1. Bandaging

2. Learning Objectives
Discuss indications for bandaging of wounds and describe the general structure of bandages
Describe common types of bandages, slings, splints, and casts used for small and large animals and provide indications for their use

3. Learning Objectives
Describe procedures for monitoring of animals with casts, bandages, splints, or slings
Discuss considerations for bandaging of abrasions, lacerations, puncture wounds, and degloving injuries
Describe classifications of burns and discuss management of burn patients

4. Bandaging Purpose Protection
To prevent simple fractures from becoming more complicated
Protection from licking, scratching, biting and any other forms of self mutilation
From infection or further contamination
Holding wound dressings and cold compresses in place
Immobilizes the wound and promotes healing

5. Bandaging Purpose Support To improve mobility To reduce pain and
swelling
Extra support for
internal fixation
of fractures

6. Bandaging Purpose Compression
- Compression bandages are a useful first aid measure to help arrest hemorrhage.
- Post operatively, bandaging is useful to prevent excess swelling; therefore reducing and preventing edema

7. Bandaging Purpose Immobilization
Of a fractured limb to prevent further trauma to damaged soft tissue
Of limb to aid speedy recovery of open wounds if near a joint, where excessive movement is undesirable
Of limb, if fracture repair is complicated and/or near the joint requiring complete rest
If internal fracture repair is not sufficient, and extra support in the form of a bandage is needed
Following manipulative procedures, after dislocated hips having been reduced

8. Bandaging Purpose Strapping/Securing To hold IV catheter in place
To keep limb extended for fluid lines and other such procedures
When necessary, to secure tail bandage to base of tail
To tape pinnae together above dogs head, for ear or head bandage

9. Bandages – Wound Healing
Promotion of Wound Healing by:
Protecting the wound from additional trauma and contamination
Preventing wound dessication (drying up)
Preventing hematoma and seroma formation
Immobilizing the wound to prevent cellular and capillary disruption

10. Bandages – Wound Healing
Minimize post-op edema around incision
Absorbs wound exudate and lifts away foreign material & loose tissue as bandage is removed
Promotes an acid environment
Keeping wound warm

11. Important Points to Remember
The bandage must serve the purpose for which it was intended
The bandage must be applied firmly, but not so tightly that circulation is impaired
It must be as comfortable as possible for the patient.
It must look professional – take pride in its appearance

12. Bandage Layers Primary (contact layer)
Is the first layer and it is in direct contact with the skin or wound
Telfa Pads Gauze Sponges
Open wounds should have a sterile primary layer

13. Primary Layer: Functions
Debridement Deliver medication Transmit exudate to 2nd layer Seal wound

14. Primary Layer – Adherent
An adherent primary layer promotes debridement in the inflammatory stage
Uses a wide mesh material (sterile gauze), allowing tissue to become incorporated into the bandage. This tissue is then removed with the bandage change
Not highly recommended due to unselective debridement and damage during the proliferative (repair) stage of wound healing
Painful to remove
Must be changed daily
Bacterial proliferation and strike-through = disadvantages with wet/dry primary layer

15. Types of Adherent Primary Layers
Dry-to-dry
Used when loose, necrotic tissue is evident.
Absorbs exudate, necrotic tissue, and foreign material.
Debris adheres to dry, sterile gauze and is removed with bandage change
Wet-to-dry
Used for wounds with dried or semi-dry exudates
Gauze is soaked in saline or chlorhexadine and applied wet
Loosens material from the wound by rehydration
As it dries, exudate is pulled into the material and away from the wound

16. Adherent Primary Layers (cont’d)
Wet-to-wet
Used on wounds with large amounts of exudates and transudates
Material covering the wound is kept moist, sometimes by injection of fluid into the bandage
Absorbs fluid easily
Can be used to heat wound, increasing capillary action and drainage of wound
Removed wet (less pain)
Disadvantage: little wound debridement because of decreased adhesion to necrotic tissue

17. Primary - Nonadherent
Moist wound care is the most important management principle
A nonadherent bandage is usually a fine mesh, nonstick material. This layer promotes moisture retention and epithelialization with minimal disruption of granulation bed.
Moist wound care enhances natural debridement within the wound by drawing the exudate form the wound and allowing the wound to bathe in this cytokine-rich material
Involves the uses of nonadherent primary bandage layers that act to keep the wound surface moist
Moist wound care results in less inflammation and less wound disruption
Either occlusive or semiocclusive

18. Semiocclusive Primary - Nonadherent
Allows air and moisture to move through the dressing
Keeps wound moist yet draws exudate and debris form the wound
Indicated for moderate to copious exudate
Must be changed frequently (Every 1 – 3 days, depending on exudate production)

19. Primary – Nonadherent Semiocclusive
Hydrogel
Hydrocolloid
Hydrophilic
Polyurethane film
Hydrophilic colloids
(Refer to p of CTVT text)

20. Primary - Nonadherent Occlusive Impermeable to moisture
Allows some air transfer
Indicated for minimal exudate
Promotes epithelialization
Changed infrequently (every 4-7 days)
Can be used as a protective layer for new epithelium preventing desiccation and abrasion of the fragile tissue.
Some products adhere to skin (hydrophilic or non-hydrophilic)

21. Bandage Layers Secondary
Covers the primary layer and supports the wound
Purpose is to be able to absorb and store fluids from the wound
Materials that can be used for this layer are cast padding or cotton roll. This layer should not be applied with excessive pressure but snug enough to keep the primary layer in

22. Usually consists of two layers
Bandage Layers
Tertiary layer
This is the holding and protective layer that holds the bandage in place
Usually consists of two layers
Vet Wrap
Elastakon
Cling gauze

23. Tertiary Layer Should be nonocclusive to allow air transfer
Strike-through = outer layer becomes wet, allowing moisture (and bacteria) to wick through the rest of the bandage
MUST CHANGE IMMEDIATELY!
Occlusive = contraindicated (traps excessive moisture leading to tissue maceration)

24. Technician Note
The middle two toes of a bandaged limb should always be exposed to allow for assessment of color, warmth, and swelling