Bandaging and Fracture Repair (VET2210) PDF

Bandage and Fracture Care VET2210 Common Types of Fractures ▶ Closed Fractures ▶ Compound Fractures ▶ Epiphyseal Fractures ▶ Greenstick Fractures Common Types of Fractures ▶ Simple ▶ Comminuted Types of Wound Healing FIRST INTENTION (primary) healing ▶ Internal fixation (ex. Pins/p...

Bandage and Fracture Care VET2210 Common Types of Fractures ▶ Closed Fractures ▶ Compound Fractures ▶ Epiphyseal Fractures ▶ Greenstick Fractures Common Types of Fractures ▶ Simple ▶ Comminuted Types of Wound Healing FIRST INTENTION (primary) healing ▶ Internal fixation (ex. Pins/plates) of fractures SECOND INTENTION healing ▶ Fractures heal thru callus formation—no internal fixation  Principles of Bandage Application 1. Properly prepare the area before application of a bandage 2. Use porous materials where applicable 3. Use ABSORBENT materials when exudates could be a problem 4. Use appropriate materials of adequate width 5. Apply materials as SMOOTHLY as possible 6. Secure protective wound pads to the skin 7. Check bandages frequently 8. Instruct clients on basic bandage care and signs of bandage failure. Bandage Components PRIMARY Layer ▶ In CONTACT with the wound ▶ Should be ▶ Sterile ▶ Allow fluid to pass to the secondary layer ▶ Protect from  Bandage Components Dry-To-Dry Dressing: Use with loose necrotic tissue or foreign material dry gauze is placed on the wound with the second layer being an absorbent layer fluid is allowed to dry and then the bandage is removed ▶ Painful - should sedate for removal!  Bandage Components Wet-To-Dry Dressing: Use with viscous exudate or if dried foreign material must be removed bandage is applied wet and allowed to dry before bandage removal Wet-To-Wet Dressing: Can transport heat to the wound and/or enhance capillary action. Applied wet and stays wet. Cause less pain when removed Bandage Components Examples of dressing material ▶ Adherent: ▶ Gauze, Non Cotton filler ▶ Nonadherent: ▶ Adaptic, Release, Telpha pads Bandage Components SECONDARY Layer ▶ Provides support ▶ Moves exudate AWAY from the wound ▶ Should be: thick enough to absorb moisture, pad the wound from trauma, and inhibit wound movement Bandage Components TERTIARY Layer ▶ OUTER layer that holds underlying bandage layers in place ▶ Porous adhesive : allows evaporation of fluid, but can allow fluid (ex. Saliva) into the wound ▶ Elastic adhesive: applies continuous dynamic pressure as the patient moves Types of Bandages Robert Jones Bandage ▶ Temporarily immobilize FRACTURES; DISTAL to the elbow or stifle ▶ Support injured soft and bony tissue ▶ Prevent excessive swelling ▶ Not appropriate for fractures of the FEMUR or the HUMERUS  Types of Bandages ▶ Robert Jones Bandage Technique cont ▶ Wrap the cotton as tightly as possible avoiding wrinkling/twisting ▶ Wrap the cotton with Kling gauze as tightly as possible and press the tape stirrups to the side of the bandage ▶ Apply self-adherent elastic tape or vet-wrap type material from the toes upward ▶ **In horses, stirrups are not used, be sure to start the bandage on the inside of the leg (starting in the Robert Jones Bandage Types of Bandages Modified Robert Jones Bandage ▶ Less bulky because you only use padding and is used to reduce postoperative swelling of limbs Modified Robert Jones Types of Bandages EHMER Sling ▶ Used after reduction of HIP LUXATION ▶ It keeps the femoral head deeply seated within the acetabulum  Types of Bandages ▶ Ehmer Sling Technique ▶ Wrap cast padding around the metatarsal area then cover it with elastic adherent tape ▶ Manually flex the stifle and keep the femur rotated slightly inward ▶ Continue the elastic tape from the metatarsal region to the stifle then to the hock creating a figure 8 pattern—cover the limb completely ▶ Abduct the limb by passing the elastic tape dorsally over the back and around the body, incorporating the knee into the wrap ▶ Monitor for swelling Ehmer Sling Types of Bandages VELPEAU Sling ▶ Prevents weight bearing on the forelimb ▶ Indicated for SCAPULAR fractures, and SHOULDER dislocations ▶ Should not be used if the patient has internal or external thoracic trauma or disease  Types of Bandages ▶ Velpeau Sling Technique ▶ Flex the carpus and metacarpus to a comfortable position and wrap ▶ Flex the antebrachium across the cranial chest wall with paw pointing toward the opposite scapulohumeral joint ▶ Apply additional wraps around the chest and flexed limb Velpeau Sling Types of Bandages Casts ▶ Provides support for fractures ▶ Materials include fiberglass casting material, and plaster casting ▶ General anesthesia is required ▶ The skin should be clean and dry ▶ Cast padding should only be used at pressure points and is not used in equine and bovine  Types of Bandages ▶ Casts cont. ▶ The cast should immobilize the joints PROXIMAL and DISTAL to the lesion ▶ Assistants should: use the flat portion of the hand to support the limb during application ▶ Examine every 6 - 8 hrs during the 1st day after application Cast Placement  Bandage Removal ▶ Outer layer with scissors ▶ Tear cotton:(distal to proximal) on lateral aspect of extremity ▶ Casts removed with an oscillating saw (Stryker) ▶ Splints can be removed  Home Care of Bandages Client education is essential ▶ TOES should be monitored daily for: warmth, swelling, and color ▶ Also monitor for FOUL ODORS and chafing areas ▶ No chewing at the bandage ▶ Should be protected when outside ▶ Never leave a plastic cover on more than 30 mins