Sa Tech Lab 4 - Bandaging

Front 1

what are 6 things from which bandages protect wounds?

Back 1

1. contamination
2. self-mutilation
3. desiccation
4. external trauma
5. heat
6. contact irritation

Front 2

what are 5 basic functions of bandages?

Back 2

1. protection
2. comfort
3. support
4. limit movement
5. aid in wound healing

Front 3

what are four ways in which bandages aid in wound healing?

Back 3

1. pressure to obliterate dead space
2. pressure to reduce edema and hemorrhage
3. absorb wound drainage
4. promote epithelialization and wound contraction

Front 4

what are five functions of the primary bandage layer?

Back 4

1. touch wound surface
2. debridement
3. medicate
4. transmit exudate
5. form an occlusive seal

Front 5

what are two parameters of a primary bandage layer?

Back 5

1. adherent or non-adherent
2. occlusive or semi-occlusive

Front 6

wet-dry bandage:
- degree of debridement
- dynamics of moisture
- what is it meant to remove?

Back 6

- good debridement
- wicking action
- absorb necrotic debris

Front 7

what can happen if a bandage is placed too wet? (2)

Back 7

- tissue maceration
- bacterial contamination

Front 8

wet-wet bandage:
- degree of debridement
- dynamics of moisture
- what is it meant to remove?

Back 8

- very little debridement
- moist environment maintained
- removes viscous exudates

Front 9

dry-dry bandage:
- what is it meant to remove?

Back 9

- removes large volumes of low-viscosity exudates and loose necrotic tissue

Front 10

a non-adherent primary layer:
- type of material
- when is applied to a wound?
- what is it meant to do?
- what type of interface is it meant to form between bandage and wound?

Back 10

- dry or petrolatum based
- applied after formation of granulation tissue
- retains moisture, prevents desiccation, and promotes epithelialization
- meant to create a hydrophilic environment for wound healing

Front 11

semi-occlusive versus occlusive bandage primary layer:
- permeability
- what type of wounds?

Back 11

- semi-occlusive: air-permeable; for exudative wounds
- occlusive: air and fluid impermeable; for less-exudative wounds (keeps tissues moist)

Front 12

what are the functions of a secondary bandage layer? (4)

Back 12

- absorb and store bad stuff away from wound surface
- has capillarity to absorption and fluid collection
- protects from trauma and helps to immobilize the wound
- holds contact layer against wound

Front 13

what are the functions of a tertiary bandage layer?

Back 13

- holds other layers in place
- protects bandage

Front 14

what are three functions of a coaptation bandage?

Back 14

- help stabilize fractures or luxations
- reduce postoperative swelling
- help to protect wounds

Front 15

what are the three basic functional layers of a coaptation bandage?

Back 15

1. padding layer (inner-most)
2. pressure layer (middle)
3. protective (outer-most)

Front 16

what materials in a are commonly used in a coaptation bandage
- padding layer?
- pressure layer?
- protective layer?

Back 16

- padding layer: cotton, cast padding, ± dressing
- pressure layer: elastic roll gauze, conforming gauze
- protective layer: Vetrap, Elasticon, porous white tape

Front 17

coaptation bandage:
- degree of weight bearing and stability
- what property of the bandage determines what it is used for?

Back 17

- designed to be protective and permit weight-bearing, but provides only limited stability
- function is determined by the number of alternate layers of padding and gauze

Front 18

what is the purpose of a coaptation bandage that is
- thinner?
- middle-range?
- thick?

Back 18

- thinner: prevent contamination or self-mutilation
- middle-range: control or reduce swelling
- thick: temporarily immobilize fractures or luxations until definitive repair can be attempted

Front 19

when is a coaptation bandage indicated to temporarily immobilize fractures or luxations?

Back 19

injuries below the elbow or stifle

Front 20

bandage stirrups
- where are they applied?
- how long do they extend off of the limb?
- what is their function?

Back 20

- they are applied medial and lateral (or dorsal and palmar/plantar) of the skin that will be bandaged
- they should extend 8-10 cm off of the distal portion of the limb
- they help prevent the bandage from slipping off once it has been applied

Front 21

what is used to prevent pressure sores in a bandage?

Back 21

donuts

Front 22

in a coaptation bandage, how much overlap when wrapping?

Back 22

50%, so that one pass = two layers of material

Front 23

what is the purpose of a modified Robert-Jones bandage?

Back 23

Used for injuries distal to the elbow or stifle, it is indicated when light compression is needed to reduce soft-tissue swelling but is not advised for any injuries that require rigid stability. It is most often used to minimize postoperative swelling or provide temporary (minimal) stability to a limb before surgery.

Front 24

what are three indications for a modified Robert-Jones bandage?

Back 24

1. management of superficial injuries that do not need much stabilizing, such as open wounds, primary or delayed wound closures, and surgical incisions
2. minimize swelling of traumatized limbs
3. absorb exudate and protect, debride, and medicate underlying wounds

Front 25

in a modified Robert-Jones bandage, how much overlap when wrapping?

Back 25

50%, so that one pass = two layers of material

Front 26

how do you apply a modified Robert-Jones bandage?

Back 26

- apply stirrups on the medial and lateral aspects of the distal limb, extending 8-10 cm beyond the digits
- place donuts if needed
-A cast padding layer is applied distal to proximal with about 50% overlap wrapping cranially to caudally around the medial aspect of the limb and caudally to cranially around the lateral aspect (to minimize external rotation - supination)
- repeat down the leg
- continue until the desired number of layers (note 1 pass = 2 layers)
- with assistant maintaining the limb, wrap conforming gauze snugly in the same manner as the cast padding
- reflect stirrups proximally under some tension ± adhesive tape to hold them in place
- apply Vetrap
- note, distal P3 and P4 should protrude from the bandage

Front 27

how many layers are typically used in a modified Robert-Jones bandage?

Back 27

6 to 10 (note one pass from distal → proximal → distal is 2 layers)

Front 28

what is the main difference in construction between a Robert-Jones bandage and a modified Robert-Jones bandage?

Back 28

a Robert Jones bandage uses a much thicker padding layer

Front 29

Robert-Jones bandage
- how much of the limb do you use?
- major indication for use and advantages

Back 29

- bandage the entire limb
- temporary stabilization of fractures; adds stability for patient comfort; prevents more soft tissue damage from bone fragments

Front 30

what type of fractures can you use a Robert-Jones bandage as the primary fixation?

Back 30

none

Front 31

a Robert-Jones bandage is used on what type of injuries?

Back 31

fractures or dislocations at or distal to the elbow / stifle

Front 32

what are the basic constituents of a Robert-Jones bandage?

Back 32

thick cotton roll, then gauze, and repeat

Front 33

what are 3 indications for spoon splint bandages?

Back 33

1. provide support to injuries of the distal forelimb (e.g., carpal arthrodesis, distal radius/ulna fractures, ulnar ostectomy)
2. provide support to injuries of the tarsus, metatarsus, and phalanges of the hind limb
3. ancillary support to internal fixation devices of the distal forelimb / distal to the tarsus

Front 34

spoon splints:
- what materials are they made from?
- where are they best used?
- what is their function?

Back 34

- plastic or aluminum
- used to protect injuries distal to the mid-radius area
- provide rigid caudal support that allows weight-bearing without significant stress to the limb below the elbow

Front 35

how do you apply a spoon splint bandage?
- before the splint
- splint
- where should the "cup" extend?
- where proximal should the splint end
- what do you do with the padded bandage if the middle digits and pads are injured?

Back 35

- The first three layers, including the stirrups and padding and gauze layers, are applied identical to those of the modified Robert-Jones bandage.
- The splint is placed on the caudal aspect of the bandaged limb.
- The closed “cup” end extends distally, past the paw. This will contact the ground during weight bearing.
- Proximally the splint must not extend past the end of the olecranon.
- If needed, the splints can be cut to the appropriate length.
- The padded bandage underlying a spoon splint may be applied with digits three and four exposed. If the digits or pads are injured, the entire paw can be enclosed providing that the compressive layer is not applied too tightly, since the digits cannot be examined for evidence of swelling.

Front 36

what are two indications for a carpal sling (carpal flexion bandage)?

Back 36

1. for stable forelimb injuries that would benefit from non-weight bearing motion (elbow and shoulder freely moveable) - for example, fractures of the radius, ulna, and humerus
2. immobilization of the carpus after repair of flexor tendon injury

Front 37

how do you apply a carpal sling (carpal flexion bandage)?

Back 37

- One or 2 layers of cast padding and a layer of conforming gauze are applied to the distal radius and metacarpals down to the digit pads.
- White adhesive tape is applied with little to no tension over the padding circumferentially around the metacarpals.
- The carpus is held partially flexed while the tape is wrapped in a figure-of-8 fashion around the distal radius and back to the metacarpals.
- The first figure-of-8 is placed closest to the flexed carpal joint and the subsequent figures-of-8 are each placed further and further away from the joint towards the foot / elbow.

Front 38

in a carpal sling (carpal flexion bandage):
- what can cause swelling of the paw?
- what is a potentially severe complication of this bandage

Back 38

- Swelling of the paw can occur if the tape is applied too tightly or if the carpus is forced into maximum flexion. The distal aspect of the third and fourth digits must remain exposed to allow monitoring for swelling.
- permanent contracture of the carpus is possible. This can be avoided by allowing limited extension within 2 to 4 weeks after surgery by lengthening the 1-inch tape loops to enable partial extension.

Front 39

what are three functions of a Velpeau sling?

Back 39

1. keeps forelimb off of the ground
2. keeps scapula against the side of thorax
3. keeps forelimb adducted

Front 40

what bandage is indicated for a medial shoulder injury/repair?

Back 40

Velpeau sling

Front 41

what bandage is indicated for a lateral shoulder injury/repair?

Back 41

Spica splint

Front 42

what are three indications for a Velpeau sling?

Back 42

1. immobilization of shoulder after luxations
2. immobilization for minimally displaced scapular fractures and proximal humeral fractures
3. to prevent an animal from using the forelimb (e.g. protect tenuous fracture repair)

Front 43

what are three functions of a Spica splint?

Back 43

1. immobilize the hip or shoulder, as well as the distal limb
2. temporary immobilization of humeral or femoral fractures or to support repair
3. elbow immobilization - reduction of elbow luxation

Front 44

how do you apply a Velpeau sling?

Back 44

1. place 2-3 layers of cast padding circumferentially around the torso while the limb is held partially flexed and adducted against the cranial aspect of the ventrolateral chest wall
- avoid patient discomfort by not fully flexing the shoulder/elbow
- the padding should be placed in front of and behind the opposite limb
2. 2-3 layers of conforming gauze are applied over the padding in the same configuration
3. a final 1-2 layers of adhesive or non-adhesive elastic wrap is applied over the gauze

Front 45

what are three indications for use of a Spica splint?

Back 45

1. additional support following humeral or femoral fracture repair
2. stabilize closed reduction of traumatic lateral shoulder luxation
3. keep elbow in extension following reduction of elbow luxation

Front 46

what are 3 functions of an Ehmer sling?

Back 46

1. prevents weight bearing in the pelvic limb
2. maintains hock and stifle in partial flexion
3. keeps coxofemoral joint internally rotated and abducted, thus keeping the femoral head beneath the dorsal acetabular rim and in the acetabulum

Front 47

what are 3 indications for an Ehmer sling?

Back 47

1. remove stress from any structures between the hip and foot
2. most commonly used to support closed or open reduction of craniodorsal hip luxations
3. prevent weight-bearing after repair of acetabular and femoral fractures

Front 48

an Ehmer sling maintains reduction of the coxofemoral joint by what three forces?

Back 48

1. internal rotation
2. flexion
3. aBDuction

Front 49

how do you apply an Ehmer sling?

Back 49

1. 1-2 layers of cast padding placed around the metatarsus
2. elastic adhesive tape is adhered to itself in a loop around the metatarsus with the non-stick surface against the padding on the metatarsus
3. the tape is passed proximally and medial to the stifle with the hock and stifle partially flexed and the adhesive side of the tape away from the sling
4. the tape is brought over the thigh, as far as possible, and is passed distally over the limb's lateral aspect, back toward the metatarsal loop passing medial to the hock/tibia
5. this layer is continued plantar to the metatarsus so the adhesive surface sticks to the previous layer
6. the tape is passed medial to lateral over the thigh again with the two adhesive surfaces stuck together, and is again directed caudodistal medial to the tibia and tarsus
7. the tape is passed laterally over the plantar aspect of the metatarsus
8. after the last layer of tape if passed under the metatarsus it is then directed cranioproximally on the lateral aspect of the leg with significant tension and is incorporated into a caudal abdominal belly band constructed of adhesive tape
9. additional strips of tape, connecting metatarsus to torso, may be needed to support the limb as desired

Front 50

why can an Ehmer sling be problematic for male patients?

Back 50

because the portion that encircles the body is cranial to the prepuce and can become soiled by urine and cause skin irritation

Front 51

how long do you usually keep an Ehmer sling on?

Back 51

10-14 days

Front 52

what are three limitations of the Ehmer sling?

Back 52

1. males - prepuce → urine scald
2. swelling of the toes
3. skin irritation

Front 53

what are three fractures where casts can provide adequate fracture reduction?

Back 53

1. below the elbow or stifle
2. greenstick fracture
3. minimally displaced spiral fractures

Front 54

what are five disadvantages to plaster casting material?

Back 54

1. relatively weak
2. slow to dry
3. messy to apply
4. weakens when wet
5. radioopaque

Front 55

what are three types of synthetic casting materials?

Back 55

1. polyester-cotton
2. fiberglass
3. thermolabile plastic