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What are indications for applying a bandage? (3)
- soft tissue injuries- open wounds (protection), strains/ sprains (immobilization)
- bone and joint injuries- fractures, joint instability (immobilization, pain control)
- surgical wounds
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What are the functions of bandages with soft tissue injuries? (6)
- protect wound from contamination
- provide debridement
- absorb exudate
- provide support and comfort
- restrict motion
- create environment for wound healing
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What are the functions of bandages with bone and joint injuries? (5)
- provide stabilization for fractures or luxation
- keep splint or cast in position
- restrict motion
- protect soft tissues
- prevent weight bearing
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What are functions of bandages for surgical wounds? (5)
- provide hemostasis
- decrease hematoma/ seroma formation
- absorb exudate
- provide support
- protect wounds from contamination
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What types of bandages can we apply to open wounds? (2)
- wet-to-dry
- moist wound healing
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How do wet-to-dry bandages work?
- non-selective (necrotic and healthy tissue) mechanical debridement
- gauze dries and adheres to wound
- fluid is wicked into secondary layer- when you rip off bandage, you rip off the outer layer of the wound
- important: change before absorptive layer become soaked (or else it won't debride)
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What types of wounds do you use wet-to-dry bandages?
wounds with necrotic tissue
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What are important points for wet-to-dry bandages? (6)
- don't put on healthy granulation tissue (non-selective debridement)--> you may delay wound healing
- dry environment does not support cell function
- bacteria readily cross gauze
- pain so requires sedation when you rip it off
- must be changed frequently (once a day) or else absorptive layer will become soaked
- fibers from gauze may adhere to wound (use high quality gauze)
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What are the principals of moist wound healing bandaging? (11)
- SELECTIVE debridement (b/c the body is doing it on its own)
- maintain moist environment (let the wound debride itself so we don't just rip off healthy and necrotic cells non-selectively)
- provide local energy source
- reduce edema by hydrophilic action
- increase levels of growth factors
- increase inflammatory response
- improve oxygen content
- improve blood flow
- less painful
- don't have to change as often
- overall better than wet-to-dry
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Describe the bandage layers of moist wound healing bandages.
primary layer is moisture retentive, non-adherent, semi-occlusive or occlusive
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Describe the primary layer of a bandage. (5)
- first layer that is in direct contact with the wound
- stimulates wound healing
- protects wound
- can apply topical agent
- should be sterile
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What are types of primary layers? Describe. (2)
- Non-adherent: doesn't stick to wound, can be occlusive (impermeable to air) or semi-occlusive (permeable to air)
- Adherent: sticks to wound, wide mesh gauze, non-occlusive
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What types of wounds do you use occlusive non-adherent, semi-occlusive non-adherent, and adherent primary layers?
- occlusive non-adherent: open wounds for moist wound healing
- semi-occlusive non-adherent: surgical wounds, epithelializing wounds
- adherent: open wounds for wet-to-dry
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With what wounds are hydrocolloids indicated?
high exudative wounds that are partial or full thickness
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With what wounds are hydrogels indicated?
minimally exudative partial or full thickness wounds
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With what wounds are alginates indicated?
moderately or highly exudative wounds that are partial or full thickness
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What types of topical agents can be added to the primary layer of a bandage? Describe. (3)
- Acemannan: acts as growth factor, stimulates epidermal growth, collagen deposition, and neovascularization
- Honey: decreases inflammation and edema, stimulates macrophage migration, accelerates sloughing of dead tissue
- Sugar: decreases inflammation and edema, do NOT use with granulation tissue
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What types of bandages do we use for contaminated or infected wounds?
- adherent non-occlusive
- non-adherent semi-occlusive
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What types of bandages do we use for clean or surgical wounds?
non-adherent semi-occlusive or occlusive
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What types of bandages do we use for wounds with healthy granulation tissue or epithelialization?
non-adherent semi-occlusive or occlusive
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Describe the functions of the secondary layer of a bandage. (4)
- absorb and hold exudate
- immobilize and support
- thickness depends on amount of exudate and degree of immobilization
- cast padding or roll cotton
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Describe the functions of the tertiary layer of a bandage. (4)
- outer protective layer
- supports and keeps other layers in place
- applies compression
- king gauze/ vetwrap/ elasticon
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What are rules of thumb for how often you need to change a bandage? (6)
- amount of exudate- if you see strikethrough, CHANGE THE BANDAGE
- type of bandage- wet-to-dry needs to be changed at least once daily
- stage of wound healing- more often earlier on
- amount of debridement needed- more for contaminated/ infected wounds
- open wounds need to be changed at least once daily
- closed incisions need to be changed every 3-7 days
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What are potential complications with bandages? (6)
- pressure sores- lateral toes, calcaneous
- dermatitis
- too tightÂ
- too loose
- fulcrum at fracture site
- skin maceration
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The modified robert jones bandage provides... (3)
- compression
- mild immobilization
- limb support
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When applying the cotton layer of a modified robert jones,... (2)
- cotton can be applied snuggly because it will break before it gets too tight
- overlap each wrap of cotton by 50%
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What are the layers of a modified robert jones?
- 1. cotton gauze/ cotton cast padding
- 2. cling gauze
- 3. vetwrap
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What are the layers of a cast?
- 1. cotton cast padding
- 2. kling gauze
- 3. cast material (casting tape, plaster of paris, fiberglass, resin impregnated polyurethane)
- 4. vetwrap
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What are the layers of a lateral splint?
- 1. cotton cast padding
- 2. kling gauze
- 3. casting tape
- 4. kling gauze
- 5. vetwrap
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Describe a tie-over bandage. (3)
- useful for bandaging locations that are challenging/ where you cannot wrap a bandage around the body
- secure bandage with stay sutures around the wound
- use umbilical tape to attach the bandage to the stay sutures
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Describe an ioban bandage. (5)
- useful for bandaging locations that are challenging
- secure the bandage with an adhesive drape
- clip fur around the area
- use spray adhesive to help dressing stick
- may need sedation for removal
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Describe an ehmer sling. (4)
- prevents weight bearing in the hind limb
- hip internally rotated
- hock externally rotatedÂ
- used for hip luxations
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Describe a spica sling. (1)
used to immobilize a limb
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Describe a velpeau bandage. (1)
prevents weight-bearing on a forelimb
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Describe negative pressure wound therapy. (4)
- applies controlled subatmospheric pressure to a wound
- reduces tissue edema and cytokines, improves bacterial clearance
- enhances blood flow
- increases granulation tissue
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