{"id":30296,"date":"2024-03-12T15:23:22","date_gmt":"2024-03-12T15:23:22","guid":{"rendered":"https:\/\/todaysveterinarynurse.com\/?p=30296"},"modified":"2024-05-15T15:15:27","modified_gmt":"2024-05-15T15:15:27","slug":"wound-bandaging-techniques-for-small-animals","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wound-management\/wound-bandaging-techniques-for-small-animals\/","title":{"rendered":"Wound Bandaging Techniques for Small Animals"},"content":{"rendered":"<div class=\"su-spacer\" style=\"height:20px\"><\/div><div class=\"su-note\"  style=\"border-color:#d8d8d8;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><div class=\"su-note-inner su-u-clearfix su-u-trim\" style=\"background-color:#f2f2f2;border-color:#ffffff;color:#333333;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><b>Abstract<\/b><\/p>\n<p class=\"p1\">Wounds present in several ways. There are 3 phases of wound healing, and the stage of wound healing at presentation may dictate wound treatment.\u00a0Wounds should be clipped and cleaned thoroughly when they first present. Topical treatments and proper bandaging techniques are crucial in ensuring that wounds heal properly. This article discusses the modified Robert Jones and tie-over bandaging techniques.<\/p>\n<p><b>Take-Home Points <\/b><\/p>\n<ul>\n<li class=\"p1\">Modified Robert Jones (MRJ) bandages should be placed distal to proximal on a patient\u2019s limb.<\/li>\n<li class=\"p1\">When placing bandage layers, make sure that each layer overlaps the previous layer by 50%.<\/li>\n<li class=\"p1\">When placing cast padding, ensure that it is free of wrinkles, which can lead to bandage sores.<\/li>\n<li class=\"p1\">Cast padding cannot be put on too tight, as it will rip; however, conform gauze can be put on too tight, so it should only be tightened in 1 direction.<\/li>\n<li class=\"p1\">MRJ bandages are better for wounds on the limbs, while tie-over bandages can be placed in most locations.<\/li>\n<\/ul>\n<\/div><\/div>\n<p class=\"p1\"><span class=\"s1\">P<\/span><span class=\"s1\">atients present to the veterinary clinic with many types of wounds, such as hit-by-car trauma, bite wounds, surgical site infections, and chronic draining tracts. Wounds can be challenging and frustrating to manage, especially in the face of multidrug-resistant organisms or other disease processes. The physiology of wounds can be complex, but most wounds can be managed in general practices. Wound type and location will determine treatment recommendations and what type of bandage will be needed, if any.<\/span><\/p>\n<h2 class=\"p3\">Wound Healing<\/h2>\n<p class=\"p2\"><span class=\"s1\">There are 2 basic types of wound healing: first and second intention. First-intention wound healing involves primary closure of the wound, which is usually used when a wound has occurred less than 24 hours prior to presentation and there is no evidence of infection or contamination. Second-intention wound healing leaves the wound open to develop a healthy bed of granulation tissue. These wounds may be closed after some wound management or left to close on their own. <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">In both types of wound healing, there are thought to be 3 phases: the inflammatory phase, the proliferative phase, and the maturation phase.<sup>1<\/sup> Multiple phases of wound healing can coexist.<\/span><\/p>\n<h3 class=\"p4\">Inflammatory Phase<\/h3>\n<p class=\"p2\"><span class=\"s1\">The inflammatory phase is considered to be the first phase of wound healing and only lasts for 72 hours. The initial injury or trauma causes leakage of intravascular fluid and blood, leading to inflammation (<\/span><span class=\"s2\"><b>FIGURE 1<\/b><\/span><span class=\"s1\">). Damaged cells release histamine, serotonin, and catecholamines, causing vasoconstriction followed by vasodilation. Platelets and other clotting factors form a platelet plug, and hemostasis is achieved with a fibrin clot. Neutrophils, followed by monocytes that transform into macrophages, enter the wound bed. Macrophages are responsible for phagocytosis of foreign material and bacteria. If the wound is not addressed in the inflammatory phase, or if it is contaminated, wound healing may be delayed.<sup>1<\/sup>\u00a0<\/span><\/p>\n<div id=\"attachment_30286\" style=\"width: 260px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig1.png\"><img fetchpriority=\"high\" decoding=\"async\" aria-describedby=\"caption-attachment-30286\" class=\" wp-image-30286\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig1.png\" alt=\"\" width=\"250\" height=\"613\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig1.png 576w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig1-122x300.png 122w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig1-417x1024.png 417w\" sizes=\"(max-width: 250px) 100vw, 250px\" \/><\/a><p id=\"caption-attachment-30286\" class=\"wp-caption-text\">Figure 1. A wound in the inflammatory phase 24 hours after injury. Inflammation associated with this phase is evident from the redness and swelling.<\/p><\/div>\n<h3 class=\"p4\">Proliferative Phase<\/h3>\n<p class=\"p2\"><span class=\"s1\">The second phase of wound healing is known as the repair or proliferative phase. This phase is marked by the presence of a granulation bed as well as epithelization of tissue and wound contracture. A granulation bed is characterized by a pink, fleshy appearance due to new capillary formation (<span class=\"s2\"><b>FIGURE<\/b><\/span><\/span><span class=\"s2\"><b>\u00a02<\/b><\/span><span class=\"s1\">).<sup>1<\/sup> Oxygen and moisture in the granulation bed allow epithelial cells on the skin edge to cross the wound to create a new epidermis, which allows the skin edges to begin to contract and come together.<sup>1,2<\/sup><\/span><\/p>\n<div id=\"attachment_30287\" style=\"width: 260px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig2.png\"><img decoding=\"async\" aria-describedby=\"caption-attachment-30287\" class=\" wp-image-30287\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig2.png\" alt=\"\" width=\"250\" height=\"471\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig2.png 576w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig2-159x300.png 159w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig2-544x1024.png 544w\" sizes=\"(max-width: 250px) 100vw, 250px\" \/><\/a><p id=\"caption-attachment-30287\" class=\"wp-caption-text\">Figure 2. Wound with a healthy bed of granulation tissue.<\/p><\/div>\n<h3 class=\"p4\">Maturation Phase<\/h3>\n<p class=\"p2\"><span class=\"s1\">The final phase of wound healing is the maturation phase (<span class=\"s2\"><b>FIGURE<\/b><\/span><\/span><span class=\"s2\"><b>\u00a03<\/b><\/span><span class=\"s1\">). Fibroblasts eventually become myofibroblasts that contract to encourage skin edges toward the middle of the wound.<sup>2<\/sup> Collagen is also present during the maturation phase and cross-links to strengthen the wound. Granulation tissue is much weaker than normal tissue during the healing process, and scar tissue has only 80% of the strength of normal tissue once fully healed.<sup>1<\/sup> <\/span><\/p>\n<div id=\"attachment_30288\" style=\"width: 260px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig3.png\"><img decoding=\"async\" aria-describedby=\"caption-attachment-30288\" class=\" wp-image-30288\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig3.png\" alt=\"\" width=\"250\" height=\"482\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig3.png 576w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig3-155x300.png 155w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig3-530x1024.png 530w\" sizes=\"(max-width: 250px) 100vw, 250px\" \/><\/a><p id=\"caption-attachment-30288\" class=\"wp-caption-text\">Figure 3. Wound in the maturation phase.<\/p><\/div>\n<h2 class=\"p3\">Wound Cleaning<\/h2>\n<p class=\"p2\"><span class=\"s1\">Wounds should be clipped wide to check for additional wounds or allow the placement of stay sutures for a tie-over bandage. The periwound area should be cleaned with chlorhexidine gluconate 4% diluted with 25 to 50 mL of saline. Chlorhexidine can be cytotoxic to tissue; therefore, surgical lubricant can be placed into the wound in a sterile fashion to protect it from the chlorhexidine. <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">When appropriate, the wound should be lavaged with sterile saline using a high-pressure lavage system. Larger volumes of lavage should be used in contaminated wounds. Aerobic and anaerobic culture specimens of the wound should be taken to determine the appropriate antimicrobial therapy, but they should be taken after lavage has been performed. Debridement can be performed with Metzenbaum scissors or a surgical blade when indicated.<\/span><\/p>\n<h2 class=\"p3\">Wound Bandaging<\/h2>\n<p class=\"p2\"><span class=\"s1\">Wounds can be covered with either a modified Robert Jones (MRJ) bandage (<\/span><span class=\"s2\"><b>BOX 1<\/b><\/span><span class=\"s1\">)<\/span><b> <\/b><span class=\"s1\">or a tie-over bandage (<\/span><span class=\"s2\"><b>BOX 2<\/b><\/span><span class=\"s1\">). Tie-over bandages can be placed anywhere on the body (e.g., head, abdomen, hip), while MRJ bandages tend to be better for wounds on the limbs. <span class=\"s2\"><b>FIGURE<\/b><\/span><\/span><span class=\"s2\"><b>\u00a04<\/b><\/span><span class=\"s1\"> shows a typical wound bandaging setup.<\/span><\/p>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">BOX 1 Modified Robert Jones Bandage: Step by Step<\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\">\n<ol>\n<li>Clip a large area surrounding the wound to expose the wound edges and to check for any additional wounds.<\/li>\n<li>Clean the periwound area with dilute chlorhexidine and lavage with saline to remove debris.<\/li>\n<li>Dry the surrounding area with gauze.<\/li>\n<li>Choose an appropriate topical therapy\/primary layer and apply in a sterile fashion.<\/li>\n<li>Apply cast padding.<\/li>\n<li>Apply conform gauze.<\/li>\n<li>Apply bandage tape.<\/li>\n<li>Apply elastic tape.<\/div><\/div><\/li>\n<\/ol>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">BOX 2 Tie-Over Bandage: Step by Step<\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\">\n<ol>\n<li>Clip a wider area (up to 3 cm) surrounding the wound. A wider area is important for tie-over bandages to allow for the stay sutures.<\/li>\n<li>Clean the periwound area with dilute chlorhexidine and lavage with saline to remove debris.<\/li>\n<li>Dry the surrounding area with gauze.<\/li>\n<li>Place stay sutures close enough to the wound to keep the bandage on but far enough from the wound in case of tissue necrosis (roughly 2\u20133 cm).<\/li>\n<li>Choose an antimicrobial\/primary layer and apply in a sterile fashion.<\/li>\n<li>Apply lap sponges into the wound bed in a sterile fashion.<\/li>\n<li>Cover lap sponges with the covering from the lap sponges or drapes.<\/li>\n<li>Place umbilical tape through the stay sutures to secure the bandage.<\/div><\/div><\/li>\n<\/ol>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-3 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:60%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69e8e7173790a\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig4A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 4A. A wound care setup with gauze boats to prepare the periwound area, with different topical products.\"><img loading=\"lazy\" decoding=\"async\" width=\"720\" height=\"960\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig4A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig4A.png 720w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig4A-225x300.png 225w\" sizes=\"(max-width: 720px) 100vw, 720px\" \/><span>Figure 4A. A wound care setup with gauze boats to prepare the periwound area, with different topical products.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig4B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 4B. Bandage material for a tie-over or modified Robert Jones bandage.\"><img loading=\"lazy\" decoding=\"async\" width=\"720\" height=\"960\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig4B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig4B.png 720w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig4B-225x300.png 225w\" sizes=\"(max-width: 720px) 100vw, 720px\" \/><span>Figure 4B. Bandage material for a tie-over or modified Robert Jones bandage.<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69e8e7173790a_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69e8e7173790a\"))}, 0);}var su_image_carousel_69e8e7173790a_script=document.getElementById(\"su_image_carousel_69e8e7173790a_script\");if(su_image_carousel_69e8e7173790a_script){su_image_carousel_69e8e7173790a_script.parentNode.removeChild(su_image_carousel_69e8e7173790a_script);}<\/script>\n<h3 class=\"p4\" id=\"mrj-bandage\">Modified Robert Jones Bandage<\/h3>\n<p class=\"p2\"><span class=\"s1\">There are 3 layers to an MRJ bandage: primary, secondary, and tertiary.\u00a0See <\/span><span class=\"s2\"><b>VIDEO 1 <\/b><\/span><span class=\"s1\">for a step-by-step demonstration of applying an MRJ bandage.<\/span><\/p>\n<div class=\"su-youtube su-u-responsive-media-yes\"><iframe width=\"600\" height=\"400\" src=\"https:\/\/www.youtube.com\/embed\/fXzBXCr4-BU?\" frameborder=\"0\" allowfullscreen allow=\"autoplay; encrypted-media; picture-in-picture\" title=\"\"><\/iframe><\/div>\n<p class=\"p5\"><b>Primary Layer<\/b><\/p>\n<p class=\"p2\"><span class=\"s1\">The first layer of the bandage is the primary or contact layer. This layer should be placed sterilely. For wounds in the initial phases of healing, wet-to-dry bandages can be used. Wet-to-dry bandages provide nonspecific mechanical debridement when they are removed; therefore, they should be avoided in wounds that have a healthy granulation bed. Wet-to-dry bandages consist of saline-soaked gauze, which is placed into a wound and then removed once it has dried. However, the current standard is moist wound healing. Moist wound healing allows excessive exudate to be removed with appropriate topical therapy and provides moisture to the wound. Regardless of bandage type used, the wound should not be excessively wet or dry.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">For moist wound healing, a few options for topical therapies exist. Honey, triple antibiotic, and alginate can be used topically to provide antimicrobial protection. Honey, a hyperosmolar substance, draws fluid out of the wound bed and can be used in conjunction with a primary layer such as nonadherent gauze (e.g., Telfa) or abdominal pad. Alginate is a primary layer and comes in ropes or sheets. When calcium alginate is used, a topical therapy should be applied to the wound first. Silver alginate is a topical therapy that may be preferred to calcium alginate because silver provides antimicrobial protection, avoiding the need for a separate topical therapy. Alginates should be used for exudative wounds, as they turn to gel when they encounter exudate. This allows them to stay in a wound bed for multiple days, thereby decreasing the frequency of bandage changes.<sup>3<\/sup><\/span><\/p>\n<p class=\"p5\"><b>Secondary Layer<\/b><\/p>\n<p class=\"p2\"><span class=\"s1\">The secondary layer of an MRJ bandage consists of cast padding and conform gauze, which can absorb any exudate that escapes the primary layer. Cast padding should begin at the distal portion of the limb and work proximally. Cast padding cannot be put on too tight as it will rip, but it should be placed without wrinkles to avoid creating bandage sores. Each layer should overlap 50% with the previous layer (<span class=\"s2\"><b>FIGURE<\/b><\/span><\/span><span class=\"s2\"><b>\u00a05A<\/b><\/span><span class=\"s1\">).<sup>3<\/sup> <\/span><\/p>\n<div id=\"attachment_30291\" style=\"width: 260px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig5A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30291\" class=\" wp-image-30291\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig5A.png\" alt=\"\" width=\"250\" height=\"463\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig5A.png 648w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig5A-162x300.png 162w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig5A-553x1024.png 553w\" sizes=\"(max-width: 250px) 100vw, 250px\" \/><\/a><p id=\"caption-attachment-30291\" class=\"wp-caption-text\">Figure 5. Secondary layer of a modified Robert Jones bandage. (A) Cast padding properly applied, with 50% overlap of the previous layer.<\/p><\/div>\n<p class=\"p2\"><span class=\"s1\">Kling or conform gauze is then applied over the cast padding. It can be applied too tightly; therefore, it is imperative to only tighten in 1 direction. Conform gauze can be used to gently apply some tension (<span class=\"s2\"><b>FIGURE<\/b><\/span><\/span><span class=\"s2\"><b>\u00a05B<\/b><\/span><span class=\"s1\">).<\/span><\/p>\n<div id=\"attachment_30292\" style=\"width: 260px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig5B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30292\" class=\" wp-image-30292\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig5B.png\" alt=\"\" width=\"250\" height=\"299\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig5B.png 720w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig5B-251x300.png 251w\" sizes=\"(max-width: 250px) 100vw, 250px\" \/><\/a><p id=\"caption-attachment-30292\" class=\"wp-caption-text\">Figure 5B. Conform gauze being applied with appropriate tension and 50% overlap.<\/p><\/div>\n<p class=\"p5\"><b>Tertiary Layer<\/b><\/p>\n<p class=\"p2\"><span class=\"s1\">The tertiary layer of an MRJ bandage is self-adherent bandaging tape (e.g., Vetrap, 3M), which provides compression and contains the bandage. Tape can also be placed too tightly; therefore, it is crucial to ensure that appropriate tension is applied.<sup>3<\/sup> Depending on the location of the wound, it is important to leave toes exposed so that owners can monitor for bandage slippage or swelling of the toes. Elastic tape (e.g., Elasticon, Johnson &amp; Johnson) can be placed to prevent scuffing of the bandage, but it is optional and should not be placed directly on the skin to avoid causing irritation (<span class=\"s2\"><b>FIGURE<\/b><\/span><\/span><span class=\"s2\"><b>\u00a06<\/b><\/span><span class=\"s1\">). Bandages should be changed if strikethrough is noted or if they slip after placement.<\/span><\/p>\n<div id=\"attachment_30293\" style=\"width: 260px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig6.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30293\" class=\" wp-image-30293\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig6.png\" alt=\"\" width=\"250\" height=\"462\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig6.png 648w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig6-162x300.png 162w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig6-554x1024.png 554w\" sizes=\"(max-width: 250px) 100vw, 250px\" \/><\/a><p id=\"caption-attachment-30293\" class=\"wp-caption-text\">Figure 6. A finished modified Robert Jones bandage with self-adherent bandaging tape and elastic tape. Elastic tape is placed at the bottom of the bandage to help protect it, but some toes are exposed to evaluate for swelling or to see if the bandage has slipped.<\/p><\/div>\n<h3 class=\"p4\">Tie-Over Bandages<\/h3>\n<p class=\"p2\"><span class=\"s1\">Tie-over bandages use the same principles as MRJ bandages with a topical therapy and contact layer. The secondary layer is usually gauze or lap sponges; lap sponges are usually covered with their wrapping to create an impervious barrier. Both the topical therapy and the lap sponges should be applied to the wound bed in a sterile fashion. Umbilical tape is placed through stay sutures to secure the bandage to the patient.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Stay sutures are placed surrounding the wound, but they should not be placed too close to the wound, as the tissue near the wound edges is weaker and may eventually necrose (<span class=\"s2\"><b>FIGURE<\/b><\/span><\/span><span class=\"s2\"><b>\u00a07<\/b><\/span><span class=\"s1\">). A distance of 2 to 3 cm is appropriate. Once the lap sponges are covered, umbilical tape is placed through the stay sutures in a crisscross fashion to keep the tie-over bandage secure (<span class=\"s2\"><b>FIGURE<\/b><\/span><\/span><span class=\"s2\"><b>\u00a08<\/b><\/span><span class=\"s1\">).\u00a0<\/span><\/p>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-3 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:60%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69e8e71737ef7\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig7.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 7. Wound with properly placed stay sutures that are not too close to the wound.\"><img loading=\"lazy\" decoding=\"async\" width=\"720\" height=\"960\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig7.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig7.png 720w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig7-225x300.png 225w\" sizes=\"(max-width: 720px) 100vw, 720px\" \/><span>Figure 7. Wound with properly placed stay sutures that are not too close to the wound.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig8.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 8. One of many ways to secure a tie-over bandage with umbilical tape.\"><img loading=\"lazy\" decoding=\"async\" width=\"720\" height=\"960\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig8.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig8.png 720w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2024\/03\/Thompson_TVNSpring24_WoundBandaging_Fig8-225x300.png 225w\" sizes=\"(max-width: 720px) 100vw, 720px\" \/><span>Figure 8. One of many ways to secure a tie-over bandage with umbilical tape.<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69e8e71737ef7_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69e8e71737ef7\"))}, 0);}var su_image_carousel_69e8e71737ef7_script=document.getElementById(\"su_image_carousel_69e8e71737ef7_script\");if(su_image_carousel_69e8e71737ef7_script){su_image_carousel_69e8e71737ef7_script.parentNode.removeChild(su_image_carousel_69e8e71737ef7_script);}<\/script>\n<p><span class=\"s1\">See <\/span><a href=\"https:\/\/youtu.be\/CWdfG-QI7jk?si=0auyWhIFQI6AE-E4\" target=\"_blank\" rel=\"noopener\"><span class=\"s2\"><b>VIDEO 2 <\/b><\/span><\/a><span class=\"s1\">for a step-by-step demonstration of applying a tie-over bandage.<\/span><\/p>\n<div style=\"width:600px\"><div id=\"su_video_player_69e8e71737f24\" class=\"su-video jp-video su-video-controls-yes\" data-id=\"su_video_player_69e8e71737f24\" data-video=\"https:\/\/youtu.be\/CWdfG-QI7jk?si=0auyWhIFQI6AE-E4\" data-swf=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/plugins\/shortcodes-ultimate\/vendor\/jplayer\/jplayer.swf\" data-autoplay=\"no\" data-loop=\"no\" data-poster=\"\"><div id=\"su_video_player_69e8e71737f24_player\" class=\"jp-jplayer\" style=\"width:600px;height:300px\"><\/div><div class=\"jp-title\"><\/div><div class=\"jp-start jp-play\"><\/div><div class=\"jp-gui\"><div class=\"jp-interface\"><div class=\"jp-progress\"><div class=\"jp-seek-bar\"><div class=\"jp-play-bar\"><\/div><\/div><\/div><div class=\"jp-current-time\"><\/div><div class=\"jp-duration\"><\/div><div class=\"jp-controls-holder\"><span class=\"jp-play\"><\/span><span class=\"jp-pause\"><\/span><span class=\"jp-mute\"><\/span><span class=\"jp-unmute\"><\/span><span class=\"jp-full-screen\"><\/span><span class=\"jp-restore-screen\"><\/span><div class=\"jp-volume-bar\"><div class=\"jp-volume-bar-value\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\n<h2 class=\"p3\">Summary<\/h2>\n<p class=\"p2\"><span class=\"s1\">While wounds can pose many challenges, they can be managed by team members in general practices. Appropriate bandage care and topical therapies can assist with and improve wound healing. Wounds can be managed many ways; therefore, it is crucial to determine the course of treatment based on the wound\u2019s location and phase of healing. Although wounds can be frustrating, they can also be quite rewarding to watch progress from presentation to fully healed. <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The two most common techniques are the modified Robert Jones and tie-over bandages.<\/p>\n","protected":false},"author":236,"featured_media":30297,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":0,"footnotes":""},"categories":[353],"tags":[145],"class_list":["post-30296","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-spring-2024","tag-peer-reviewed","column-skills-check","clinical_topics-wound-management"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Wound Bandaging 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