Bandage Book (2010) PDF
Bandage Book (2010) PDF
Bandage Book (2010) PDF
PADDING
PADDING
PADDING
Method 1:
1 Dress any open wounds as appropriate, pad out toes, including stopper pad and
dew-claws if present, then cut two lengths of zinc oxide tape to cover at least 15
- 20cm (6 - 8 inches) up the leg and 10 - 12 cm (4 - 5 inches) overlap at the toes.
Stick these to the anterior and posterior aspects of the leg respectively, ensuring
coverage over and above metatarsal/metacarpal region. Stick loose ends together for
the time being to prevent them sticking to anything else! These are known as the
‘stirrups’. See figure 1.
2 Pad out toes as necessary. Carefully unroll the end of a complete roll of cotton
wool. Position roll over leg to start ½ way up the toe nail - reverse roll cotton wool
spirally up to proximal end of leg. (Narrow rolls of cotton wool are available for short
legged dogs, called Ortho-Wool). Wrap the cotton wool around the leg at least 4 - 5
times as firmly as is possible. See figure 2.
NB: A 500g roll should be sufficient for a large dog’s legs.
continued…
FIGURE 3
CONFORMING
BINDING
LAYER
PADDING
TOP
COVERING
PADDING
Stirrups
The importance of leaving the two middle toe nails exposed is twofold: Firstly to
enable the animal to balance and secondly to allow regular checking of the animal’s
circulation (which is easier in white nailed dogs) and its temperature. Extremes in
temperature (too hot/cold) may also indicate possible infection, or bandage on too
tightly.
Method 2:
A variation of this method is to use alternate layers of cotton wool and conforming
bandage followed by another layer of cotton wool and another layer of conforming
bandage, repeated to give at least three layers of each. The remainder of the bandage
would be applied the same as described in the previous method.
The successful result should still produce a plain cylindrical bandage with a resonant
sound heard when the bandage is flicked.
Suggested materials:
For stirrups:
A-Tape™ (zinc oxide)
Padding:
Cotton Wool (Vet, BP, HQ), Millsoft™, Orthowool™, Cotton Gauze Wadding,
Orthoband™.
Conforming Layer:
Knit-Fix™, Knit-Firm™, Co-Lastic™, Co-Form™.
Third Layer:
Wrapz™, Bandesive™, R-Band™, E-Band™.
FIGURE 1 5
2
Crutch bar on
medial side of leg
6. Stirrups
FIGURE 2
2
4
7. Covering layer
6. Stirrups showing motion of
bandage
3
A great deal of practice is needed to master the skill of applying a Thomas Extension
splint, but it is very useful for fractures of the fore or hind limbs, where other means
of support are impractical. The Thomas Extension splint may be left in situ for up to
six weeks, but the leg should be checked for sores frequently and the animal rested
as much as possible. You should be aware that the animal may have difficulty in
manoeuvring, especially trying to stand, from a lateral position.
The second distance to be measured, is from the extended toe, point 3, then around
the loose perimeter of the animal’s leg, via points 4, 5, 1, 2 and back to 3 on figure 1.
The aluminium is cut to this length, then padded with cotton wool, or another such
suitable material, to protect the leg from pressure sores, and to act as a cushion from
any external forces. Join ends together, shaping scaffold support to make a splint
around the circumference of the limb - as in figure 1.
The horizontal crutch should then be joined to the main splint at the correct height
(as previously measured) on the medial aspect - point 1 in figure 1.
Any wounds should be suitably dressed, then ‘stirrups’ applied to the distal end of
splint at point 3, having first been attached to the toes, point 6.
The ‘stirrups’ are used to extend the toes, and by fixing them to point 3, it will ensure
stability without excess movement. A cohesive covering is then applied to cover
the lower splint, and prevent lateral to medial movement of the limb, see figure 2.
Adhesive bandages may be used if preferred, but may cause discomfort to the animal
where it comes into contact with the animal’s hair. By only partially covering the
splint, good ventilation of the leg is ensured.
Suitable materials:
l
rigina
in g our o ave
Join eh
ges w ”.
banda and “Splash all
o ” ve
“Cam w styles ha s you
ry.co.uk
ne rtie
These rior prope but in
p e p z
the su from Wra at leave
e c t s t h
exp sign
rina
!
ng de hoice
dazzli poilt for c
Ava
e
you s
vet
ilab
to ge
le d
le
buy ill p
online at www.m
ce!
e
4
5 1
2
Flexion
FIGURE 2
5
4
2
1
FIGURE 3
4
This bandage is used specifically to immobilise the shoulder, usually as the treatment
following reduction of shoulder dislocation. Although the bandage performs this task
very efficiently, care must be taken when using it particularly on larger breeds, or just
older dogs. The reason for this being that the restriction may cause difficulty in free
movement. If the dog has arthritic joints or pain in other such joints, he is therefore
less likely to move about to urinate, eat or perform other functions, thus slowing
recovery.
Pad out foot as necessary with cotton wool. Using a conforming bandage, secure
ends to a pre padded metacarpal region. Take bandage from lateral to medial
direction points 2 to 1 over the palmar aspect of paw. Flex carpus, elbow and
shoulder to maximum. Bring bandage up over lateral paw, limb and lateral aspect of
shoulder, point 3, then down to opposite axilla point 4, and back under the chest to
points 1 and 2. Repeat from steps 2, 3, 4 taking bandage dorsally around point 5
over lateral aspect of shoulder to point 3. See figure 1.
For ease of application we have numbered the significant points of the diagram as
follows:
1 Medial Metacarpal
2 Lateral Metacarpal
3 Anterior Aspect of Shoulder
4 Opposite Axilla
5 Knee Joint
To simplify the steps on how to apply the velpeau sling from the start, follow this
sequence:
2-1-2 * 3 - 4 - 5 - 3 - 4 - 2.
Repeat from asterisk * until sufficient support for immobilisation of the elbow, thus
preventing any extension of this joint. See figure 2.
For neatness and a firm support, the whole bandage can then be covered by an
appropriate cohesive or adhesive bandage as preferred.
POINTS TO REMEMBER :
Do not use a ‘figure of eight’ in the construction of this type of bandage. There
should be no bandage in front of opposite shoulder, all revolutions pass back under
opposite axilla at point 4, See Fig 3.
Suggested materials:
Padding: Orthoband™, Cotton Wool (Vet, BP, HQ), Millsoft™.
3
4
FIGURE 2
1
The Ehmer Sling is used for immobilisation of the hip joint, usually for support
post reduction of a hip dislocation, where the femoral head has luxated from the
acetabulum. Likewise it may be used to prevent weight bearing on a hind limb. The
ultimate aim however, is the same for both variations i.e. the foot slightly rotated
inwards, the hock outwards, thus forcing the femoral head back into the acetabulum,
with the leg held in extreme flexion.
The shape and size of the animal must be taken into consideration when using this
bandage, particularly if the animal is either obese or heavily muscled, as this may
cause the bandage to slip. Also if the animal is old or has arthritic joints, this may
cause difficulty in flexing the patient’s affected limb comfortably, making it less likely
to move about, eat, urinate or perform other functions, thus slowing recovery.
Secure bandage around pre padded metatarsal area leaving toes exposed if preferred.
Using a conforming bandage, take it from the Medial Metatarsal around the lateral
aspect of metatarsal point 1, up the medial aspect of the stifle point 3. The area over
the femur is then padded and the bandage brought over the lateral aspect of the
thigh, point 4, returning to point 1. See figure 1.
For ease of application we have numbered the significant points on the diagram as
follows:
1 Lateral Metatarsal
2 Medial Metatarsal
3 Medial Stifle-Anterior
4 Lateral Thigh Femur
Therefore to simplify the steps needed to be taken to apply the bandage from the
start is as follows:
2 - 1 - 2 - 3 - 4 to hold foot in slight inward rotation, to be followed by point
1 - 2 - 3 - 4 Repeat sequentially, until sufficient support is acquired. Secure end.
See figure 2.
A final top covering of cohesive bandage may be used to help protect the underlying
conforming bandage and provide extra support whilst remaining lightweight and
porous. If preferred, adhesive bandages may be used in place of a cohesive, but they
may be more difficult to remove.
Suggested materials:
Padding and strips: Orthoband™, Cotton Wool (Vet, BP, HQ), Millsoft™,
Cotton Wadding, OrthoWool™.
Flexion 2 5
1
FIGURE 2
3 4
5
1
2
Flexion
As the name suggests, this bandage is a modified variation of the afore mentioned
Ehmer Sling. This may also be described as the ‘Figure of Eight’ bandage or even the
‘Butterfly’ bandage. The ultimate aim however, is the same for both variations i.e.
the foot slightly rotated inwards, the hock outwards, thus forcing the femoral head
back into the acetabulum, with the leg held in extreme flexion.
POINTS TO REMEMBER:
You may find it necessary between points 4 and 5 and points 2 and 3, to rotate your
bandage through 180º to ease application and fit more comfortably.
1 Lateral Metatarsal
2 Medial Metatarsal
3 Medial Stifle-Anterior Femur
4 Lateral Thigh
5 Medial Hock
Therefore to simplify the steps needed to be taken to apply this bandage from the
start are as follows:-
1 - 2 - 3 - 4 - 5 followed by:- * 2 - 1 - 3 - 4 - 5
Repeated in this order from the * until sufficient support is acquired. Secure ends.
A final top covering of cohesive bandage may be used to help protect the underlying
conforming bandage and provide extra support whilst remaining lightweight and
porous.
Suggested materials:
Padding and strips: Orthoband™, Cotton Wool (Vet, BP, HQ), Millsoft™,
Cotton Wadding, OrthoWool™.
5
2 3
FIGURE 2
TAPE
Used quite commonly mainly holding dressings in place around the chest or shoulder
region, or for holding chest drains securely following surgery. Select and apply
sufficient and appropriate padding. Choose an appropriate width conforming or
cohesive bandage. Start your bandage at the withers point 4; take bandage down
to point 1, through the fore legs point 2 and around the left axilla point 3, up over
shoulder point 4, down over opposite axilla point 5, through under sternum (in a
cranial direction) point 2, up over to point 4, returning down to right axilla point 5,
under the chest to point 3 returning to point 4. See figure 1.
To simplify the application of the bandage, we have labelled the diagram with the
following points:
1 Right shoulder
2 Sternum
3 Left Axilla
4 Top of shoulder
5 Right Axilla
Do note that this type of bandage will not provide as much support, compared with
the chest bandage previously described, but is ideal for holding dressings or chest
drains in place.
Suggested materials:
Chest Bandage:
Millpledge Bandages:
Knit-Fix™, Knit-Firm™, Co-Form™, Co-Lastic™, Wrapz™.
Stockinette
This type of bandage is not used too widely. Depending on the shape of the patient
and also the breed, it can be very difficult to apply, let alone keep in place. It is useful
to use an abdominal bandage to hold a dressing in place after a mid-line operation, to
help prevent haemorrhage, or just as an absorbent layer for a weeping wound.
With abdominal bandages, apart from rolling in, there is also a tendency for them
to slip. It is therefore a good idea to use a cohesive bandage, with a strip of adhesive
tape at each end to anchor it down. Alternatively, take bandage around shoulders
and/or sternum to prevent bandage slipping.
Remember to keep the animal’s comfort in mind, use wider bandages, and do not
apply too tightly, as this may interfere with its breathing.
Alternatively you may use a stockinette bandage pulled over the animal’s body
with appropriate holes cut in for the limbs. Also make sure male dogs can urinate
unhindered.
Suggested materials:
Dressings:
Poultex®, Zorbopad™.
Padding:
Orthoband™
Conforming Layer:
Wider widths of Knit-Fix™, Knit-Firm™, Co-Form™, Co-Lastic™.
1. Cut away base 2. Cut holes where shown 3. Thread tape through holes
This enables the tape ends to be pulled in a purse string manner and neatly tied
for quick and easy application and removal by the owner. These bags are ideal,
due to the strength and thickness of the plastic. Instruct the owner on how to
apply the bag and also to remove immediately on returning after the walk. This
is to prevent unnecessary sweating of the foot.
c) Ask owner to look out for any swelling, discharge, pain or unpleasant smell from
around the bandage. Insist on reporting back to the surgery immediately if in any
doubt.
d) If necessary, provide help and advice to prevent animal interfering with its
bandage, such as using a bitter spray such as “Chewy No-No™” or an Elizabethan
Collar or bucket around the head. Do impress on owners that the animal may
need to be supervised whilst initially wearing such protection.
e) If patient requires complete rest and isn’t too co-operative, e.g. a boisterous
puppy, it may be necessary to use mild tranquillisers such as ACP. This must, of
course, be done under the Veterinary Surgeon’s strict directions of dosage and
length of treatment, and must be carefully explained to the owner.
f) Finally, listen to the owner. Answer their varied and many questions, and reassure
them they can telephone any time for advice, or return the animal to the surgery
if they are at all concerned.
That the finished bandage is neat - no loose ends where the patient may be able to
claw, chew or pull undone.
That the bandage is sufficient for the purpose for which it was intended; e.g. if for
immobilisation of a limb, that the animal cannot actually bend that limb.
That your patient is as comfortable as possible. This will aid a speedy recovery if the
patient can continue with as much normality as possible.
That it appears professional. It is very embarrassing when the patient gets home and
shakes off your prized bandage!
That the bandage is applied firmly but not too tightly. Check for dyspnoea, having
applied head, neck, chest or abdominal bandages.
CHEWY NONO
A preventative spray to
discourage chewing, bandage
biting and other destructive
chewing habits.
A pressure bandage by its own nature has real potential to cause harm to the
limb, and as such should be applied carefully, with subsequent attention paid to
the horse.
If serious haemorrhage is evident, immediate pressure should be applied to the
wound. If minor venous or capillary haemorrhage is evident, it may be appropriate
to clean the wound before applying the pressure bandage. Common sense should
indicate the necessity of which action to take.
If cleansing is appropriate and not likely to cause further damage, cold water
should be used to rinse the area. The cold water will assist in vasoconstriction, thus
minimising blood flow as far as possible. Prolonged rinsing should be avoided. Sterile
saline solution is preferable, but tap water is adequate, and realistically more readily
available in an emergency. In some instances, it may be appropriate to apply an ice
pack before bandaging.
If an open wound is present, a dressing pad should be applied. Avoid placing cotton
wool onto the wound. Adequate padding material should then be applied, with even
pressure around the limb, to 5cm (2 inches) thick. It is important to use a bandage
with sufficient width – at least 7.5cm but preferably 10cm wide in order to avoid the
bandage from creating a tourniquet effect.
General guidelines:
· If practicable, clean the wound first.
· Cover the wound with a dressing pad.
· Apply soft absorbent padding, distributed evenly.
· Apply the support layer, beginning at the foot, working proximally.
· Apply the pressure bandage at least 12½cm (5 inches) above the point of injury.
· Ensure uniform tension is applied throughout, ensuring one finger can be placed
down the inside of the bandage.
· If blood soaks through, apply another bandage over the top, taking care not to
disturb the first.
The hock is vulnerable to trauma, fatigue and stress. Bandaging may be
recommended following surgery, to protect a wound, or to reduce oedema or heat.
continued…
1. Lateral View
A Apply primary dressing such as
Zorbopad™ or Poultex ® depending
B on wound being on either A or B.
2. Dorsal View
Wrap secondary dressing
such as Orthoband™
starting proximally,
continuing into a figure of
eight.
· Pad to at least 5cm (2 inches) thick, and the padding layer should extend at least
12½cm (5 inches) above and below the point of hock.
· Using a figure of eight pattern, begin just below the point of hock. Wind from the
medial aspect around the back of the hock to the lateral aspect then follow on,
extending down medial to lateral (figure of eight).
· Begin applying the supporting bandage below the point of the hock, wrap front
to back, lateral to medial, spiralling upwards, overlapping at 50% of the bandage
width.
· Repeat the figure-of-eight until the bandage extends 10-15cm (4-6 inches) above
the point of hock, 1½cm (½ inch) from the edge of the padding layer.
· Secure the bandage at the top and bottom with an adhesive tape.
ADDITIONAL CONSIDERATIONS:
Horses with hock bandages should be confined at rest unless specified otherwise by
the veterinary surgeon. The bandage should be checked two to three times a day,
with attention paid to any increase in lameness or oedema. In addition, should the
bandage become wet or soiled, it should be replaced immediately.