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2025 - Intro to Surgery 737A > Exam 2: Lecture 13: Bandaging and Bandaging Techniques > Flashcards

Exam 2: Lecture 13: Bandaging and Bandaging Techniques Flashcards

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1
Q

What are the goals of bandages?

A

-Protects wound
-Speeds wound healing

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2
Q

What can happen with complications of bandages?

A

-Complications can result in limb amputation or kill your patient

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3
Q

What are the good things bandages can do?

A

-Provide wound cleanliness
-Control wound environment
-Reduce edema & hemorrhage
-Eliminate dead space
-Immobilize injured tissue
-Minimize scar tissue
-Make patient more comfortable

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4
Q

What are complications with bandages?

A

-Patient discomfort
-Patient mutilation of bandage & wound
-Bacterial colonization of wound
-Ischemic injury
-Damage to healing tissues
-Become GI foreign body obstruction

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5
Q

What is another name for soft padded bandage?

A

-Modified Robert Jones

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6
Q

What does the Modified Robert Jones bandage do?

A

-Imobilizes limb
-Decreases/limits soft tissue swelling
-Absorbs wound exudate
-Add splint material
Fracture MUST be below the elbow/stifle

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7
Q

What are the 3 basic layers of a bandage?

A
  1. Primary (contact layer)
  2. Secondary (intermediate layer)
  3. Tertiary (outer layer)
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8
Q

What are the functions of the primary layer of the bandage?

A

-Debrides tissue
-Delivers medication
-Transfers wound exudate
-Forms an occlusive seal
-Minimizes pain
-Prevents excessive loss of body fluids

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9
Q

What layer of bandage is shown?

A

-Primary layer

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10
Q

What are the functions of the secondary layer of the bandage?

A

-Absorbs & stores deleterious agents
-Retards (delays or holds back) bacterial growth
-Pads wound from trauma
-Splints wound to prevent movement
-Holds primary bandage layer in place

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11
Q

What layer of the bandage is shown here?

A

-Secondary layer

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12
Q

What are the functions of the tertiary layer of bandages?

A

-Holds the other bandage layers in place
-Protects against external bacterial colonization
-Cosmesis

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13
Q

What layer of bandage is shown?

A

-Tertiary layer

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14
Q

What are the types of primary layers?

A

-Adherent
-Nonadherent
-Occlusive
-Semi-occlusive

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15
Q

The primary/contact layer of bandage is chosen based on

A

-Phase of wound healing
-Amount of exudate
-Wound location & depth
-Presence of absence of eschar
-Amount of necrosis or infection

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16
Q

When would we use adherent type primary bandage layers and how to use it?

A

-Used when wound debridement required
-May be wet or dry

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17
Q

When would we use nonadherent type primary bandage layers and what does it do?

A

-During repair phase or if no necrotic debris
-Retains moisture to promote epithelialization & prevent dehydration
-Drains excess fluid & prevents maceration

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18
Q

What is the occlusive type of primary bandage layer?

A

-Impermeable to air
-Use on nonexudative wounds to keep moist
-Speeds rate & quality of healing compared to dressings allowing desiccation
-Use in partial thickness wounds w/out necrosis or infection

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19
Q

What is the semi-occlusive type of primary bandage layer?

A

-Allows air to penetrate
-Allows exudate to escape

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20
Q

What is the most commonly used primary layer?

A

-Semi-occlusive

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21
Q

What are the steps for applying a soft padded bandage?

A
  1. Tape stirrups
  2. Primary layer
  3. Secondary layer
  4. Tertiary layer
  5. Labeling
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22
Q

How should tape stirrups be applied?

A

-Distal 1/3 of limb
-Medial & lateral or dorsal & palmar/plantar
-Tabbed ends or tongue depressor to help separation

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23
Q

When doing a modified robert jones bandage (aka a soft padded bandage) what is a good tip for toes?

A

Place cotton between toes:
-Decreases moisture build-up
-Increases patient comfort
-Don’t forget dewclaw

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24
Q

What are characteristics when applying the primary layer of the bandage?

A

-Contact layer
-Nonadherent
-+/- medication
-Usually sterile
-Wicking

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25
What are the characteristics when applying the second layer of the bandage?
-Intermediate layer -Absorbent -Supportive -+/- Rigid support -Applied toes up, overlapping, firm even pressure
26
How do you apply the second layer of bandage?
-Separate tape stirrups -Rotate stirrups proximally while twisting 180 degrees -Secure stirrups to underlying wrap
27
What purpose do tape stirrups have?
-Prevents distal slipping
28
How is the tertiary layer applied?
-Toes-up -Overlapping -Firm, even pressure
29
What is important to note about the tertiary bandage layer?
-This is what the client sees!!
30
What is used to apply a walking pad on a bandage & how is it applied?
-Elastikon or durable material -Very adhesive -Water resistance -Applied w/out much pressure since elastic properties may lead to swelling
31
How should you label bandages?
-Date -Initials -Reminders -Warnings
32
What adherent bandages are **no longer recommended**?
-Wet-to-dry -Dry-to-dry
33
When would we use a tie-over bandage?
-**Wounds in an area inaccessible to standard bandaging techniques** (e.g. hip, shoulder, axilla, or perineum)
34
What is a tie-over bandage?
-Contact & absorbent layers are held in place w/ tie-over bandage
35
What type of bandage would you use here?
-Tie-over bandage
36
How do you apply a tie over bandage?
-Apply several sutures or skin staples w/ loose loops around periphery of wound -Apply primary & secondary bandage layers -Hold tertiary layer by lacing umbilical tape or heavy suture through loose skin sutures or staples
37
When do we use a **pressure relief bandage**?
-Usually over bony prominence -To treat/prevent pressure sores
38
What do **pressure bandages** do?
-Facilitates control of minor hemorrhage, edema, & excess granulation tissue -**The more convex the surface, the greater pressure exerted by dressing on tissue**
39
When do you use wet adherent bandages?
-Wound surface has necrotic tissue, foreign matter, or viscous exudate
40
How do you use wet adherent bandages?
-Sterile wide mesh gauze soaked in: sterile saline solution & 1:40 (0.05%) chlorohexadine diacetate -Necrotic tissue & foreign material adhere to gauze & are removed w/ bandage
41
When are dry adherent bandages used?
-When wound surface has loose necrotic tissue & foreign material -**When wound has large quantity of low-viscosity exudate that does not aggregate**
42
What do **Robert Jones** bandages do?
-Immobilizes -Decreases/limits soft tissue swelling -Absorbs wound exudate
43
What do **Soft padded (modified robert jones** bandages do?
-Similar benefits as Robert Jones -Add splint material -**Fracture MUST be below elbow/stifle**
44
What bandage is this and how do you know?
**Robert Jones** -Very large/thick bandage -Uses rolled/sheet cotton -Wrapped w/ more compression
45
What bandage is this and how do you know?
**Soft padded (Modified Robert Jones)** -Similar benefits as Robert Jones -Add splint material
46
How do we modify the bandage for proximal extremity lesions?
-Continue bandage up leg, around chest or abdomen & between legs to create spica type bandage
47
What type of wound is this bandage for?
-Proximal extremity lesions
48
What is different between a paw bandage and a leg bandage?
-A paw bandage is placed like a leg bandage except **digits are covered**
49
How do we place a paw bandage?
-After placing stirrups & contact layer reflect cast padding over digits from dorsal to ventral-then ventral to dorsal -Wrap padding around distal limb -Conform bandage to limb w/ elastic gauze -Secure bandage w/ elastic tape in similar fashion
50
What is a Schroeder-Thomas splint?
Traction splint -Labor intensive -Soft tissue complications -Lacks predictability
51
What is a Spica splint?
-For **immobilization of shoulder**
52
What type of splint is this?
-Schroeder-Thomas splint
53
What type of splint is this?
-Spica splint
54
What is an Ehmer sling?
-(Remember "Ehmer Femur") -To prevent pelvic limb from being weight bearing -Post hip reduction or acetabular fractures
55
What is a Velpeau sling?
-"Velpeau Elbow" -To prevent forelimb from being weight bearing -After shoulder/forelimb procedures
56
Which sling is this?
-Ehmer sling
57
Which sling is this?
-Velpeau sling
58
When and why do we do casts for fractures?
-Stable minimally displaced fractures -Young rapidly healing animals -**Only injuries distal to elbow/stifle** -Unable to repair w/ surgical techniques
59
What do you need to do with the client if wanting to do a cast for a fracture?
-Discuss the expense with the owner, can be an issue
60
What kind of fractures cannot be casted?
-Open fractures
61
What do you need to do before placing a cast for a fracture?
-Swelling needs to be reduced prior to casting
62
What fractures may not need sedation to cast and what fractures do?
-Greenstick fractures may not need sedation -Displaced fractures -> general anesthesia
63
What should you always do after casting, and what needs to happen for it to be a good cast?
-**Always radiograph after casting** -**Must have >50% overlap of fracture ends** in EACH of 2 radiographic views
64
How often do you need to check casts for fractures?
-Check at least every 2 weeks, but weekly initially if possible
65
How do you place a cast for fracture?
Place w/ limb in standing position -Encourages use when walking -Limits muscle atrophy & joint stiffness -Shortens recovery period after removal
66
What are **common complications** of casts for fractures?
-Slipping/loosening -Water or urine-soaked -Joint stiffness & muscle atrophy -Pressure sores (hard materials or constricting bands, prominences)
67
More padding on casting =
Less well immobilized
68
What do bandages require from clients and you?
-**Bandages require high degree of client compliance!** -**Discharge should include verbal, written & visual instructions for clients** -**Check frequently**
69
What does the change frequency of a bandage depend on?
-Age -Activity -Cleanliness -Associated wounds -Swelling
70
What are some signs the bandage is uncomfortable?
-Chewing at bandage -Lameness increase after discharge
71
What signs mean **remove the bandage**?
-**Odor** (means swelling) -**Toe temperature** (compare to other foot) -**Nail bed cyanosis** -**If ANY doubt -> REMOVE**
72
What are some special considerations when bandaging a cat?
-Bandage paralysis
73
What are some rules to remember about bandages?
-**Leave middle 2 toes (claws) exposed when possible** -**Bandages start at toes & go up limb to avoid swelling** -**Keep limb in physiologic position** (typically standing, do NOT apply w/ limb in full extension (straight) -**Overlap 1/3 to 1/2 the width of your wrap** -**Apply firm even pressure during application** -**Owner compliance - Key to success!** -**No single dressing produces optimum microenvironment for all wounds or all stages of wound healing of single wound** -**Identify underlying structures**

2025 - Intro to Surgery 737A (29 decks)

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