Dr. Sylvestre outlines key common and potential complications associated with veterinary bandaging and provides insight into why these issues arise and how to prevent them.
Complications seen include:
-Skin irritation, this can be mild simply a bit annoying for the pet or it can be more substantial like a full blown dermatitis.
-Decubitus sores are a difficult complications to deal with. These occur over bony protuberances.
-Distal swelling or edema is when the toes exposed start to swell. This can occur because the bandage is too tight or because there are too many toes exposed and therefore the blood flow becomes more sluggish and even a appropriate tension can cause the toes to swell. This usually resolves quickly when the bandage is removed. However, it is not managed quickly enough then ischemic necrosis can ensue.
-Bandage slippage occurs often but it is not always considered a complication because there is no damage to the pet. However, it means the bandage is not fulfilling its job.
Underlying Causes
-The layers of the bandage are applied in an inappropriate order or are omitted. The proper order of the various layers is discussed briefly in the video.
-The bandage is not properly applied. It is important not to have too many toes exposed distally. You should just be able to see the 3rd and 4th digits so that the bandage can be monitored properly (by assessing the toes) but not more.
-Too much tension can be applied to the bandage. This is actually an uncommon problem if an appropriate amount of padding has been applied prior to the compressive layer. If there is no padding or insufficient padding then too much tension can be a problem. So place sufficient padding!
-Not enough tension is a more common problem. IF there is not enough tension then the bandage is likely to slip and not fulfill its function.
-Bunching of the bandaging material can lead to discomfort for the patient and this usually occurs if the padding material is not applied with care and with 50% overlap. Also if the kling layer is too loose then that can also allow the bandage materials to bunch up.
-Poor monitoring and poor follow-up. these are HUGE contributors to bandage complications going from a small easily managed issue to a difficult problem to manage. At follow up appointments is where the slightly irritated skin over a bony prominence can be observed and managed so that the decubitus sore is prevented. It is better to deal with an “extra” bandage change rather than a major problem to deal with.
