps to enhance repair.
Advantages are that it lowers pain, highers natural debridement and highers epithelialization
What are the secondary bandaging materials?
Cast padding that is easy to use, conforms well, less bulky
Roll cotton that absorbs and is bulky immobilizes limbs and compresses
Conforming gauze that stabilizes padding, +/- compression
What are the materials of te tertiary bandaging?
Tape- porous or non-porous that allows air transfer,Elastikon that conforms, and white tape that does not conform
Self adhesive- Vetrap ,em vetrap
What is a dry-to-dry adherent primary layer of bandaging?
Applied dry so excess exudate can come onto it which creates low viscosity.
Necrotic tissue- loose attachments
Foreign materials
Absorbs fluids so you change them when dry
What is a wet-to-dry bandage?
Fluids used to create primary layer are NaCl or LRS or sterile H20 with antiseptics
Excess exudate with high viscosity that dilutes exudate
Necrotic tissue in loose attachments
Foreign materials that absorb fluids to change when dry
what is a non-adherent semi-occlusive bandage?
Air/moisture vapor indicates moderate exudate and copious exudate
Change frequently to prevent maceration and exudate dependent
+/- hydro active absorbable to retain fluids and enhance healing like debridement, epithelialization, and fibroplasia
What are the types of non-adherent semi-occlusive bandaging?
Without hydroactive Tesla pads and adaptive
With hydroactive ultec
What are the non-adhesive Occlusive primary layers for. Bandaging?
Moisture impermeable, some air
Indications are the minimal exudate with partial thickness and granulation beds.
You want to change these frequently because it is exudate dependent, +/- hydroactive , will absorb and retain fluids and enhances healing with debridement, epithelization,, and fibroplasia
What are the types of non-adhesive occlusive bandaging?
Without hydroactive- Tegaderm and Biocclusive
With hydroactive- Nu-gel and Hydrocol
What indicates a Robert jones bandage?
When you want to immobilize the limb that maybe fractured on the distal limbs.
Control hemorrhages that alters hydrostatic pressure.
Control edema that alters hydrostatic pressure
Robert jones closing procedures
Skin arterioles- 30mmHg
Muscles arterioles-50mmHg
Pressure is created initially with 50-60 mm Hg. In te nest 15 minutes you got about 20mm Hg
How do you apply a Robert jones bandage?
Tape stirrups on medial and lateral aspects of the limb. Then the primary layers of padding where the wound or incision is if you have one. Then the padding from distal to proximal whole leg up to the inguinal region of the limb and it must over lap 50%. You want to bandage to look cylindrical, after all padding is applied. Then compression conforming gauze to compact the bandage in, has to have even pressure from distal to proximal ends and 50% overlap. The take your tape and tape the medial and lateral aspects of the bandage.
Tertiary layer of vetrap to compress the bandage even more from distal to proximal on whole leg with 50% overlap lap as well and tape end of vetrap.
What is the purpose of a modified Robert jones bandage?
To immobilize the limb to use a splint for wound and limb protect for post-op.
How would you apply a modified Robert jones bandage?
Primary layer- tape stirrups on both lateral and medial aspects
Secondary layer- padding from distal to proximal aspects to inguinal region of limb, multiple layers for cushion. Even pressure all the way to distal and proximal aspects with 50% overlap.
Tertiary layer is the splint that goes on top of the secondary layer, measured to limb. Wrap splint with layer of padding and tape bandage. Wrap with vetrap. /
What indications are for placing a chest/abdominal bandage?
Chest wounds and chest tubes
Lower rib fractures and higher intra abdominal pressure and hemorrhage less than or equal to 4 hours to loosen bandage
Encircling and avoid excess constriction
How do you apply a chest bandage?
Three layers for chest
Use forelimbs to prevent slipping
Primary layer is used to protect wound if it is there
How do you apply a chest/abdominal bandage?
Landmarks
1= right shoulder
2= sternum
3=left axilla
4=top of shoulder
5= right axilla
Bandage direction 4-1-2-3-4-5-2-4-5-3
Repeat figure 8
How would you apply an abdominal bandage?
Three layers on abdomen
Adhesive tape to secure hair
Watch “plumbing” don’t obstruct and prevent soiling
What are the general considerations for sling bandages?
To immobilize hip joint
Elmer- rear limb
Velpeau- sling on front limbs,, scapula proximal
prevent weight bearing, ephemeral or Velpeau, 0-90 flexión, carpal flexión
Prevent contracture with 90-90 flexión
What indicates an ephemeral bandage?
Craniodorsal hip luxation in a lateral rotation and abduction
Materials needed
Use minimal padding to prevent slipping, elastic tape either adhesive, self-adhesive and be cautious of an obstruction
