Author

Stephen J. Birchard DVM, MS, Diplomate ACVS

Monday, February 10, 2014

Tie-Over Bandage: The greatest thing for open wounds since the wet to dry dressing


Have a dog or cat with an open skin wound in a difficult area to bandage? This situation is screaming out for a tie-over bandage.  They can be placed virtually anywhere and they are practical, effective, and inexpensive. They can be constructed as a wet saline dressing, a sugar bandage, or even a petroleum impregnated gauze dressing.

As with any bandage sedation may be necessary, such as dexdomitor or acepromazine combined with hydromorphone. Consider general anesthesia for severe wounds that will require extensive debridement.

Equipment needed:

  • Suture (2-0 polpropylene or nylon is best. Be sure to use a monofilament suture)
  • Sterile sponges (2 x 2’s, 4 x 4’s, or laparotomy sponges depending on size of the wound)
  • Sterile paper drape or other thin impervious material
  • Umbilical tape


Technique:

Fig. 1: From left to right the steps for constructing a tie-over bandage
(from: Knapp DW. Management of the open wound. In: Saunders Manual of Small Animal Practice,
Birchard and Sherding, editors, Elsevier, 2006, pg. 549)
  1. Debride and flush the wound with sterile saline.
  2. Place several loops of suture through the skin, around the wound. (Fig 1)
  3. Pack the wound with sterile moistened sponges or sugar.
  4. Cover the sponges with sterile paper drape material.
  5. Lace umbilical tape back and forth through the suture loops to secure the bandage in place. (There is no prescribed method for this step; just make it look pretty.)
  6. Change the bandage daily.
Video of the tie-over technique


Examples:

Extensive bite wounds in this Labrador resulted in a large open wound
from the lumbar area to the base of the tail.
After debridement and flushing, a wet saline tie-over bandage was placed.
Extensive burn wounds in a pit bull with areas of full and partial thickness
skin necrosis.
After debridement and flushing the entire injured area was covered by a
wet saline tie over bandage.

I will show the results of wound management in both of the above dogs in future blogs. 
Post any questions or comments.