How To Avoid Bandage Complications

Tips on how to avoid common issues that arise after mistaken placement of bandages.

Minor complications such as redness, edema and abrasions are common after placement of a bandage. But few studies are dedicated to severe complications such as ischemia, open wounds and necrosis.

A British team1 reported serious complications in 11 patients (nine dogs and two cats) after a variety of bandages were applied. Nine patients required surgical debridement, five received a skin graft, three had one or several toes amputated, and one needed carpal arthrodesis.

Even worse: two patients had a leg amputated and two others died.

The main problem here is ischemia. Ischemic lesions are caused by a bandage that is too tight, a lack of cotton padding around pressure points and secondary tissue edema. To avoid such embarrassing complications, the recommendation is:

• Use generous cotton padding.
• Leave toes 3 and 4 visible so you and the owner can assess swelling.
• Educate your client to take proper care of the bandage.

Most serious implications occur within 24 to 48 hours after application. If the patient starts to chew or lick a bandage excessively, or is unexpectedly in pain, think “bandage complication.” The patient should be readmitted and the bandage changed.

Long-term results in this study are only good in four cases out of 11 patients. Among the seven “unhappy” patients, three have ongoing lameness, two had a limb amputation and two died.

This study is a good reminder that a bandage should not be taken lightly and that client education is critical.

Dr. Phil Zeltzman is a small animal board-certified surgeon at Valley Central Veterinary Referral Center in Whitehall, Pa. His website is www.DrPhilZeltzman.com.

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FOOTNOTE:

1. DM Anderson and RA White. “Ischemic bandage injuries: a case series and review of the literature.” Vet. Surgery 2000, Vol 29, N 6, p. 488-498.

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