Abstract
Objective The aim of this study was to measure and compare sub-bandage pressures after a rigid splint was applied to the forelimb of a dog by surgeons and veterinary students. Animals One, adult, Labrador Retriever. Methods Sub-bandage pressure was measured at five locations on the limb of a dog using a previously validated pneumatic compression measurement system over a 4-hour period after splint application. All participants received the same instructions and the same dog was used for each splint application. Results Across time and location, mean sub-bandage pressures from the experienced group were significantly greater than those from the inexperienced group at all transducer locations and at all time points. People from the inexperienced group recorded the greatest range in sub-bandage pressures and had significantly higher-pressure differences across the five locations sub-bandage pressure was measured. Conclusions and Clinical Relevance Surgeons applied their splint bandages with approximately 50% greater pressure and 50% less variability between locations. The large range in sub-bandage pressures found may suggest that decreased and/or increased sub-bandage pressure may predispose to bandage complications.
Highlights
Rigid splints and bandages are routinely used in veterinary medicine
The large range in sub-bandage pressures found may suggest that decreased and/or increased sub-bandage pressure may predispose to bandage complications
Complications arising from suboptimal bandage application include vascular compromise, ischaemia, oedema, rub sores
Summary
Rigid splints and bandages are routinely used in veterinary medicine. When applied and managed appropriately, splints and bandages can provide an effective means of immobilization, stabilization, wound protection, minimization of oedema, elimination of dead space and a clean environment.[1,2] Application of bandages is not without risk. Complications arising from suboptimal bandage application include vascular compromise, ischaemia, oedema, rub sores. Necrosis and ineffective treatment of the underlying problem.[2,3,4] Meeson and colleagues reported that 63% of patients with a cast for a distal limb orthopaedic injury developed a soft tissue injury; 40% of patients required continued care because of the complication.[5] Identifying predisposing factors is critical to reducing iatrogenic soft tissue injuries. It has been suggested that dermal sores or lesions usually develop at areas of high pressure.[6] Empirically, soft tissue wounds secondary to bandages and casts occur adjacent to elevated areas of the limb such as the calcanei, styloids, malleoli or pads. It has been reported that less soft tissue coverage (e.g. muscle and subcutaneous tissue) results in reduced compressibility, thinner skin over bone prominences or elevated pressure.[6,7,8] received March 11, 2019 accepted after revision July 23, 2019
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