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. <HOME> 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.
