casts, slings, and splints
Clinical Textbook for Veterinary Technicians 7th ed by McCurnin
and Bassert, pgs.
Objectives: understand the role bandages play in healing, recognize
signs of complications that can occur with bandages/casts, be able to
critique a proper bandage fit, be able to instruct clients on bandage care,
know the 3 layers of a typical bandage, know the constructions and purpose
of various types of bandages (limb, trunk, ear, tail, paw, hip, and
Robert-Jones), be familiar with splints, slings, and casts, understand cast
Bandaging is both an art and a science. Like other clinical techniques in
veterinary medicine it is important to know and understand the "science"
(what materials to use, when, why and how). But, applying effective and
acceptable appearing bandages is truly an art! It takes lots of practice to
develop bandaging skills and just when you think you have it mastered that
"special" patient comes along that gets out of every bandage.
A) Bandages promote healing by:
1) protecting the wound from
contamination and drying
2) decreasing the possibility of self
3) decreasing swelling and edema
4) decreasing seroma or hematoma
B) Signs of improper bandage fit and/or problems include:
1) swelling above or below bandage
2) redness or discoloration of skin
5) excessive chewing or licking
6) cool extremity
C) The following should be avoided when applying bandages:
1) Creating pressure rings: the
tourniquet effect can cause serious tissue
damage distal to the pressure ring
a) by using bandage material that is
b) by using
uneven pressure when applying bandages
2) Increasing bandage pressure over
joints and bony protuberances,
which can lead to necrosis of tissue at these pressure points
3) Creating ridges or lumps in
bandage which can lead to necrosis of
tissue below the ridges.
4) Using non-porous materials which
do not allow oxygen to the wound
or exudates to escape.
5) Using non absorbent bandage
materials that do not wick away
exudates from the wound site.
D) Client education and compliance is essential for successful treatment:
1) Clients judge the treatment by the
appearance of the bandage and how
well it stays in place (not the unseen tedious work of applying the
2) Clients should be told the
importance of noting the condition of the
bandage at least twice a day.
3) Signs of improper fit and problems
(from B above) should be explained
4) Clients should be told how to
protect bandage from moisture and dirt
when exercising patient.
E) Types of bandages
1) The three-layered bandage with
stirrups (see diagram for description of
application in text):
a) most common
bandage type used for wounds on extremities and
variations in technique and materials common
the wound must be
prepared (clipped, debrided, cleaned etc.) before
d) adhesive tape strips
are placed (extremities only) on each side
wound. The tape length is
estimated at twice the length of the finished
d) primary or
contact layer is next to skin or wound and includes various
types of dressing materials (wet/dry)
e) secondary layer
is supportive and can be padded and absorptive
f) third or
outer layer is protective and holds previous layers in place
decrease bandage slippage and "lock" bandage in place
Legend has it that a veterinary technician working at the Bergh Animal
Hospital in Boston "invented" stirrups.
2) Robert Jones bandage and
modified Robert Jones: (pages 107-109)
a) used as
immobilizing and stabilizing device
b) pre or post
c) in some cases
can be used in the same manner as a cast
3) Specialized bandages
and explanation of application:
a) Trunk bandage: When might this bandage be used?
1) STERILE DRESSING OVER WOUND
2) GAUZE (REGULAR OR ELASTIC)
3) ADHESIVE TAPE/Gauze - attach to fur/skin front
b) Stockinet: What
could this be used for?
1) GAUZE DRESSING
3) ELASTIC ADHESIVE TAPE
c) Ear - hematoma (post-surgical) for long and
ERECT EAR BANDAGE
1) Make cone (ear shaped) from cotton.
2) Place inside ear
3) Anchor with several short pieces of elastic
tape placed around the
1) Ear dressing, ear lifted over head.
2) Gauze or elastic gauze wrapped over ear and behind opposite ear to
3) Continue below jaw, bring wrap over ear again & in front of opposite ear
this time. Repeat 2-4 more wraps until ear secure.
4) Apply finishing tape to secure.
* Check for tightness
bandages -keeping bandages on the tail is very
difficult. Here are 2 different styles of bandages that you might want to
The many tailed Bandage
"Many tailed bandage"
1) Lightly dress tail tip
2) Make two X bandages (cut slits in regular one inch
bandage) twice the length of tail (or shaved area). Bandages
should be -1/2 the circumference of the
3) Place first bandage on tail, space each tail of the
tape slightly apart. '
4) Place other bandage at right angle,
most of the tail should be covered with bandage.
5) Place single tape around base of tail
to skin or fur- sometimes additional layers of tape around this last tape
wrap are applied, but the hair is "shingled"- meaning that a small amount of
hair at the cranial edge of the tape is brought out and allowed to
overlap the tape, then the next tape is wrapped over that and also slightly
overlaps the previous tape wrap.
Syringe cover tail bandage
1) Use appropriate sized syringe cover with needle cap
2) Prepare tail. Place cover over tail.
3). Tape sides of cover and secure with tape around base
e) Limb Bandage
LIMB BANDAGE using
1) Apply 2 strips of adhesive
tape on sides of
the leg (or front & back) to provide a "grip" for
About double the length of the
2) Tab the ends. Can use tongue depressors on ends to prevent tangling of
3) Cover leison with dressing.
4) Using gauze or elastic gauze, start (distally)
at the paw, leaving middle two paws out, wrap
over lap each wrap ~
5) Bring the stirrup ends up and turn them so the sticky side comes over
gauze, this helps lock the bandage in place.
6) Cover this with finishing tape. Add inter-digital
f) Feline paw -post operative (declaw), using rubber finger exam glove
Finger glove bandage
of the bandage.
1) Dress area with LARGE amount of cotton
it should be about 2-3 times the size of paw,
this acts as pressure bandage.
2) Gently, roll finger clot over dressing, to its
Latex should not be torn on top or bottom.
3) Place wide piece of tape (with tab) at the top
4) To remove bandage cut top tape,
will usually finish removing it.
G) Padded hip bandage
PADDED HIP BANDAGE (DONUT).
size hole cut
1) Double layer of thick cotton (combine
roll) with appropriate
2) Elastic tape or gauze around thigh and
over hip to secure cotton roll in place
3) Sterile dressing applied through
hole to decubital
II) Splints: Splints are used to support and protect legs and allow some
weight bearing. A carpal or front leg splint is described
below. Splints (slings and casts) are
usually applied by veterinarians.
A) Carpal or metacarpal splint (spoon splint)
1) A very common splint that can be
fashioned in-house by using fiberglass casting materials or it can be
purchased (usually made of plastic with foam
2) Various sizes can be made or purchased.
3) The distal end is spoon shaped to fit the bottom of the paw.
4) The splint should not extend proximally beyond the elbow or it will
rub against the chest
5) The splint is usually applied over two layers of material and stirrups
used to lock the splint in place.
6) It is sometimes used to protect fractures or dislocations of the
lower leg for young or very small animals.
7) A similar splint can be used on the metacarpal region of hind leg for
fractures or problems of the lower hind leg (below the hock joint).
B) Thomas splint: This splint is rarely used in small animal medicine
now, see text for photo (pg. 126) and explanation of itsí use in livestock.
III) Slings: Slings are used to immobilize a leg and prevent movement or
weight bearing. Photos and descriptions of the following slings are in the
A) Ehmer sling: This sling is used on the hind leg, primarily after
luxation/dislocation of the hip. Application is done by
the veterinarian to
cause adduction of the coxo-femora joint.
B) Velpeau (Val-paw) sling: This sling used on the front limb after
fracture or dislocation of the scapula.
C) 90-90 flexion sling: Both the knee and hock joints are placed in 90
degree flexion and taped. Used after surgery of hindlimb to decrease
quadriceps contracture and stifle stiffness.
D) Carpal sling: The carpus is bandaged then flexed and figured eight
taped above and around the radius and ulna.Promotes non
VII) Casts: Casts are used to protect legs after surgery and to
allow some weight bearing. They are used as primary fracture stabilization
in some cases and are less expensive than bone plating or other
Patients that are sent home with casts should be rechecked frequently
because problems can develop under that cast often without the owner
A) Plaster vs. fiberglass: These days almost everyone uses fiberglass
casting material. It is lighter, stronger and dries quickly.
B) Application of casts:
1) With the patient under anesthesia the leg can be adjusted and held at
the proper angle.
2) Cast padding and stockingnette are applied to decrease pressure sores.
Excessive padding or incorrectly applied padding can actually cause pressure
3) Moistened casting tape (usually dunked in a bucket of warm water for a
few seconds) is applied and overlapped up and then down the leg. Gloves are
4) The warmer the water used to moisten the faster the cast will set.
5) Depending on the size of the patient more layers of fiberglass casting
can be used, with more layers the cast is heavier and stronger but takes
longer to dry and set.
6) A hair dryer can be used to dry the cast faster.
C) Removal: Casts are best removed with an autopsy saw (Stryker) which
uses a high speed vibrating blade that doesnít cut the skin unless lots of
pressure is applied. Because of the sound of the saw some patients may
require tranquilization. Casts are usually left in place 4-8 weeks.
Radiographs can be taken with casts on a patient.
What changes in radiographic settings are needed if x-raying a fracture
with a cast?
Answers to be e-mailed to Dr. Bidwell:
1) Give an example of materials that could be used for each of the 3
layers of a 3-layer bandage.
2) Why are non-occlusive bandage materials especially important?
3) What is the difference between the regular and modified Robert Jones
4) In lay terms, what is a cranial dorsal coxofemoral luxation?
5) Why should the protective plastic bags applied to protect a bandage
from moisture or dirt not be left in place for more than about 30 minutes.
6) List 2 differences between the 3 layered bandage used in small animals
and the lower leg wound bandage described for horses.
7) Why is a lower limb support bandage used? (2)
8) What is the most popular splint material for large animals?
9) What type of splint is commonly used in cattle with lower leg
10) What is a major problem with this device related to patient injury?
11) What is meant by the term "shingled"?