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What do we use bandages for?
- protect the wound
- protect granulation tissue
- support before surgical repair
- prevent edema, seromas, hemorrhage
- immoblize wound
- support catheters
- minimize exuberant granulation tissue
- absorb wound exudates
- help debride loose tissue as bandage is changed
- prevent soiling of environment
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What does a bandage protect a wound from?
- contamination
- infection
- self-mutilation from the patient
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What is a seroma?
pocket of fluid in tissue
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What do we use bandages to immobilize a wound?
- promote healing
- less pain
- before fracture repair - less tissue damage
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What are 3 types of debridements?
- surgical
- own body doing it (macrophages)
- bandages
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Should we cast over open wounds?
no
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What direction do we bandage?
- go from distal to proximal
- go from lateral to medial
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Should we rotate the limb when bandaging?
no
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What should we leave exposed in full length bandages, splints, or casts? Why?
leave the 2 middle toes exposed so you can check for color, warmth, and swelling
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Is the appearance of the bandage important? Why?
yes, the client will judge you by what it looks like so it should be neat and clean
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Why is it important to keep the bandage clean and dry?
to reduce moist dermatitis, infection, discomfort, chewing
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How do we keep a patients bandage dry and clean?
- cover with stockinette
- keep patient on a rack
- walk patient often
- plastic bag on limb for walks outside
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What are some signs of discomfort?
- chewing, licking
- chafing at edges
- odor
- redness
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Should we give the client written home care instructions about taking care of their pets bandages?
yes
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What can excess pressure from the bandage do?
cut off circulation and cause necrosis
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What are different types of excess pressure?
- pressure ring
- pressure point
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What is a pressure ring?
band of pressure around the limb
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What does a pressure ring cause?
edema of distal tissue
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How do we prevent a pressure ring?
- apply bandage in spirl barber pole fashion
- do not pull tight
- wrap from toe to wound (not just the wounded area)
- leave 2 middle toes exposed
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Where are the pressure points?
pad around prominences (elbow and carpal pad)
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How do we prevent pressure points?
- may cut a hole in the wrap
- distribute pressure evenly
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What can we do to help keep bandages on?
- apply to clean, dry skin or hair
- clip long hair
- apply anchor tapes
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What is another name for anchor tapes?
tape stirrups
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What is the purpose of anchor tapes?
placed to prevent cast, splint, or bandage from sliding off the leg
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How do we apply anchor tapes?
- Cut two lengthwise strips that extend well past the toes
- Apply loose spiral tape on the leg to hold lengthwise strips in place
- Bandage the limb
- Twist so sticky side is against bandage
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What are some common problems with bandages?
- dirty, infected
- skin reaction to tape
- self-trauma
- patient removes bandage
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What are gauze sponges?
porous woven folded fabric (usually squares or rectangle shaped)
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What are gauze rolls?
loose woven fabric in rolls (stretchy or not stretchy)
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What is elastic gauze?
- does not adhere to patient
- different colors and sizes
- adheres to itself
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What is another name for elastic gauze?
Vetrap
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Can elastic gauze be applied too quickly?
yes
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What can happen if elastic gauze is applied too tightly?
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What is adhesive tape?
- porous, permits air to get to wound
- sticks to itself and to the patient
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What is elastic tape?
- elastic adhesive tape
- sticks to itself and patient
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What is another name for elastic tape?
Elastikon
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What is non-adhering sponges?
- do not adhere to wound
- do not tear away scab or granulation tissue when removed
- less painful to remove
- tends to trap in moisture
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What is non-adhereing sponges usually used for?
used for primary layer of bandage over wound
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What is another name for non-adhereing sponges?
Telfa pads
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What are stockinettes?
- woven tube of cloth
- elastic, comes in a roll
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What do we use stockinettes for?
apply under cast padding
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What is cast padding?
- small rolls of pressed cotton
- smooth or corrugated
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What is cast padding used for?
- pad simple bandages
- pad casts
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What is roll cotton?
- large and bulky
- major padding
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Who is roll cotton usually used for?
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What are the different layers of bandages?
- primary layer
- secondary layer
- tertiary layer
- supporting layer
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What is the purpose of the primary layer?
in contact with the skin
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What are the different types of primary layer?
- adherent
- non-adherent
- semi-occlusive
- occlusive
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When do we use adherent primary layer?
used if some debridement is needed
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What can be used as a adherent primary layer?
gauze sponges
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When do we use non-adherent primary layer?
- required when healthy granulation tissue fills wound
- protects skin, not removes skin
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What can be used as a non-adherent primary layer?
telfa pads
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What is semi-occlusive primary layer?
- allow air to penetrate
- allows exudate to escape
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What can be used as a semi-occlusive primary layer?
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What is an occlusive primary layer?
- no air penetration
- no exudate escapes
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What can we use as an occlusive primary layer?
waterproof adhesive tape
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When should we not use an occlusive primary layer?
if exudate is present because it holds it in against the wound and causes maceration of wound
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What is the secondary layer?
padding - cast padding, roll cotton
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What can happen if the secondary layer is not done correctly?
can damage tissue and cause edema or necrosis
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What is the tertiary layer?
main outer layer
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What is the purpose of the tertiary layer?
- holding and protection
- holds the bandage together
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What can be used for the tertiary layer?
- adhesive tape
- Vetrap
- Elasticon
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What are some after care instructions for bandages?
- keep clean and dry
- restrict exercise
- watch for problems
- bandage changes and rechecks as indicated
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How do we restrict exercise?
- house confinement
- leash walk
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What is the purpose of restricting exercise?
- decreases trauma
- less opportunity to get dirty
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What kind of problems does the owner need to look for after their pet has been bandaged?
- licking, chewing, odor, redness, chafing
- patient stops using leg
- observe toe color, warmth
- toenails spread means swelling
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What can cause problems with bandages?
- uncomfortable and patient messes with it
- too tight - poor circulation
- infected
- fracture site breaking down
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What is the general rule of thumb for bandage changes?
the more a wound is draining, the more often the bandage should be changed
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At each bandage change, the wound should be...
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How often should bandages, splints, and casts should be rechecked?
at least every 10 - 14 days
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What should we document in the medical record about rechecks of bandages?
- document when we did the recheck
- document if the owner did not show up
- document phone calls
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