What is Bandage Casting?
A bandage cast allows for rigid structural support where injury to a limb has occurred, especially in the joint area, while allowing access to the wound. A bandage cast may be used in conjunction with a bivalved cast shell if necessary to provide more support and still allow access to a wound. Casts are traditionally associated with fracture repair, but when injuries or wounds occur in the joint area that require immobilization, while allowing periodic access to the wound for treatment, a bandage cast may be an option. Standard casts usually require anesthetic to apply and can result in cast rub sores due to lack of padding and rigidity. They also require hospitalization which may not be practical or may be cost prohibitive. A bandage cast consisting of a bandage with a rigid structure and sometime a bivalve cast overtop, that can be removed for the treatment of wounds, allows for a horse to be in their home environment, avoiding the need for expensive hospitalization while providing semi rigid support to the limb and joint affected. Bandage casts can be applied by a veterinarian or under veterinary supervision, without anesthesia, and the horse can be maintained in their home environment.
Bandage Casting Procedure in Horses
Before bandage cast application, wounds must be addressed. If continued wound maintenance is required and more support is needed, a bivalved cast can be used in conjunction with a bandage cast. A bandage cast can be applied without general anesthetic, although in an uncooperative horse sedation may be beneficial. If a bandage cast will involve the foot, and a horseshoe is present, it should be removed. The area to be bandage casted is cleaned.
The bandage cast consists of a nonadherent dressing covered with cotton and gauze bandaging. It is important that the bandage is applied smoothly without wrinkles or folds that could interfere with circulation. Rolled cotton or sheet cotton is then placed and secured with non-stretch, 6 in gauze, followed by additional layer of cotton and gauze, and then flexible adhesive wrap. The bulbs of the heel and sole of the foot may be included in the bandage cast depending on the location of injury. The resulting bandage wrap should be uniform and approximately 1 inch thick. If a bivalve cast is being used it is formed over top of the bandage then cut lengthwise in two places and joined with wires or fasteners so that it can be placed over the bandage and held in place with an additional bandage over top. The bivalve cast can then be removed and the bandage cast underneath changed and wound treated as required. A bandage cast can be left in place for two to three weeks if the bandage does not displace, loosen, or compress and no issues with swelling or wound exudate are detected. Usually the bandage cast is changed more often to access the wound for treatment.
Efficacy of Bandage Casting in Horses
Bandage casts are appropriate for soft tissue injury where support to the area is required. They allow for treatment of the wound and are associated with less issues than regular casts.
- General anesthesia not required
- Hospitalization not required
- Increased comfort with padding while still supplying rigid support
- Less likelihood of error causing circulatory problems, and can be easily adjusted if required to correct application errors
- Decreased cast rub sores
Bandage Casting Recovery in Horses
Stall rest is required to avoid displacement of the bandage and rest the affected limb. The bandage cast should be checked for signs of swelling, circulation, and exudate from the wound. Heat in the affected limb, cast sores, compromise of the cast through openings, compression, or loosening need to be addressed immediately. When walked, the horse should be turned away from the casted limb to avoid them pivoting on the injured limb. Your horse should also be checked regularly for heart rate, body temperature, food and water intake and output. Provide a stall with lots of bedding to encourage your horse to lie down and rest, and elevated food and water to reduce movement as much as possible. The wound will need to be addressed regularly as directed by your veterinarian and any medications such as antibiotics and antiinflammatories administered as directed. Regular follow up with your veterinarian to monitor the wound or injury and to assist with rebandage casting if required may be needed.
Cost of Bandage Casting in Horses
The cost of supplies for bandage casts will vary depending on how often the cast needs to be reapplied in order to treat the wound. Materials can be expensive if repeated changing is required, including non-adhesive bandage, cotton, gauze and adhesive wrap, which may range from $20 to $50 or more per application. The cost of your veterinarian's services will also vary depending on mileage to your location, if the horse is being treated at the home site, and the cost of living in your area. Veterinary charges to apply a bandage cast range from $200 to $300 and may not include mileage. The cost of supplies and care to treat the wound in the limb may be in addition to these fees.
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Horse Bandage Casting Considerations
Bandage casts are associated with less complications than plaster casts, and allow for ongoing treatment of wounds. Cast sores and circulatory problems are notably decreased with bandage casts over traditional casts. Also, because hospitalization is not required bandage casts are often a more feasible option for horse owners.
Bandage Casting Prevention in Horses
Providing your horse with a safe turn out and stalling environment will make them less likely to incur injuries requiring bandage casting. Sharp objects should be removed and safe fencing employed to avoid injury. In addition, while exercising or performing, watch your horse for signs of strain that could indicate injury, provide rest, and obtain treatment to prevent injuries from becoming profound.