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