What are the benefits of triple layered bandage?

RE: Benefits of triple layered bandage

Elise Steyvers — Mon, 10 Aug 2020 12:54:14 GMT

Indeed, that is what I was afraid of as well. Will definitely try with bandaging around the arm. Great tip

RE: Benefits of triple layered bandage

Georgie Hollis — Fri, 07 Aug 2020 14:00:54 GMT

I'm with Shelly on her answers. If i can be more dramatic even (only because i dare!) but i think using Vetwrap/Cohesive without any orthopaedic underpadding could be considered an accident waiting to happen. I tend to look at these things from a very black and white legal perspective if there is difficult debate.

So. If a bouncy greyhound is bandaged for 4 days with the combination of just dressing and vet wrap and suffers a bandage rub (over the carpus say - not necessarily where the original wound is), and that rub causes sufficient complications (both in terms of finances, stress and welfare) that the client complains, they could take that all the way to VDS involvement. If the VDS explore the complications and find that the bandage was knowingly applied without the layer that is designed to help reduce and dissipate pressure it would be very difficult to justify why it wasn't included.

That answer is to the point and i'm sorry if its a bit direct, but probably where the argument could end ultimately. Vetwrap/Cohesive should definitely not be left on without underpadding of any kind for more than a few hours at a time. There is a mathematical/physics equation that is done to measure pressures under a bandage which justify use of the orthopaedic underpadding layers, but they are usually only done in product testing/industry research.

IF you want a practical demonstration of why its better to use the Orthopaedic and Conforming layer under Vetwrap - get a colleague's hand (ideally the one in question) and bandage to the wrist with just cohesive/vet wrap, Ask them to do something manual and see how it feels - (eg. roll up an unrolled vet wrap back onto the roll.) Bandage the other hand with the orthopaedic underpadding beneath and ask them to repeat the exercise. See if they feel the difference ... they can't help but notice it! ... there is some cool science to this and physics that really help understand the issues, but if they like friction burn they'll possibly enjoy the cohesive only experience.

RE: Benefits of triple layered bandage

shelly jefferies — Thu, 06 Aug 2020 18:15:11 GMT

Hi Elise

Thanks for the question, it sounds like a challenge! I suppose where I would start first is do you see many patients returning with bandage related complications, because if this is a rare occurrence it may be hard to change habits which aren't necessarily causing problems.......however that doesn't mean we shouldn't try.

The practice sounds like it may be up for change as you mention you could discuss things at the next meeting, have you tried speaking to the other RVN's about it, maybe asking if they know of a reason the practice does it like that, as thinking back to your training nurses were always taught, primary, secondary and tertiary layers for bandaging. If the nurse aren't that receptive is there a lead vet you could ask. Maybe may be more convincing or easier to put to them if you have done some cpd recently on bandaging.

The reasons for doing a three layer bandage are padding, support, and protection. That can be from the patient, the environment or other factors. The main bandaging injuries are friction, shearing and pressure. I would be really concerned about pressure related injuries just using a cohesive and elasticated layer such as vetrap, as there is no padding for protection, especially over boney prominence's.

From a CPD point of view do you think the practice would be up for an in house CPD session which can be arranged once Covid restrictions are lifted a little, delivered by one of our Bandaging Angels, going right back to basics? Alternatively we do have an offer on at the moment on Vet Wound Library membership for just £25 for 3 months - during which time you can access all our recorded webinars (there is a great one on bandaging) and the webinars coming up over the coming 3 months. That may be a way of then bring the discussion forward in a meeting if you have some recent CPD to discuss.

Hope that's helpful and any more questions please let us know, and keep trying to improve things ;-)