Bandaging principles and techniques

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Bandaging Principles and Techniques, Bandage Layers, Modified Robert Jones, Splints, Spica Splint, Schroeder - Thomas Splint, Casts, Ehmer Sling, Velpeau Sling

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Bandaging principles and techniques

  1. 1. BANDAGING PRINCIPLES AND TECHNIQUES DR. SATYAJEET SINGH DEPARTMENT OF VETERINARY SURGERY AND RADIOLOGY
  2. 2. LECTURE OBJECTIVES • Review bandage layers • Functions and indications for specific bandages • General bandage care • Complications
  3. 3. GENERAL FUNCTIONS • Aid in wound healing • Prevent open wound contamination • Wound debridement • Maintain moist wound environment • Support or protect deeper body partsSupport or protect deeper body parts • PressurePressure • Prevent/reduce swelling or hemorrhagePrevent/reduce swelling or hemorrhage • Prevent weight bearingPrevent weight bearing • Immobilization of tissuesImmobilization of tissues • Often serve multiple functionsOften serve multiple functions
  4. 4. EVERY WOUND DESERVES A BANDAGE…
  5. 5. … A REAL BANDAGE
  6. 6. … A REAL BANDAGE
  7. 7. GENERAL FUNCTIONS • Aid in wound healingAid in wound healing • Prevent open wound contaminationPrevent open wound contamination • Wound debridementWound debridement • Maintain moist wound environmentMaintain moist wound environment • Support or protect deeper body parts • Pressure • Prevent/reduce swelling or hemorrhage • Prevent weight bearing • Immobilization of tissues • Often serve multiple functionsOften serve multiple functions
  8. 8. IMMOBILIZATI ON
  9. 9. GENERAL FUNCTIONS • Aid in wound healingAid in wound healing • Prevent open wound contaminationPrevent open wound contamination • Wound debridementWound debridement • Maintain moist wound environmentMaintain moist wound environment • Support or protect deeper body partsSupport or protect deeper body parts • PressurePressure • Prevent/reduce swelling or hemorrhagePrevent/reduce swelling or hemorrhage • Prevent weight bearingPrevent weight bearing • Immobilization of tissuesImmobilization of tissues • Often serve multiple functions
  10. 10. BANDAGE LAYERS Primary Layer • In direct contact with skin or wound • Choice of material dictated by • Presence / absence of wound • Stage of wound healing • Amount exudate • Necrosis/infection
  11. 11. BANDAGE LAYERS Primary Layer Functions: • Debridement • Deliver medication • Transmit exudate to 2nd layer • Seal wound
  12. 12. BANDAGE LAYERS Secondary Layer Functions: • Absorption of wound exudate / fluid • Support • Compression
  13. 13. BANDAGE LAYERS Tertiary Layer Functions: • Protects from environment • Holds bandage in place • Immobilizes
  14. 14. BANDAGE LAYERS Tertiary Layer Functions: • Protects from environment • Holds bandage in place • Immobilizes
  15. 15. GENERAL PRINCIPLES • Improperly placed bandages can be very harmful!!! • Too loose will not help; Too tight will harm • Avoid circumferential tape • When placing bandage, remember: • Daily care necessary • Weekly change mandatory
  16. 16. BANDAGE TYPES • Modified Robert Jones*** • Robert Jones • Splints*** • Spica Splint • Schroeder - Thomas Splint • Casts • Ehmer Sling • Robinson Sling • Velpeau Sling
  17. 17. MODIFIED ROBERT JONES • Very common bandage • Forelimb or hindlimb • Numerous indications • Protect incision or wound • Provide support (minimal) • Prevent / reduce swelling
  18. 18. MODIFIED ROBERT JONES Tips • Always work distal to proximal • Maintain constant pressure • 50 % overlap • Place the limb in functional position • Avoid wrinkles • Visualization of middle toes
  19. 19. MODIFIED ROBERT JONES TipsTips • Always work distal to proximalAlways work distal to proximal • Maintain constant pressureMaintain constant pressure • 50 % overlap50 % overlap • Place the limb in functional positionPlace the limb in functional position • Avoid wrinklesAvoid wrinkles • Visualization of middle toes
  20. 20. MODIFIED ROBERT JONES Layers • Stirrups
  21. 21. MODIFIED ROBERT JONES Layers • Stirrups • Primary layer (if required)
  22. 22. MODIFIED ROBERT JONES Layers • Stirrups • Primary layer (if required) • Cast padding
  23. 23. MODIFIED ROBERT JONES Layers • Stirrups • Primary layer (if required) • Cast padding • Rolled gauze
  24. 24. MODIFIED ROBERT JONES Layers • Stirrups • Primary layer (if required) • Cast padding • Rolled gauze
  25. 25. MODIFIED ROBERT JONES
  26. 26. MODIFIED ROBERT JONES Layers • Stirrups • Primary layer (if required) • Cast padding • Rolled gauze • Vetrap®
  27. 27. MODIFIED ROBERT JONES
  28. 28. MODIFIED ROBERT JONES TipsTips • Always work distal to proximalAlways work distal to proximal • Maintain constant pressureMaintain constant pressure • 50 % overlap50 % overlap • Place the limb in functional positionPlace the limb in functional position • Avoid wrinklesAvoid wrinkles • Visualization of middle toesVisualization of middle toes
  29. 29. ROBERT JONES Indications • Distal limb fractures • Compression • Temporary immobilization and support Not used as much as used to be
  30. 30. ROBERT JONES Layers: • Primary layer (if needed) • Large amounts of roll cotton • Rolled gauze applied tightly • Vetrap®
  31. 31. ROBERT JONES
  32. 32. ROBERT JONES
  33. 33. SPLINTS • Preformed •Plastic •Aluminum Designed to be applied in a specific position on the limb: •Forelimb → caudal lateral •Hindlimb → lateral
  34. 34. SPLINTS • Preformed •Plastic •Aluminum Designed to be applied in a specific position on the limb: •Forelimb → caudal lateral •Hindlimb → lateral
  35. 35. SPLINTS • Molded • Water activated fiberglass • Thermolabile plastic Can be perfectly fitted and adapted to specific situation • PreformedPreformed –PlasticPlastic –AluminumAluminum Designed to be applied inDesigned to be applied in a specific position on thea specific position on the limb:limb: –ForelimbForelimb →→ caudalcaudal laterallateral –HindlimbHindlimb →→ laterallateral
  36. 36. MOLDED LATERAL SPLINT
  37. 37. SPLINTS Indications • Provide additional stability to fracture repair • Post carpal / tarsal arthrodesis • Support after cast or ESF removal • Protect soft tissue repairs of the distal limbs
  38. 38. SPLINTS Application • Same layers as MRJ: • Cast padding • Rolled gauze • Splint • Rolled gauze • Vetrap • Apply over sufficient padding • Too much padding will result in loss of stability
  39. 39. SPLINTS Application • Splint must extend well beyond area to support • Padding must extend beyond splint
  40. 40. WHAT IS WRONG WITH THIS SPLINT?
  41. 41. WHAT IS WRONG WITH THIS SPLINT?
  42. 42. SPICA SPLINT • Used for stabilization of the humerus and femur • Splint applied laterally extending over the shoulder or hip • Not adequate for most fractures
  43. 43. SCHROEDER - THOMAS SPLINT • Properly applied can maintain traction on distal limb fractures • Indications • Fractures below the elbow or stifle • Immobilization of elbow, carpus, stifle and tarsus
  44. 44. SCHROEDER - THOMAS SPLINT
  45. 45. CASTS Indications Case selection is of prime importance!!! • Rare, non-displaced, simple transverse fractures below elbow or stifle Owner compliance is mandatory!!! • Proper care at home • Regular examination by veterinarian
  46. 46. CASTS Application • Cast must extend well beyond the fracture site • Layers • Stirrups • Stockinette • Cast padding • Rolled gauze • Cast material • Vetrap® • May be “bivalved”: allows for changing
  47. 47. CASTS
  48. 48. SPECIAL BANDAGES
  49. 49. EHMER SLING • Used to prevent weight bearing of pelvic limb • Results in: • Abduction of limb • Internal rotation of hip • Indications: • Post reduction of hip luxation • Post acetabular fracture repair
  50. 50. EHMER SLING
  51. 51. EHMER SLING
  52. 52. EHMER SLING
  53. 53. ROBINSON SLING • Used to prevent weight bearing on hindlimb • Allows some range of motion of tarsus and stifle
  54. 54. VELPEAU SLING • Non-weight bearing sling for the forelimb • Indications: • Immobilization following shoulder surgery • Scapular fractures • Following reduction of shoulder luxation
  55. 55. BANDAGE CARE Close observation and care is critical • Change as often as necessary • Keep clean and dry • Cover with plastic when outside/Remove plastic inside • Monitor for swelling proximal and distal • Monitor for foul odor • Licking and chewing can indicate a problem Hummm…Hummm… This soundsThis sounds like examlike exam material…material…
  56. 56. BANDAGE CARE Close observation and care is criticalClose observation and care is critical • Change as often as necessary • Keep clean and dryKeep clean and dry • Cover with plastic when outside/Remove plastic insideCover with plastic when outside/Remove plastic inside • Monitor for swelling proximal and distalMonitor for swelling proximal and distal • Monitor for foul odorMonitor for foul odor • Licking and chewing can indicate a problemLicking and chewing can indicate a problem • Immediately if:Immediately if: - Strike through- Strike through - Soiled- Soiled - Wet- Wet - Malodorous- Malodorous - Bandage is causing pressure sore- Bandage is causing pressure sore - Vascular compromize- Vascular compromize - Any doubt- Any doubt • At least weeklyAt least weekly • As often as necessary for woundAs often as necessary for wound carecare
  57. 57. BANDAGE CARE Close observation and care is critical • Change as often as necessary • Keep clean and dry • Cover with plastic when outside/Remove plastic inside • Monitor for swelling proximal and distal • Monitor for foul odor • Licking and chewing can indicate a problem
  58. 58. COMPLICATIONS Bandaging of a body part can result in: • Ineffective treatment • Vascular compromiseVascular compromise • DermatitisDermatitis • Skin and soft tissue necrosisSkin and soft tissue necrosis • Loss of range of motionLoss of range of motion
  59. 59. COMPLICATIONS
  60. 60. COMPLICATIONS Bandaging of a body part can result in: • Ineffective treatment • Vascular compromise • DermatitisDermatitis • Skin and soft tissue necrosisSkin and soft tissue necrosis • Loss of range of motionLoss of range of motion
  61. 61. COMPLICATIONS Bandaging of a body part can result in: • Ineffective treatment • Vascular compromise • Dermatitis • Skin and soft tissue necrosisSkin and soft tissue necrosis • Loss of range of motionLoss of range of motion
  62. 62. COMPLICATIONS
  63. 63. COMPLICATIONS Bandaging of a body part can result in: • Ineffective treatment • Vascular compromise • Dermatitis • Skin and soft tissue necrosis • Loss of range of motionLoss of range of motion
  64. 64. COMPLICATIONS
  65. 65. COMPLICATIONS
  66. 66. COMPLICATIONS
  67. 67. COMPLICATIONS Bandaging of a body part can result in: • Ineffective treatment • Vascular compromise • Dermatitis • Skin and soft tissue necrosis • Loss of range of motion
  68. 68. SUMMARY • Bandages can be very harmful!!! • When placing a bandage, remember: • Daily care necessary • Weekly change mandatory
  69. 69. ADDITIONAL READING • Piermattei DL, Flo GL: Handbook of Small Animal Orthopedics and Fracture Repair (ed 3). Philadelphia, PA, Saunders, 1997, pp 49-67
  70. 70. QUESTIONS???

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