Contents of Today's Veterinary Practice - JAN-FEB 2012

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

Page 65 of 83

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A
B
C
Figure 3. Open wound secondary to abscess surgery of the caudal thigh. The clinician is using a tie-over bandage (dry-to-dry bandage) due to wound location. (A) Stay sutures are placed in a circular pattern around the wound to help hold the bandage in place. (B) Sterile gauze squares are placed in and on the wound to absorb effusion; the next layer is sterile lap sponges (not shown). (C) The waterproof layer used is an absorbent pad cut to size and secured with umbilical tape using a criss-cross tying method.
1. A «Àim>ÀÞÉVonÌ>VÌÊl>ÞiÀ of sterile gauze packed into and on the wound
2. A ÃiVon`>ÀÞÊl>ÞiÀ of sterile laparotomy sponges 3. A ÌiÀÌi>ÀÞÊ l>ÞiÀ of waterproof material, which can be a surgical drape or an absorbent pad cut to cover the other layers.
Stay sutures are placed in a circular pattern around
the wound and umbilical tape is tied over to secure all of the layers in place.
Bandage Layers All bandages are comprised of a contact layer, second- ary layer, and a tertiary layer. The specific material used in each layer is determined by the type of wound and the bandage's particular function. The frequency of bandage changes depends on bandage type and wound exudate.
Primary (Contact) Layer Primary layers may be adherent, nonadher- ent, or semi-occlusive. UÊ `hiÀinÌ bandages include both dry- to-dry and wet-to-dry bandages; they are created with sterile gauze squares. It
is
important to remember that these sponges debride the wound and their removal may be painful to the patient.
» Dry-to-dry bandages are used for wounds producing increased amounts of low-viscosity
64 Today's Veterinary Practice January/February 2012
fluid/exudate and if foreign debris and necrotic tissue are present; for example, wounds that are producing a large volume of noninfected serum-like fluid.
» Wet-to-dry bandages are indicated for wounds producing higher viscosity fluid/exudate and if loose debris is present; for example, wounds that are still contaminated after debridement and producing purulent exudate. The gauze sponges are moistened with a sterile, balanced electrolyte solution.
UÊ on>`hiÀinÌ bandages, such as Telfa pads (Kendall Brands, covidien.com), are used to cover a wound for protection but do not provide any additional benefits.
UÊ on>`hiÀinÌ]ÊÃimi-oVVlÕÃiÛi bandages can be created using Vaseline-impregnated gauze, which is a material that allows fluid to absorb into the intermediate layer of the bandage. It keeps the wound moist and allows atraumatic removal of the dressing.
UÊ"ÌhiÀÊ Ãimi-oVVlÕÃiÛi bandages can be created
using hydrocolloid- and hydrogel-type bandages. » Hydrocolloids form a nonadherent, semi-occlu- sive gel. The dressings are permeable to oxygen, carbon dioxide, and water and are comprised of a polyurethane layer, colloid matrix, and sterile backing. After wound contact, they become gel- like and form a protective layer.