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 66 of 83

TODAY'S TECHNICIAN |
» Hydrogel is a nonadhesive, absorbent polyeth- ylene oxide membrane that covers a gelatinous membrane, which absorbs exudate and keeps the wound moist.2
Both hydrocolloids and hydrogel may speed epithlial- ization on acute, partial-thickness wounds.
Secondary Layer Secondary layers are comprised of bandage materials that can absorb exudate, secure the contact layer, and provide some pressure to decrease dead space and/or prevent edema. Examples of materials commonly used to create this layer are cast padding and roll cotton ( i}ÕÀiÊ{).
Tertiary Layer The purpose of the tertiary layer is primarily to secure other parts of the bandage. Conforming, stretch-gauze bandage ( i}ÕÀiÊx) is used. An outer layer ( i}ÕÀiÊÈ) of either Vetrap (3m.com) or Elastikon (jnj.com) is used to secure the 3 layers of the bandage.
Drainage Systems When there is an abundance of dead space related to the wound or a seroma formation secondary to the wound or surgical intervention, an active or passive draining system is needed for optimal success in wound healing. Several types of draining systems are currently avail-
able in veterinary medicine. UÊ*>ÃÃiÛiÊ`À>inà do not involve suction but instead simply rely on the pressure differentials between body cavities and the exterior of the body to func- tion.
UÊ VÌiÛiÊ`À>inà are maintained under either low- or high-pressure suction.
Passive Drains The most common type of passive drain is the Penrose
(crbard.com) drain ( i}ÕÀiÊÇ, page 66). UÊThe Penrose drain is a length of soft rubber tubing that is applied by inserting one end of the tubing into the wound or surgical site; then tunneling the tubing ventrally toward a small skin incision where it exits the body.
Figure 4. Secondary layer from a bandage made of cast padding.
UÊThis drain pulls excess fluid from the body using constant suction.
UÊThe part of the drain in the wound or body cavity is made of Teflon (dupont.com) and designed with a series of holes or openings that allow appropri- ate draining.
UÊThe drain is connected to plastic tubing that is sutured to the skin at the insertion site; the exte- rior end of the tubing is connected to a plastic bulb, which creates negative pressure when squeezed and released, providing suction.
Economical alternatives to the Jackson-Pratt drain can
be made; two setups are commonly used: UÊBoth setups use a 30-inch or longer, sterile mac- robore IV extension set that the surgeon alters by
UÊThe drain prevents the accumulation of fluid (ie, serosanguinous fluid, blood, purulent material) under the skin.
Figure 5. Tertiary layer of a bandage (conforming stretch gauze).
UÊThe fluid doesn't exit through the tube itself, but rather around the tube, draining at the incision sites.
UÊThe Penrose drain relies solely on gravity to func- tion; there is no collection system associated with it.
Active Drains Jackson-Pratt (cardinal.com) drains are an active drain with a collection system attached. Although more expen- sive than passive drains, active drains may decrease the likelihood of an ascending wound infection developing through the drain. They also minimize the need for a band- age to absorb fluid, which is the case with a passive drain.
Figure 6. Outer layer of a bandage (ie, Vetrap, Elastikon).
January/February 2012 Today's Veterinary Practice 65
Principles of Wound Care & Bandaging Techniques