Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Bandaging principles and techniques

44,170 views

Published on

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

Published in: Health & Medicine, Business

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???

×