Veterinary Medicine - December 2008 - (Page 658)

2008 Practical advice from the presentations PEER-REVIEWED Central Avoid common bandaging mistakes in dogs and cats Improperly placing a bandage at the outset or having a good bandage go wrong can endanger an animal’s limb. Follow these tips to practice prime wound-care principles and choose the appropriate and most comfortable bandage. Jayce Lineberger, DVM T he way you initially treat a wound and apply a bandage is crucial, even if some time has passed since the injury occurred. Apply these tips to allow healing to progress unimpeded. The condition The bandage you select will depend on the condition you are treating. Are you treating an open wound that needs to be kept covered as it heals? It is common to apply a wet-to-dry bandage that is converted to a nonadherent bandage once a granulation bed develops and the wound is properly débrided. With the advent of some of the newer products available, we have a better selection of materials. This gives us the chance to apply the appropriate material to the particular wound. Are you treating a patient with a fractured limb that only needs immobilization until surgery can be performed or until the wound can heal properly? Your best option may be a soft-padded bandage that incorporates a lateral splint. Or in a patient that has a closed fracture distal to the elbow or sti e that risks becoming an open fracture without stabilization, a Robert-Jones bandage will work well. Is the injury a luxation that can be managed with an appropriate bandage? For example, a simple elbow luxation once reduced can be managed with a spica splint, or a craniodorsal hip luxation that is stable after closed reduction can possibly be managed with an Ehmer sling. pup. Choose a bandage that is appropriate for the patient. Important factors to consider are age, activity level, species, size, body weight or conformation, and current health status. The client Find out how well the owner can maintain the bandage. A bandage can become more of a detriment than a bene t if it isn’t cared for properly. In some cases, you may even elect not to place a bandage if an owner can’t provide appropriate home care. For example, certain fractures (e.g. a nondisplaced greenstick fracture involving a distal extremity) or luxations and subluxations may be amenable to external coaptation, but if the owner will be unable to manage the patient or the bandage, then surgical stabilization may be a better option. You’ll also need to know whether the owner can present the patient for routine bandage changes. The timing of bandage changes is crucial. If the bandage is placed perfectly but the patient isn’t presented for a bandage change at the right time, the bandage can worsen the condition. For example, a wet-to-dry bandage placed over a severe open wound that is left on the limb for a week when it was supposed to be changed daily can be disastrous. Maceration of previously healthy tissue may ensue, making the wound more susceptible to infection, or the bandage may harbor bacteria, resulting in or exacerbating an infection. TAKE CARE AND TIME TO KEEP THE WOUND HEALTHY You can apply Halstead’s principles of surgical technique to veterinary wound care as well: Use gentle tissue handling, don’t compromise the blood supply, control bleeding, and be as aseptic as possible—use sterile technique when cleaning the wound and when changing bandages. And don’t be in a rush to get the wound to heal—the time it takes depends on the wound. It’s important not to leave something (e.g. excess suture material, necrotic tissue, bandage material from a previous bandage, medications known to impede wound healing) behind that will impede wound healing. Keep the wound as healthy as possible so the body can heal the wound ef ciently. CHOOSE THE RIGHT BANDAGE When you are choosing a bandage to protect the wound and help it heal, keep the condition, the patient, and the client in mind: The patient One bandage doesn’t t all. The bandage you select for an energetic 10-month-old Labrador retriever must be considerably stronger than the bandage you select for a 10-year-old Labrador retriever. For example, a midshaft nondisplaced greenstick tibial fracture may respond well to a lateral splint in an older patient that is sedentary, but you may want to consider a full-cylinder cast in a younger Jayce Lineberger, DVM Mission MedVet 5914 Johnson Drive Mission, KS 66202 APPLY THE RIGHT BANDAGE THE RIGHT WAY After you’ve chosen an appropriate bandage, keep these tips in mind to ensure you’ve applied a comfortable bandage. 658 December 2008 VETERINARY MEDICINE

Table of Contents Feed for the Digital Edition of Veterinary Medicine - December 2008

Veterinary Medicine - December 2008 Contents Letters Thanking Our Valued Reviewers Practical Matters Idea Exchange Why Do Dogs and Cats Eat Grass? Managing Atypical and Critical Cases of Primary Hypoadrenocorticism in Dogs Behaviors Suggestive of Postoperative Pain in Cats What to Consider When Considering Digital Radiography Avoid Common Bandaging Mistakes in Dogs and Cats IMHA: Diagnosing and Treating a Complex Disease CE Form/Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - December 2008

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