Bandages and Drains
Mike Conzemius, DVM, PhDDiplomate ACVS
Iowa State University
BandagesWound dressingsPadded/support bandages– Robert Jones, “bobby jones”
Splints/Casts– Spica– full cast, half cast, metal rod reinforced bandage
Slings– Velpeau, Ehmer, Hobbles, Robinson
Pressure bandages
Wound Dressingscontact layer– adherent
• dry to dry; wet to dry; wet to wet– nonadherent
• semiocclusive or occlusivepadding layer– absorption of fluid, secure contact layer,
obliterate dead spacesupport layer
Bandage Principles
stirrupsleave access to two toesdistal to proximaleven amount of paddingeven tension when applying support layerbandage care
Padded/Support Bandages
immobilization of fractures prior to surgeryreduction of postoperative edemaRobert Jones Bandage– heavily padded with cotton– immobilization at or below elbow or knee
Spica splint– immobilization above elbow or knee
Full Cast
Cut before finishing
Robert Jones
Robert Jones Bandage
Spica Splint
Pressure Bandages
control hemorrhage, edema, dead spaceapply from distal to proximalapply evenlyleave access to tips of toes12-24 hours, 30-50 mmHg
Tourniquet
Start distal
SlingsVelpeau Sling– forelimb immobilization– scapular fracture
Ehmer Sling– hindlimb immobilization– craniodorsal hip luxation
Robinson sling– hindlimb not weight bearing sling
Hobbles– ventral hip luxation
Bandage Care
check toes BID; change if swollen or coldkeep clean and dry; change if wetchange if odor developschange if patient traumatizes bandagechange if patient anorexic, depressed, feverchange if limb function worsenschange every two weeksevery patient/owner gets written instructions
Drains
eliminate dead space– open fracture
eliminate established collection of fluid or gas– peritonitis, pleuritis
prophylactic elimination of fluid or gas that may form– for contaminated procedures– total ear canal ablation
Penrose drain with red rubber catheter. They can be used togetherand additional fenestrations can be added to increase surface area for drainage.
Drain Classification
passive drains– fx by gravity, overflow– separate incision sites and through space– penrose, sump, triple lumen
active drains– apply negative pressure– open (pump) or closed (tube) suction
Drain Removal
drains are foreign bodiesdecreased fluid productionaltered fluid cellularity (type and count)post-op hemorrhage ~ 1 to 2 daysbacterial infection ~ 2 to 5 dayslarge area of dead space ~ 3 to 14 days
Top Related