bandaging techniques

Question 1

how will you bandage a large animal

Answer 1

sedation
however, if there is a lot of blood loss, my be contraindicated due to sedative hypertension
regional anaesthesia may be best

Question 2

what might make suturing wounds complex in large animals

Answer 2

lack of availible extra skin - may need to use mattress suture patterns

Question 3

When is a Robert James bandage used?

Answer 3

Emergency first stage stabilisation of fractured long bones

Immediate post-surgical protection of repair to long bones and other fractures

Very common

Question 4

When are gutter splints used?

Which species are they used in?

What else needs to be applied? (2)

Answer 4

Stabilise fractures below the carpus and hock

Used in cats and smaller dogs because there is less weight

Padding needs to be applied to the limb to protect it from the edges of the splint

A tertiary layer is needed to hold the splint in place

Question 5

When are plasters of Paris and fiberglass impregnated with resin used? (3)

What else needs to be applied

Answer 5

A stable fracture of long bones

Oblique fractures

Fractures where there is a complete bone to act as a splint e.g fractured radius and complete ulna

Suitable padding to make sure the cast isn’t too tight / rubbing

Too much padding can cause instability and movement at the fracture sight

Question 6

Why do we need bandages? (5)

Answer 6

They are an aid to the ongoing healing of a wound, surgical site or first aid

Stabilise the wound surface = prevents disruption to the healing response

Protection from trauma or contamination

Self trauma is a big issue

Stop bacteria colonising

Aids clotting

Question 7

How many layers are used in bandages?

Answer 7

Question 8

What is the primary layer of a bandage?

Answer 8

It is the dressing

Contact layer - most important part

Aids healing of wound and protects it

Question 9

What is the secondary layer of a bandage?

Answer 9

2 components to this layer

Padding

Provides comfort

Absorbs excessive exudate material

Needs to be thick enough to prevent strike through to the tertiary layer

Open weave / conforming bandage

Applies light pressure to hold the padding in place

Absorbs excessive exudate

Don’t apply too tight or you will get over compression = poor circulation to limb

Question 10

What is in the tertiary layer of a bandage?

Answer 10

Holds the other layers in place

Provides protection when walking

Cohesive layer (sticks to itself but not the patient)

Material has memory and tightens on application

An additional adhesive layer may be used because they are stronger and thicker (e.g E band)but make sure it doesn’t stick to the patient as it will hurt when removed

Question 11

What is strike through?

Answer 11

Fluid from wound leaks through bandage layers to outside = direct link back to the wound

Can also happen in reverse - fluid gets from the outside of the bandage through to the wound (e.g walking in the rain)

These need to be prevented to stop infection and disruption to the skin around the wound

Question 12

Name 5 different types of dressing

Answer 12

Dry sterile swabs

Impregnated dressings

Semi-occlusive dressings

Absorbent dressings

Alginates

Question 13

Why are dry sterile swabs useful?

Answer 13

Applied directly to the wound

Useful for debridement of a wound if surgical intervention is not needed

Question 14

What are impregnated dressings?

Answer 14

These have something on them to facilitate wound healing e.g petroleum or antibiotics

They can be used for superficial open wounds that we feel are infected or dirty

Question 15

What are semi-occlusive dressings?

Answer 15

These have a non-stick material with a central absorbent core

They often come with an adhesive to allow the dressing to be kept in place

They are good for short term post surgical closure

Question 16

What are absorbent dressings?

Answer 16

These are often padded and colour coded to show which side goes onto the wound

They can be designed to absorb different amount of exudate from large wounds

They are not suitable for surgery

They need to be removed from the surface whilst maintaining a moist healing area

Question 17

What are alginates?

Answer 17

These are made up of naturally occurring kelp/seaweed

They can be moistened and applied to a wound that has become static and help to encourage release in to the wound

They release inflammatory factors that will restate the process

They will dry and need to be flushed with saline to remove

Question 18

What are topical wound gels?

Answer 18

Keep wound moist whilst also drawing away excess exudate into the absorbent dressing above

Can also be used when there is a large cavity that no other dressing will fit into

Question 19

What issues can occur when bandages aren’t applied correctly? (4)

Answer 19

• Swelling
• Tissue necrosis
• Pressure ulcers
• Patient interference

Question 20

What are these?

Answer 20

Ring dressings

They can protect bony prominences

But can lead to pressure in other locations if not changed regularly

Question 21

Name 3 types of bandaging techniques that are commonly used in equine practice

Answer 21

Simple bandage

Figure of 8 bandage

Robert Jones bandage

Question 22

What is a simple dressing?

Answer 22

Soft band on the leg to hold dressings in place

Light padding

Conforming bandage

Vet wrap

Question 23

What is a figure of 8 bandage?

Answer 23

Goes over joints - particularly carpus and tarsus

Avoids pressure points on the accessory carpus bone

Question 24

What is a Robert Jones bandage?

Answer 24

Minimum of 3 layers

1 layer = padding + conforming

Supports the fracture beneath it

Question 25

What are the 5 layers of an equine bandage? How does this differ in a Robert Jones bandage?

Answer 25

1. Protective material (softban) 2. Padding (cotton wool/Gamgee) 3. Conforming (elasticated bandage e.g. knitfirm) 4. Outer layer (vetwrap) 5. Finishing (Elastoplast, duct tape, splints?) In normal bandages there is one layer of padding and conforming In Robert Jones bandages there are 3 layers of padding and conforming (PC + PC + PC)

Question 26

When are splints used in horses? Which materials can be used?

Answer 26

Unstable fractures Unstable tendon injuries Commercially available easy to apply splints Rigid drainpipe / guttering, Wood stakes / planks

Question 27

Where do splints need to be applied?

Answer 27

It varies depending on where the issue is Split into 4 regions according to the biomechanics and forces on each region Region 1: alignment of dorsal cortices, splint placed dorsally (commercial splints) Region 2: splint placed laterally and caudally Region 3: splint placed laterally (and medially) Region 4: forelimb - stabilise carpus