Bandaging Principles and Techniques.ppt

1、Bandaging Principles and Techniques,By Catherine Briere, DVM,(VMED 5260),Lecture Objectives,Review bandage layers Functions and indications for specific bandages General bandage care Complications,General Functions,Aid in wound healing Prevent open wound contamination Wound debridement Maintain mois

2、t wound environment Support or protect deeper body parts Pressure Prevent/reduce swelling or hemorrhage Prevent weight bearing Immobilization of tissues Often serve multiple functions,Every wound deserves a bandage, a real bandage, a real bandage,General Functions,Aid in wound healing Prevent open w

3、ound contamination Wound debridement Maintain moist wound environment Support or protect deeper body parts Pressure Prevent/reduce swelling or hemorrhage Prevent weight bearing Immobilization of tissues Often serve multiple functions,Immobilization,General Functions,Aid in wound healing Prevent open

4、 wound contamination Wound debridement Maintain moist wound environment Support or protect deeper body parts Pressure Prevent/reduce swelling or hemorrhage Prevent weight bearing Immobilization of tissues Often serve multiple functions,Bandage Layers,Primary Layer In direct contact with skin or woun

5、d Choice of material dictated by Presence / absence of wound Stage of wound healing Amount exudate Necrosis/infection,Bandage Layers,Primary Layer Functions: Debridement Deliver medication Transmit exudate to 2nd layer Seal wound,Bandage Layers,Secondary Layer Functions: Absorption of wound exudate

6、/ fluid Support Compression,Bandage Layers,Tertiary Layer Functions: Protects from environment Holds bandage in place Immobilizes,Bandage Layers,Tertiary Layer Functions: Protects from environment Holds bandage in place Immobilizes,General Principles,Improperly placed bandages can be very harmful! T

7、oo loose will not help; Too tight will harm Avoid circumferential tape When placing bandage, remember: Daily care necessary Weekly change mandatory,Bandage Types,Modified Robert Jones* Robert Jones Splints* Spica Splint Schroeder - Thomas Splint Casts Ehmer Sling Robinson Sling Velpeau Sling,Modifie

8、d Robert Jones,Very common bandage Forelimb or hindlimb Numerous indications Protect incision or wound Provide support (minimal) Prevent / reduce swelling,Modified Robert Jones,Tips Always work distal to proximal Maintain constant pressure 50 % overlap Place the limb in functional position Avoid wri

9、nkles Visualization of middle toes,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,Modified Robert Jones,Layers Stirrups,Modified Robert Jones,Layers Stirrups Primary l

10、ayer (if required),Modified Robert Jones,Layers Stirrups Primary layer (if required) Cast padding,Modified Robert Jones,Layers Stirrups Primary layer (if required) Cast padding Rolled gauze,Modified Robert Jones,Layers Stirrups Primary layer (if required) Cast padding Rolled gauze,Modified Robert Jo

11、nes,Modified Robert Jones,Layers Stirrups Primary layer (if required) Cast padding Rolled gauze Vetrap,Modified Robert Jones,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

12、toes,Robert Jones,Indications Distal limb fractures Compression Temporary immobilization and support Not used as much as used to be,Robert Jones,Layers: Primary layer (if needed) Large amounts of roll cotton Rolled gauze applied tightly Vetrap,Robert Jones,Robert Jones,Splints,Preformed Plastic Alum

13、inum Designed to be applied in a specific position on the limb: Forelimb caudal lateral Hindlimb lateral,Splints,Preformed Plastic Aluminum Designed to be applied in a specific position on the limb: Forelimb caudal lateral Hindlimb lateral,Splints,Molded Water activated fiberglass Thermolabile plast

14、ic Can be perfectly fitted and adapted to specific situation,Preformed Plastic Aluminum Designed to be applied in a specific position on the limb: Forelimb caudal lateral Hindlimb lateral,Molded Lateral Splint,Splints,Indications Provide additional stability to fracture repair Post carpal / tarsal a

15、rthrodesis Support after cast or ESF removal Protect soft tissue repairs of the distal limbs,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,Splints,Application Splint must ex

16、tend well beyond area to support Padding must extend beyond splint,What is wrong with this splint?,What is wrong with this splint?,Spica Splint,Used for stabilization of the humerus and femur Splint applied laterally extending over the shoulder or hip Not adequate for most fractures,Schroeder - Thom

17、as Splint,Properly applied can maintain traction on distal limb fractures Indications Fractures below the elbow or stifle Immobilization of elbow, carpus, stifle and tarsus,Schroeder - Thomas Splint,Casts,Indications Case selection is of prime importance! Rare, non-displaced, simple transverse fract

18、ures below elbow or stifle Owner compliance is mandatory! Proper care at home Regular examination by veterinarian,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,Casts,S

19、pecial bandages,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,Ehmer Sling,Ehmer Sling,Ehmer Sling,Robinson Sling,Used to prevent weight bearing on hindlimb A

20、llows some range of motion of tarsus and stifle,Velpeau Sling,Non-weight bearing sling for the forelimb Indications: Immobilization following shoulder surgery Scapular fractures Following reduction of shoulder luxation,Bandage Care,Close observation and care is critical Change as often as necessary

21、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 This sounds like exam material,Bandage Care,Close observation and care is critical Change as often as necessary Kee

22、p 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,Immediately if: - Strike through - Soiled - Wet - Malodorous - Bandage is causing pressure sore - Vascular compromize - Any

23、doubt At least weekly As often as necessary for wound care,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

24、indicate a problem,Complications,Bandaging of a body part can result in: Ineffective treatment Vascular compromise Dermatitis Skin and soft tissue necrosis Loss of range of motion,Complications,Complications,Bandaging of a body part can result in: Ineffective treatment Vascular compromise Dermatitis Skin and soft tissue necrosis Loss of range of motion,Complicati