When dressing an area of the body, remember:

• Make sure that you are dressing the correct part of the anatomy.
• Make sure that you know your anatomical directions.
• Know your left from your right!
• Don't forget to talk to the conscious patients.
• Adorn protective clothing if provided.
• Select the appropriate equipment before you begin and logically think over the procedure in your head before setting to work.
  Remember that in many situations where you are required to dress a wound, there may be more than 1 example of appropriate materials. In such circumstances, it is up to you to make a sensible choice, even though there may be no specific right or wrong answer. The selection of dressing materials is often dictated in practice not only by the type and severity of the wound, but also by cost and personal preference.

Practical examination example:

A Boxer dog has had a general anaesthetic to suture a wound to the palmar aspect of his left paw. The veterinary surgeon has asked you to dress the surgical wound. Demonstrate how you would do so (you are given a large cuddly toy upon which to work).

Suggested Equipment

• Apron and gloves
• Antiseptic solution for cleansing
• Straight Mayo scissors
• Cotton wool
• Rondopad
• 5cm Soffban
• 5cm Knitfirm
• 5cm Co-flex
• 2.5cm Elastoplast

Procedure

• Ask an assistant to monitor the dog's vital signs since he is still under general anaesthetic.
• Adorn protective apron and gloves if provided.
• Assess the surgical wound. Although you are dealing with a toy dog, imagine it to be a real patient. In real life you would check that the sutures are apposed and that there is no haemorrhage.
• Take some cotton wool and break off some small strips to place between the digits, pads and dew claws. This helps to prevent the toes from chafing and absorbs sweat produced.
• Next select a suitable material for the dressing which comes into contact with the wound. A clean, sutured wound is most suited to a non-adherent dry dressing (a cotton acrylic fibre pad with a perforated polyester film such as Rondopad). These dressings come in various sizes, but can be cut to fit any shape or size of wound. Place the dressing, in a sterile fashion, gently over the sutures remembering to place it shiny side down.
• Next apply a PRIMARY PADDING LAYER. A sutured wound to the pad is likely to need some padding in order to provide protection when the dog walks, but not so much that the dressing is likely to easily be pulled off. 5cm Cellona orthopaedic padding or Soffban is ideal for a Boxer sized dog and has the advantage over cotton wool that it comes ready to use in an easy to apply roll.
• Next secure the dressing and primary layers with cotton conforming bandage (the SECONDARY LAYER: 5 or 7.5cm Knitfirm is suitable). Apply the bandage longitudinally to the cranial and caudal surface of the limb and then turn it to wind around the limb in a figure-of-8 pattern. This serves to ensure that there is an even tension throughout the bandage. Use the carpus as an anchor in order to ensure that the dressing stays in place. Always bandage distal to proximal limb.
• Now select a suitable TERTIARY LAYER (the most exterior part of the dressing). Conforming, cohesive bandage such as Co-flex is ideal. 5 or 7.5cm are suitably sized. Cohesive dressings do not stick to the fur itself and therefore allow the dressing to be removed without pulling away large clumps of fur. The disadvantage is that sometimes they can be too easily removed. Never be tempted to apply sticky tape to the top of the bandage onto the pet's fur. It is very important that this layer of the dressing is not applied too tightly. Pull out a length of Co-flex prior to use in order to prevent this. An overly tight dressing can cause circulation problems and if not enough blood is getting to the wound, then healing may be impaired.
• Check that the dressing is smooth and comfortable. Ensure that the tertiary layer covers the intermediate layers. The padding layer should always be visible at the top of the bandage to ensure comfort and prevent soreness through rubbing.
• Make sure that you can answer the following questions:
  i) How can patient interference be prevented? (see the Q & A section of this module)
  ii) What advice should the owner be given upon discharge of the dog? (see Key Notes A & B of this module).