BANDAGING TECHNIQUES

BANDAGING TECHNIQUES
BANDAGING TECHNIQUES
The ideal bandage
1)optimises environment for healing in every way
2)is comfortable for the patient
3)is easy for the owner to manage
4)is not expensive and biodegradable to dispose of
Three layers
1)contact = dressing = primary layer
2)padding & support = intermediate layer
3)outer layer
Tertiary
( Outer )
Layer
Secondary
( Intermediate )
Layer
Primary
( Contact )
Layer
Sterile & final barrier to contamination
touches & protects the wound surface
optimises the wound environment
Transfers exudate to secondary layer
eg:sterile gauze
or others)
TYPES OF CONTACT LAYER
Adherent-stick to the wound like a wet to dry bandage eg:sterile gauze pads
Non adherent
Occlusive layer-water resistant. Keep moisture outside &wound fluid in.
for wounds with established granulation tissue
eg:Hydrocolloid, Hydrogel, calcium-alginate
Semi occlusive layer- allowing fluid to drain into absorbent layer
for open wounds without established granulation tissue
eg:Telfa pads, Paraffin gauze
Hydrocolloid Hydrogel
Other special contact layers
Silver impregnated dressing
Iodine impregnated dressing
Activated charcoal impregnated dressing
Manuka honey impregnated dressing
Hypertonic saline dressing
Copolymer starch dressing
Moisture-retentive dressing
Polyurethane foam/film dressing
SECONDAR
Y LAYER
TERTIAERY
LAYER
eg:cotton,
absorbing pads
eg.porous surgical adhesive tape
Occlusive water proof tape
A)Adhesive tape- sticky on one side, form the stirrup to which bandage will attach
B)Gauze- clearing wound exudate & necrotic tissue
C)Cotton cast padding- pliable, highly absorbent, major material of secondary layer
D)Elastikon tape- form tertiary layer, stretchable
E)Sterile pad (if an open wound exists)- serve as primary layer
Antiseptic-stop the growth &action of bacteria. Germicide for wound healing
A
B C
D
E
Casts and splints
 Protect surgical repairs.
 Provide a degree of rigidity. Stabilize a fracture
 Allow more comfortable transport of the animal.
 The rigidity of a cast will exceed that of a splint
Splints should be applied after a basic bandage is applied
( contact layer, cast padding)
Then fixed to the limb with porous adhesive tape.
Aluminium splint rods-they must be cut and bent to shape.
Commercial plastic and metal splints-available in a variety of sizes and shapes.
Thermomoldable plastic splinting material-Manually moulded to the conformation of the area
Fiberglass casting tape- light, durable, and water resistant.
Splint
Cast
BANDAGING TECHNIQUES
BANDAGING LIMBS
• Most common bandaging sites
 To protect wound& to support broken leg
 It extend down to toes to avoid twist/slip
Adhesive tape stirrups are placed
on the leg to secure the bandage.
A sterile pad covers and
protects the wound.
Cotton padding is wrapped
thickly around the leg.
Gauze is applied over the
cotton padding to compress
and secure the bandage.
The entire bandage is wrapped
with Elastikon tape.
1.
2. 3. 4.
5.
BANDAGING TAILS
 After surgical repair or tumour removal
 Apply final tape(stick directly to tail skin)over bandage
Adhesive tape is wound
spirally around the tail
Wound dressing pad
applied at the tail tip
Padding material is
wound in the direction of
tail base
Layer of elastic bandage is
applied to secure the
padding material
1.
2.
3.
4.
Bandaging Ears
.
 An Elizabethan collar is a stiff cardboard or
plastic cone shaped structure that goes
around the animal’s neck
 If an eye needs to be bandaged, place the
bandage over the head to include the affected eye.
.
An Elizabethan collar prevents an
animal from scratching face injuries
or biting other body injuries.
Bandaging Eyes
).
Bandaging Dog and Cat Torsos
Bandages over the
abdomen/chest - to
protect surgical sites or to
secure surgically placed
structures (chest tubes &
abdominal drains)
Place torso bandages by
applying rolled cotton around
the chest or abdomen&
covered with rolled gauze and
secured with tape.
Bandaging Birds
BIRD’S LEG
• Treat leg fracture with a splinted bandage
(Tongue depressor/Schroeder-Thomas splint)
BIRD’S WING
• Temporary support of injuries & fractured bone in wings
• Bandage wing separately from it’s body using gauze & tape
• Some wing bandages incorporate splint
Re-Dressing a Wound
 When re-dressing a wound - important to know which primary
bandage material best suits the wound’s stage of healing.
 The primary layer of the bandage may vary,
 Reapply a bandage with the same bandaging technique &
bandaging principles used previously
 Apply bandage without constriction, slippage & should be
checked frequently
.
• Most of the bandages are applied as pressure bandages ( to prevent bleeding & swelling)
• Don’t bandage unless absolutely necessary
• A bandage placed too tightly will cut off the blood supply.
A bandage placed too loosely(too much padding) may slip
GENERAL RECOMMENDATIONS REGARDING BANDAGE CARE
• The bandage should not get wet, covered with a water resistant sock.
• If the animal suddenly starts licking or chewing, it should be changed
• The interval of bandage change depends on the indications
• Many bandages are padded with cotton wool or synthetic fibres-based on ease of use
• Cotton loses elasticity once wet
• Synthetic fibres(Artiflex)-poor absorber of wound fluid& cause irritation
• Padding between toes prevent pressure sores
Robert -Jones bandage-large amount of padding
provide immobilization without compressing vascular supply
Modified Robert-Jones bandage-less padding is used
BANDAGING TECHNIQUES
1.Shoulder support bandage with splint
Indications
1. Scapular fractures.
2. comminuted humerus fractures (during transport).
3. Immobilisation after certain shoulder operations.
4. Immobilisation of the elbow after repositioning of elbow luxation.
5. Following soft tissue surgery of wounds in the axillar region.
Aftercare
bandage that should be changed or removed 4 days to 3 weeks
after application, depending on the indication and condition of the bandage
In an anaesthetised dog,
cotton padding is applied
between the toes.
padding is wound
around the leg in
proximal direction
A wide roll of cotton wool
or (Artiflex) is applied
It ends behind the dog’s back,
then passed around the neck.
The elastic bandage is applied
from distal to proximal.
1. 2.
3.
4.
5.
For immobilisation of the
limb, a splint (thermoplastic
material)is added.
The splint is fixed
with an elastic bandage.
This self-adhesive bandage
is applied lengthwise.
Adding strength to
the entire bandage.
6. 7.
8. 9.
2.PADDED PRESSURE BANDAGE LOWER FRONT LIMB
(INCLUDING THE CARPUS)
Indications
1. Treatment of wounds/haemorrhages of the paw
2. Aftercare following surgery of the foot
3. Prevention of licking.
Interdigital spaces are
padded with cotton wool.
Then, cotton wool is applied
around the lower limb,
including the carpus. .
1.
2.
The padding is secured with
hydrophilic gauze bandage
The bandage may be
finished by securing it with
self-adhesive bandage.
free edge of the gauze
bandage is folded backwards,
close the lower part of the
bandage
Then, elastic bandage
material is used to secure the
padding & to produce a
pressure bandage.
3. 4.
5. 6.
3.ELASTIC SUPPORT BANDAGE, HIND LIMB
(INCLUDING THE STIFLE)
Indications
1. Prevention of postoperative oedema, both in the wound area
(inflammatory oedema) and more peripheral (congestive oedema).
2. Treatment of peripheral oedema following trauma (femoral fracture)
• Elastic bandages(Gazofix) is usually applied without padding to the (shaved) skin
• The nails of the 3rd and 4th digit remain visible, to check for congestion
• During application, the leg is held in a normal standing position
The bandage is applied in such a way that:
The elastic bandage is first
wound around the lower limb,
The bandage is applied
from distal to proximal.
Don’t constrict the
Achilles tendon.
The bandage is then wound in downward
spirals, until the stifle is well covered.
The elastic bandages acts
as a support stocking, for
an optimal venous return
1.
2.
3.
4.
4.PLASTER OF PARIS SPLINT BANDAGE (PLASTER CAST)
Indications for a plaster cast
1. Extra-articular fractures distal to the proximal third of the radius or tibia.
2. Supported fractures, i.e. fracture of only the radius/ulna or of the tibia/fibula.
3. Fissure.
Plaster cast in human patients-swellings are avoided by keeping the limb in a raised position,
The plaster bandage in companion animals should be weight bearing
Aftercare
should be kept bone dry at all times.
should be protected e.g. by a rubber cover.
plaster splint should be checked daily.
Fracture healing usually takes six to eight weeks.
Advantages of applying the plaster in a semi-circular manner
(front limb: applied to the back, hind limb: to the front)
1 .simultaneous
immobilisation of the
fracture- by the plaster &
treatment of the soft tissue
swelling -by the padded
bandage.
2.The risk of congestion is
less than with a circular
application of the splint;
3. the splint is (lighter)
causing less hindrance to
locomotion without loss of
stability
4. the splint is easy to
change - in case of growth
of the limb concerned,
5.It is also easy to remove
while an oscillating saw is
necessary for circular
plaster casts.
• Length of the splint is determined.
• Care should be taken to stretch the elbow
• Six of these lengths of plaster of Paris
are folded on top of each other.
• The edges are folded back lengthwise.
creating a ridge in the centre of the splint,
(for better positioning ).
• The splint is folded, submersed in warm
water and is smoothed out on a table top.
• Care should be taken that the plaster
does not dry out or break.
• The layers are transposed as a whole
and applied
1.
2.
3.
4.
• Hydrophilic gauze is wound around the plaster
(for exact shape of the palmar once hardened).
• During the hardening phase limb should be kept still
• Once the splint is hardened the gauze is removed.
sharp edges or corners are removed
• The splint bandage is finished
using a layer of cotton wool.
• padding are stabilised using
elastic bandage material.
5.
6.
7.
8.
EHMER SLING
• used to prevent weight bearing
of a hind limb and may be used after hip luxation
• cause severe pressure sores, if placed incorrectly
1. Cotton wool is placed around the foot
2. A conforming bandage (eg;. K-band) is wrapped around the foot
3. The stifle is then flexed as far as possible
4.The k-band is passed medially (between the limb and
the body) And out over the quadriceps muscle
5.The bandage passes round the back of the tibia to
wrap around the metatarsals.
6.This should look like a figure-of-eight from the front
of the patient
7.Finally, a layer of cohesive bandage is applied
to provide further support
VELPEAU SLING
To prevent weight-bearing of fore limb
(after scapular fracture/shoulder dislocation)
1.The carpus and paw are padded with cotton wool
2.The forelimb is flexed as close to the trunk as possible.
3.K band is wrapped around the carpus and
brought up over shoulder
4.The bandage is continued round the body,
passing behind the opposite elbow to wrap
around the body, spreading tension evenly over the limb
5.A cohesive layer (Vetrap, petflex) applied to
improve support
Indications:
• Same indications as Velpeau sling, but the elbow
joint maintains full range of motion.
• Cats tolerate carpal slings better than Velpeau slings
Technique:
1. Flex the carpus and wrap cotton bandage around it
2. Maintain flexion with an elastic tape
3. Do not flex the carpus above 90 degrees
Carpal sling
Indications
• Ventral hip luxation (after reposition),
fractures of the plevic floor
Technique
1. A self sticking tape is used
2. Enclose both distal tibiae in either a tape.
3. Stick the tapes together, so that the cat may
walk, but straddling is prevented
4. Secure the sling with two pieces of tape
placed on both medial aspects of the tibiae.
Hobble sling
 Discomfort
 Lameness
 gangrene in pressure areas
 Secondary infections
 Circulatory interference(congestion underneath the bandage)
 Lead to swelling &peripheral area become cold(hair will fall out)
 Parts of toe or footpads may slough off followed by necrosis
COMPLICATIONS
OF BANDAGING
How can we prevent problems?
• Training veterinary staff.
• Educating clients about bandage aftercare
Drip bag in place ~The toes should be
adequately padded
Doughnuts‘- used to protect
from pressure sores. extra padding
A Medipaw bandage cover
provides brilliant protection
PREVENTING BANDAGE MOLESTATION
..
.
Wire basket-type muzzles-keep a dog from molesting
a bandage. It must be removed for eating
Side braces - keep a dog away
from its hind quarters.(can be fashioned from aluminium
splint rods)
Elizabethan collars - keep a dog’s
head/mouth away from anything caudal to the device
The care giver will have to take care of
hygienic habits
BANDAGING TECHNIQUES
1 de 42

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BANDAGING TECHNIQUES

  • 3. The ideal bandage 1)optimises environment for healing in every way 2)is comfortable for the patient 3)is easy for the owner to manage 4)is not expensive and biodegradable to dispose of Three layers 1)contact = dressing = primary layer 2)padding & support = intermediate layer 3)outer layer Tertiary ( Outer ) Layer Secondary ( Intermediate ) Layer Primary ( Contact ) Layer
  • 4. Sterile & final barrier to contamination touches & protects the wound surface optimises the wound environment Transfers exudate to secondary layer eg:sterile gauze or others)
  • 5. TYPES OF CONTACT LAYER Adherent-stick to the wound like a wet to dry bandage eg:sterile gauze pads Non adherent Occlusive layer-water resistant. Keep moisture outside &wound fluid in. for wounds with established granulation tissue eg:Hydrocolloid, Hydrogel, calcium-alginate Semi occlusive layer- allowing fluid to drain into absorbent layer for open wounds without established granulation tissue eg:Telfa pads, Paraffin gauze Hydrocolloid Hydrogel
  • 6. Other special contact layers Silver impregnated dressing Iodine impregnated dressing Activated charcoal impregnated dressing Manuka honey impregnated dressing Hypertonic saline dressing Copolymer starch dressing Moisture-retentive dressing Polyurethane foam/film dressing
  • 7. SECONDAR Y LAYER TERTIAERY LAYER eg:cotton, absorbing pads eg.porous surgical adhesive tape Occlusive water proof tape
  • 8. A)Adhesive tape- sticky on one side, form the stirrup to which bandage will attach B)Gauze- clearing wound exudate & necrotic tissue C)Cotton cast padding- pliable, highly absorbent, major material of secondary layer D)Elastikon tape- form tertiary layer, stretchable E)Sterile pad (if an open wound exists)- serve as primary layer Antiseptic-stop the growth &action of bacteria. Germicide for wound healing A B C D E
  • 9. Casts and splints  Protect surgical repairs.  Provide a degree of rigidity. Stabilize a fracture  Allow more comfortable transport of the animal.  The rigidity of a cast will exceed that of a splint Splints should be applied after a basic bandage is applied ( contact layer, cast padding) Then fixed to the limb with porous adhesive tape.
  • 10. Aluminium splint rods-they must be cut and bent to shape. Commercial plastic and metal splints-available in a variety of sizes and shapes. Thermomoldable plastic splinting material-Manually moulded to the conformation of the area Fiberglass casting tape- light, durable, and water resistant. Splint Cast
  • 12. BANDAGING LIMBS • Most common bandaging sites  To protect wound& to support broken leg  It extend down to toes to avoid twist/slip Adhesive tape stirrups are placed on the leg to secure the bandage. A sterile pad covers and protects the wound. Cotton padding is wrapped thickly around the leg. Gauze is applied over the cotton padding to compress and secure the bandage. The entire bandage is wrapped with Elastikon tape. 1. 2. 3. 4. 5.
  • 13. BANDAGING TAILS  After surgical repair or tumour removal  Apply final tape(stick directly to tail skin)over bandage Adhesive tape is wound spirally around the tail Wound dressing pad applied at the tail tip Padding material is wound in the direction of tail base Layer of elastic bandage is applied to secure the padding material 1. 2. 3. 4.
  • 15.  An Elizabethan collar is a stiff cardboard or plastic cone shaped structure that goes around the animal’s neck  If an eye needs to be bandaged, place the bandage over the head to include the affected eye. . An Elizabethan collar prevents an animal from scratching face injuries or biting other body injuries. Bandaging Eyes
  • 16. ). Bandaging Dog and Cat Torsos Bandages over the abdomen/chest - to protect surgical sites or to secure surgically placed structures (chest tubes & abdominal drains) Place torso bandages by applying rolled cotton around the chest or abdomen& covered with rolled gauze and secured with tape.
  • 17. Bandaging Birds BIRD’S LEG • Treat leg fracture with a splinted bandage (Tongue depressor/Schroeder-Thomas splint) BIRD’S WING • Temporary support of injuries & fractured bone in wings • Bandage wing separately from it’s body using gauze & tape • Some wing bandages incorporate splint
  • 18. Re-Dressing a Wound  When re-dressing a wound - important to know which primary bandage material best suits the wound’s stage of healing.  The primary layer of the bandage may vary,  Reapply a bandage with the same bandaging technique & bandaging principles used previously  Apply bandage without constriction, slippage & should be checked frequently .
  • 19. • Most of the bandages are applied as pressure bandages ( to prevent bleeding & swelling) • Don’t bandage unless absolutely necessary • A bandage placed too tightly will cut off the blood supply. A bandage placed too loosely(too much padding) may slip GENERAL RECOMMENDATIONS REGARDING BANDAGE CARE • The bandage should not get wet, covered with a water resistant sock. • If the animal suddenly starts licking or chewing, it should be changed • The interval of bandage change depends on the indications
  • 20. • Many bandages are padded with cotton wool or synthetic fibres-based on ease of use • Cotton loses elasticity once wet • Synthetic fibres(Artiflex)-poor absorber of wound fluid& cause irritation • Padding between toes prevent pressure sores Robert -Jones bandage-large amount of padding provide immobilization without compressing vascular supply Modified Robert-Jones bandage-less padding is used
  • 22. 1.Shoulder support bandage with splint Indications 1. Scapular fractures. 2. comminuted humerus fractures (during transport). 3. Immobilisation after certain shoulder operations. 4. Immobilisation of the elbow after repositioning of elbow luxation. 5. Following soft tissue surgery of wounds in the axillar region. Aftercare bandage that should be changed or removed 4 days to 3 weeks after application, depending on the indication and condition of the bandage
  • 23. In an anaesthetised dog, cotton padding is applied between the toes. padding is wound around the leg in proximal direction A wide roll of cotton wool or (Artiflex) is applied It ends behind the dog’s back, then passed around the neck. The elastic bandage is applied from distal to proximal. 1. 2. 3. 4. 5.
  • 24. For immobilisation of the limb, a splint (thermoplastic material)is added. The splint is fixed with an elastic bandage. This self-adhesive bandage is applied lengthwise. Adding strength to the entire bandage. 6. 7. 8. 9.
  • 25. 2.PADDED PRESSURE BANDAGE LOWER FRONT LIMB (INCLUDING THE CARPUS) Indications 1. Treatment of wounds/haemorrhages of the paw 2. Aftercare following surgery of the foot 3. Prevention of licking. Interdigital spaces are padded with cotton wool. Then, cotton wool is applied around the lower limb, including the carpus. . 1. 2.
  • 26. The padding is secured with hydrophilic gauze bandage The bandage may be finished by securing it with self-adhesive bandage. free edge of the gauze bandage is folded backwards, close the lower part of the bandage Then, elastic bandage material is used to secure the padding & to produce a pressure bandage. 3. 4. 5. 6.
  • 27. 3.ELASTIC SUPPORT BANDAGE, HIND LIMB (INCLUDING THE STIFLE) Indications 1. Prevention of postoperative oedema, both in the wound area (inflammatory oedema) and more peripheral (congestive oedema). 2. Treatment of peripheral oedema following trauma (femoral fracture) • Elastic bandages(Gazofix) is usually applied without padding to the (shaved) skin • The nails of the 3rd and 4th digit remain visible, to check for congestion • During application, the leg is held in a normal standing position The bandage is applied in such a way that:
  • 28. The elastic bandage is first wound around the lower limb, The bandage is applied from distal to proximal. Don’t constrict the Achilles tendon. The bandage is then wound in downward spirals, until the stifle is well covered. The elastic bandages acts as a support stocking, for an optimal venous return 1. 2. 3. 4.
  • 29. 4.PLASTER OF PARIS SPLINT BANDAGE (PLASTER CAST) Indications for a plaster cast 1. Extra-articular fractures distal to the proximal third of the radius or tibia. 2. Supported fractures, i.e. fracture of only the radius/ulna or of the tibia/fibula. 3. Fissure. Plaster cast in human patients-swellings are avoided by keeping the limb in a raised position, The plaster bandage in companion animals should be weight bearing Aftercare should be kept bone dry at all times. should be protected e.g. by a rubber cover. plaster splint should be checked daily. Fracture healing usually takes six to eight weeks.
  • 30. Advantages of applying the plaster in a semi-circular manner (front limb: applied to the back, hind limb: to the front) 1 .simultaneous immobilisation of the fracture- by the plaster & treatment of the soft tissue swelling -by the padded bandage. 2.The risk of congestion is less than with a circular application of the splint; 3. the splint is (lighter) causing less hindrance to locomotion without loss of stability 4. the splint is easy to change - in case of growth of the limb concerned, 5.It is also easy to remove while an oscillating saw is necessary for circular plaster casts.
  • 31. • Length of the splint is determined. • Care should be taken to stretch the elbow • Six of these lengths of plaster of Paris are folded on top of each other. • The edges are folded back lengthwise. creating a ridge in the centre of the splint, (for better positioning ). • The splint is folded, submersed in warm water and is smoothed out on a table top. • Care should be taken that the plaster does not dry out or break. • The layers are transposed as a whole and applied 1. 2. 3. 4.
  • 32. • Hydrophilic gauze is wound around the plaster (for exact shape of the palmar once hardened). • During the hardening phase limb should be kept still • Once the splint is hardened the gauze is removed. sharp edges or corners are removed • The splint bandage is finished using a layer of cotton wool. • padding are stabilised using elastic bandage material. 5. 6. 7. 8.
  • 33. EHMER SLING • used to prevent weight bearing of a hind limb and may be used after hip luxation • cause severe pressure sores, if placed incorrectly 1. Cotton wool is placed around the foot 2. A conforming bandage (eg;. K-band) is wrapped around the foot 3. The stifle is then flexed as far as possible
  • 34. 4.The k-band is passed medially (between the limb and the body) And out over the quadriceps muscle 5.The bandage passes round the back of the tibia to wrap around the metatarsals. 6.This should look like a figure-of-eight from the front of the patient 7.Finally, a layer of cohesive bandage is applied to provide further support
  • 35. VELPEAU SLING To prevent weight-bearing of fore limb (after scapular fracture/shoulder dislocation) 1.The carpus and paw are padded with cotton wool 2.The forelimb is flexed as close to the trunk as possible.
  • 36. 3.K band is wrapped around the carpus and brought up over shoulder 4.The bandage is continued round the body, passing behind the opposite elbow to wrap around the body, spreading tension evenly over the limb 5.A cohesive layer (Vetrap, petflex) applied to improve support
  • 37. Indications: • Same indications as Velpeau sling, but the elbow joint maintains full range of motion. • Cats tolerate carpal slings better than Velpeau slings Technique: 1. Flex the carpus and wrap cotton bandage around it 2. Maintain flexion with an elastic tape 3. Do not flex the carpus above 90 degrees Carpal sling
  • 38. Indications • Ventral hip luxation (after reposition), fractures of the plevic floor Technique 1. A self sticking tape is used 2. Enclose both distal tibiae in either a tape. 3. Stick the tapes together, so that the cat may walk, but straddling is prevented 4. Secure the sling with two pieces of tape placed on both medial aspects of the tibiae. Hobble sling
  • 39.  Discomfort  Lameness  gangrene in pressure areas  Secondary infections  Circulatory interference(congestion underneath the bandage)  Lead to swelling &peripheral area become cold(hair will fall out)  Parts of toe or footpads may slough off followed by necrosis COMPLICATIONS OF BANDAGING
  • 40. How can we prevent problems? • Training veterinary staff. • Educating clients about bandage aftercare Drip bag in place ~The toes should be adequately padded Doughnuts‘- used to protect from pressure sores. extra padding A Medipaw bandage cover provides brilliant protection
  • 41. PREVENTING BANDAGE MOLESTATION .. . Wire basket-type muzzles-keep a dog from molesting a bandage. It must be removed for eating Side braces - keep a dog away from its hind quarters.(can be fashioned from aluminium splint rods) Elizabethan collars - keep a dog’s head/mouth away from anything caudal to the device The care giver will have to take care of hygienic habits