Bandages and Drains

Bandages and Drains
Mike Conzemius, DVM, PhD
Diplomate ACVS
Iowa State University
Bandages
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Wound dressings
Padded/support bandages
– Robert Jones, “bobby jones”
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Splints/Casts
– Spica
– full cast, half cast, metal rod reinforced bandage
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Slings
– Velpeau, Ehmer, Hobbles, Robinson
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Pressure bandages
Wound Dressings
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contact layer
– adherent
• dry to dry; wet to dry; wet to wet
– nonadherent
• semiocclusive or occlusive
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padding layer
– absorption of fluid, secure contact layer,
obliterate dead space
support layer
Bandage Principles
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stirrups
leave access to two toes
distal to proximal
even amount of padding
even tension when applying support
layer
bandage care
Padded/Support Bandages
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immobilization of fractures prior to surgery
reduction of postoperative edema
Robert 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
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control hemorrhage, edema, dead
space
apply from distal to proximal
apply evenly
leave access to tips of toes
12-24 hours, 30-50 mmHg
Tourniquet
Start distal
Slings
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Velpeau Sling
– forelimb immobilization
– scapular fracture
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Ehmer Sling
– hindlimb immobilization
– craniodorsal hip luxation
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Robinson sling
– hindlimb not weight bearing sling
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Hobbles
– ventral hip luxation
Bandage Care
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check toes BID; change if swollen or cold
keep clean and dry; change if wet
change if odor develops
change if patient traumatizes bandage
change if patient anorexic, depressed, fever
change if limb function worsens
change every two weeks
every patient/owner gets written instructions
Drains
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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 together
and additional fenestrations can be added to increase surface area
for drainage.
Drain Classification
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passive drains
– fx by gravity, overflow
– separate incision sites and through space
– penrose, sump, triple lumen
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active drains
– apply negative pressure
– open (pump) or closed (tube) suction
Drain Removal
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drains are foreign bodies
decreased fluid production
altered fluid cellularity (type and count)
post-op hemorrhage ~ 1 to 2 days
bacterial infection ~ 2 to 5 days
large area of dead space ~ 3 to 14 days