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. BANDAGING PRINCIPLES AND TECHNIQUES DR. SATYAJEET SINGH DEPARTMENT OF VETERINARY SURGERY AND RADIOLOGY
- 2. LECTURE OBJECTIVES • Review bandage layers • Functions and indications for specific bandages • General bandage care • Complications
- 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
- 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
- 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. 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. BANDAGE LAYERS Primary Layer Functions: • Debridement • Deliver medication • Transmit exudate to 2nd layer • Seal wound
- 12. BANDAGE LAYERS Secondary Layer Functions: • Absorption of wound exudate / fluid • Support • Compression
- 13. BANDAGE LAYERS Tertiary Layer Functions: • Protects from environment • Holds bandage in place • Immobilizes
- 14. BANDAGE LAYERS Tertiary Layer Functions: • Protects from environment • Holds bandage in place • Immobilizes
- 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. BANDAGE TYPES • Modified Robert Jones*** • Robert Jones • Splints*** • Spica Splint • Schroeder - Thomas Splint • Casts • Ehmer Sling • Robinson Sling • Velpeau Sling
- 17. MODIFIED ROBERT JONES • Very common bandage • Forelimb or hindlimb • Numerous indications • Protect incision or wound • Provide support (minimal) • Prevent / reduce swelling
- 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. 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. MODIFIED ROBERT JONES Layers • Stirrups
- 21. MODIFIED ROBERT JONES Layers • Stirrups • Primary layer (if required)
- 22. MODIFIED ROBERT JONES Layers • Stirrups • Primary layer (if required) • Cast padding
- 23. MODIFIED ROBERT JONES Layers • Stirrups • Primary layer (if required) • Cast padding • Rolled gauze
- 24. MODIFIED ROBERT JONES Layers • Stirrups • Primary layer (if required) • Cast padding • Rolled gauze
- 26. MODIFIED ROBERT JONES Layers • Stirrups • Primary layer (if required) • Cast padding • Rolled gauze • Vetrap®
- 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. ROBERT JONES Indications • Distal limb fractures • Compression • Temporary immobilization and support Not used as much as used to be
- 30. ROBERT JONES Layers: • Primary layer (if needed) • Large amounts of roll cotton • Rolled gauze applied tightly • Vetrap®
- 31. ROBERT JONES
- 32. ROBERT JONES
- 33. SPLINTS • Preformed •Plastic •Aluminum Designed to be applied in a specific position on the limb: •Forelimb → caudal lateral •Hindlimb → lateral
- 34. SPLINTS • Preformed •Plastic •Aluminum Designed to be applied in a specific position on the limb: •Forelimb → caudal lateral •Hindlimb → lateral
- 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
- 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. 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. SPLINTS Application • Splint must extend well beyond area to support • Padding must extend beyond splint
- 40. WHAT IS WRONG WITH THIS SPLINT?
- 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. 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
- 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. 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. CASTS
- 48. SPECIAL BANDAGES
- 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. EHMER SLING
- 51. EHMER SLING
- 52. EHMER SLING
- 53. ROBINSON SLING • Used to prevent weight bearing on hindlimb • Allows some range of motion of tarsus and stifle
- 54. VELPEAU SLING • Non-weight bearing sling for the forelimb • Indications: • Immobilization following shoulder surgery • Scapular fractures • Following reduction of shoulder luxation
- 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. 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. 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. 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. COMPLICATIONS
- 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. 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. COMPLICATIONS
- 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. COMPLICATIONS
- 65. COMPLICATIONS
- 66. COMPLICATIONS
- 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. SUMMARY • Bandages can be very harmful!!! • When placing a bandage, remember: • Daily care necessary • Weekly change mandatory
- 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. QUESTIONS???