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Bandage Check-in: Reassess, reapply; reinforce.

Dr. Sylvestre described the protocol that she used EVERYTIME a patient came for a bandage change. This protocol really helped her identify and deal with POTENTIAL issues, and therefore prevented many complications from becoming problems. Be proactive and follow this protocol:

The Assessment:

Have a really good look and feel of the bandage to identify the issues that need to be readjusted. Check for dermatitis which occurs if the bandage gets wet.

Cuts and wounds, these usually occur at the top of the bandage. This usually happens because of the gauze kling is wrapped directly on the skin.

Check for decubitus ulcers but mostly for broken hairs and redness over the bony prominences. If it is identified, apply a donut.

Interdigital dermitis, check between the toes for wetness, greasiness, smell the area also to see if there is a yeasty smell.

Manage the issues and re-apply the bandage:

Manage the wounds as per your favorite protocol. Dermatitis should be cleaned, dried and perhaps an antibacterial cream can be applied. Decide if antibiotics are necessary.

Manage the interdigital dermatitis by cleaning and drying between the toes; perhaps shave the hair; perhaps apply powder or place cotton between the toes. Modify the bandage accordingly such as placing a donut or using more padding and more tension when applying the bandage.

Reinforce bandage care:

It is best to share with the owner the issues that you have noticed with the bandage so that they understand what the issues are/were and they too can adjust their monitoring habits.

Book the follow-up appointment BEFORE they leave because a WEEKLY recheck is very important. Re-educate the client regarding bandage care!

Follow-up and document the “no-shows” because these are the ones that will end up with a complication.

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