Page 2349 - Cote clinical veterinary advisor dogs and cats 4th

1162 Slings, Casts, and Other Forms of Immobilization

Casts: • Ehmer sling (hindlimb) ○ Repeat the pattern two or three times to
layer the tape.
• Apply adhesive tape stirrups. ○ Lightly pad the metatarsal region with ○ If maintaining hip reduction, following
cast padding.
VetBooks.ir length proximally and distally. Stockinette ○ Hold the stifle and tarsus in flexion. the last pattern, pass the tape over the
• Roll stockinette over the limb, allowing extra
lateral side of the flexed leg over the back
○ Pass adhesive tape around the padded
is optional but does give the cast a more
finished appearance.
stick the tape to itself on the abdominal
side of the metatarsus.
• Apply a light layer of cast padding over metatarsal region, coming up the lateral and around the abdomen as a belly band;
stockinette. ○ Twist tape 180° to keep the adhesive side wall, taking care to exclude the prepuce
• Apply roll gauze with light and even against the skin, and pass it medially to in males. NOTE: Adhesive tape must be
compression. the stifle. stuck directly to haired skin to avoid
• Apply casting tape over the gauze in distal-to- ○ Pass the tape over the lateral thigh as far slippage.
proximal direction, overlapping by 50% and proximally into the inguinal region as ○ To avoid joint contracture, the sling should
avoiding digital pressure and wrinkles during possible. not be used for more than 2 weeks.
application. Layer as needed for appropriate ○ Again twist the tape to keep the adhesive ○ The limb must be monitored frequently
strength. against the skin, and pass it distally medial for swelling or skin abrasion.
• Support the limb at multiple points while to the hock.
hardening to avoid dents or incorrect ○ Continue tape back up to the starting Postprocedure
alignment. point at the lateral side of the metatarsal • Check digits and distal limb at least q 12h
• Roll stockinette ends over the cast ends. region. for any signs of ischemic injury.
• Apply the stirrups to the cast. Their purpose
is to prevent the cast from slipping off the
limb.
• Cover with an outer tertiary layer of elastic
conforming tape.
Slings:
• Velpeau sling (forelimb)
○ Lightly pad the foot and carpus with cast
padding to prevent excessive flexion.
○ Wrap conforming gauze around the foot
from medial to lateral.
○ Hold the limb adducted against the body
wall with the carpus, elbow, and shoulder
in flexion.
○ Roll the conforming roll gauze around
the limb and thorax, passing caudally to
the opposite forelimb to prevent slipping. A B C
○ Continue on the same pattern for two
to three layers, incorporating the entire SLINGS, CASTS, AND OTHER FORMS OF IMMOBILIZATION Velpeau sling. A, Conforming gauze
carpus and paw. bandage material is wrapped loosely around the paw, with direction of wrapping causing the gauze to pass
○ Apply a light tertiary layer of conforming from medial to lateral on the dorsal surface of the paw. B, With carpus, elbow, and shoulder all flexed, gauze
tape over the gauze in the same pattern. is brought from paw over the lateral aspect of limb and shoulder, over thorax and dorsum, and caudal to the
○ The easiest way to perform these steps is opposite axilla. It then continues across the ventral thorax, back to the starting point. C, Several more layers
of gauze are applied in a similar manner, and a few layers are brought around (cranial to) the flexed carpus
with the patient awake and standing. to prevent extension of the elbow because extension could force the distal limb out of the bandage. Wide
○ To avoid joint contracture, the sling should elastic tape is used for covering the gauze in a pattern similar to that used for the gauze application, which
not be used for more than 2 weeks. completes application of the splint.

A B C D E
SLINGS, CASTS, AND OTHER FORMS OF IMMOBILIZATION Ehmer sling. A, Adhesive tape is passed around
the lightly padded metatarsal region, coming up the lateral side of the metatarsus. B, Tape is twisted 180°, and stifle
and tarsus are held in flexion. Adhesive side of tape is applied to medial side of stifle, continuing up and over thigh
as proximal into inguinal space as possible. C, Tape is again twisted 180° to keep adhesive side against skin and is
applied to medial side of hock and then around to starting point on lateral side of metatarsals. Tape is continued for
another 1-2 layers over same pattern for greater support. D, To support hip reduction, tape may be continued over
the back, with the hip in slight abduction. E, Tape is passed once around the body and stuck to itself as a belly band.

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