Equine First Aid - Bandaging a Horse
By Jess Hallas-Kilcoyne
Just as every horse owner should possess, at the very minimum, a basic knowledge of areas of horse care such as nutrition, common illnesses, and hoof care, so too should they have at least a rudimentary understanding of the proper techniques for bandaging a horse’s legs.
There are a number of situations in which leg bandages may be necessary or advisable. Some of the most common reasons for bandaging a horse’s legs include:
- Providing warmth and support to stiff or sore tendons and ligaments;
- Preventing or reducing swelling after exercise or during stall rest;
- Protecting legs from injury during exercise or trailering
- Covering wounds to prevent contamination and facilitate healing.
Different occasions call for different types of bandages, but all equine leg bandages can be dangerous if applied incorrectly. In many cases it is preferable to leave a horse’s leg unwrapped altogether rather than bandage it improperly.
Bandaging Layers & Materials
In order to correctly bandage a horse’s leg, you must first be familiar with the various bandaging layers and their function, as well as the appropriate materials for each layer. Generally speaking, a leg bandage should always consist of at least two layers (padding and bandage), with wound bandages requiring a minimum third layer (wound dressing).
Layer 1: Wound Dressing – If a wound is present, the primary or contact layer should be a wound dressing. The appropriate dressing may vary depending on the type of wound and stage of healing, but the most commonly used wound dressing is a sterile non-adherent gauze pad.
Layer 2: Padding – The intermediate bandaging layer consists of soft, absorbent padding material to cushion and protect the limb, and to help evenly distribute pressure applied by the bandage. Roll cotton, sheet cotton, and combine cotton (also known as Gamgee™) are excellent padding materials, as are commercial cotton or flannel “pillow” or quilted wraps, which can be washed and reused.
Photo: Equi-Health Canada
Duct tape or vet wrap “suspenders” offer a creative solution to the problem of sagging or slipping bandages on the horse’s forearm or gaskin. Photo: Penny Batherson
Layer 3: Bandage – The third and outermost bandaging layer consists of the bandage itself, which secures the other layers and provides compression. There are many choices of bandage materials, including fleece, cotton, and polyester knit bandages with Velcro® fasteners, as well as flexible cohesive bandages, such as 3M Vetrap™, PowerFlex®, and Co-Flex®, which are frequently collectively referred to as “vet wrap.” Whatever material you choose, make sure the bandage is between four and six inches wide, as a narrower bandage can result in pressure points and general constriction of the limb.
Basic Principles of Bandaging
Regardless of the type and purpose of the bandage, there are several basic principles that are of critical importance when it comes to bandaging your horse’s legs safely and effectively.
1. Begin with clean, dry legs and bandages. Trapped beneath the bandage, dirt and debris can cause skin irritation and infect the wound (if one is present), while moisture can lead to a fungal infection.
2. Apply correct tension. The greatest challenge when it comes to bandaging a horse’s legs is achieving the right degree of tension. Applied too loosely, a bandage will not only fail to provide adequate support, but may slip out of place or come undone altogether. If the bandage slips and bunches, it can create pressure points on the back of the leg that can cause damage to the tendons, sometimes called a “bandage bow.” On the other hand, a bandage that is wrapped too tightly will impede circulation in the limb and can also result in a tendon injury.
The ideal tension for a correctly applied leg bandage is best described as “snug.” Essentially, the bandage should be tight enough to remain securely in place but not so tight as to restrict blood flow in the limb.
3. Make wraps smooth and even. The bandage and the padding underneath should lie flat and smooth, without any wrinkles, bunches, or ridges that could cause pressure points. Leg bandages are wrapped in a spiral pattern, and each wrap you make around the leg should overlap the preceding layer by about 50 percent to ensure consistent, even distribution of pressure.
4. Provide adequate padding. An inadequate amount of padding between the bandage and the limb can result in constriction on the limb, inhibiting blood flow and creating pressure points that can lead to injury. As a general rule, the layer of padding should be at least one inch in thickness in order to adequately cushion and protect the leg. Always make sure there is about an inch of padding showing above and below the bandage.
5. Wrap from front to back, outside to inside (counter-clockwise on left legs, clockwise on right legs). This ensures tension from the bandage is applied to the front of the leg rather than on the delicate tendons at the back of the leg.
6. Start the wrap over bone at the inside front of the leg. Never start or finish the wrap over the tendons, which may cause damage, or over a joint, as the constant movement will loosen the bandage and may cause it to bunch or unravel.
7. Wrap legs in pairs. While it isn’t necessary to wrap all four legs, standing bandages and exercise bandages should always be applied to both front legs, or both hind legs.
8. Check leg bandages frequently and re-bandage if necessary. As a general rule, standing bandages should not be worn for longer than 12 hours at a time, while wound bandages should usually be changed every day.
9. When in doubt, ask your veterinarian. If you have never bandaged a horse’s legs or are in any doubt about proper bandaging technique, ask your veterinarian to demonstrate the correct procedure and to supervise your first bandaging efforts.
The main function of standing bandages (also called stable or stall bandages) is to provide protection, mild support, and warmth to the tendons and ligaments in the horse’s lower leg. Frequently used to help prevent edema or “stocking up” caused by inactivity and often following strenuous exercise, these general purpose bandages can also be used to cover the leg after applying a wound dressing, poultice, liniment, or other topical.
Standing bandages consist of an inner layer of padding material – usually no-bow, quilted, or pillow wraps, although roll, sheet, or combine cotton are also suitable – over which commercial standing (or stable) bandages made of stretchy cotton or polyester knit with Velcro® fasteners are applied. When applied correctly, a standing bandage should cover the horse’s lower leg from just below the knee or hock down to the bottom of the fetlock (see Figure 1: Applying a Standing Bandage).
Remember, if you apply a standing bandage to one leg, you should also wrap the opposite leg. Standing bandages are typically worn for about 12 hours at a time and should never be left on for longer than 24 hours without being removed and rewrapped.
Wound bandages should be finished with adhesive bandaging tape or masking tape wrapped loosely around the end of the bandage to secure it, and around the top and bottom of the bandage to seal out dirt and debris that could contaminate the wound. Photo: Jess Hallas-Kilcoyne
Most wound bandages tend to consist of roll, sheet, or combine cotton for padding and a flexible cohesive bandage, or vet wrap, for the outer bandage, although in some cases pillow or quilted wraps and stretchy knit bandages may be suitable alternatives.
Before bandaging a wounded leg, make sure the leg is clean and dry, and the wound has been cleaned, rinsed, and treated as recommended by your veterinarian. The specific bandaging technique may vary depending on the location of the leg wound (e.g. cannon bone, knee or hock, or forearm or gaskin), but the general procedure for applying a wound bandage is as follows:
1. Cover the wound with a sterile, non-adherent gauze pad or other dressing, and secure it by loosely wrapping roll gauze around the leg two or three times.
2. Wrap roll, sheet, or combine cotton around the leg, making sure to cover the wound and dressing completely, until the layer of padding is at least one inch in thickness.
3. Apply the bandage, starting an inch below the top of the padding and wrapping down the leg in a spiral pattern with each wrap of the bandage overlapping the preceding layer by about 50 percent. Wrap down to within an inch of the bottom of the padding, then spiral up again to finish near the top.
4. Use an adhesive bandaging tape, such as Elastikon®, or masking tape to secure the end of the bandage, and wrap the tape loosely around the top and bottom of the bandage to seal out dirt and debris.
Check the bandage several times throughout the day to make sure it hasn’t slipped or become tighter or looser. The bandage should be changed at least every other day, unless your veterinarian indicates otherwise or the bandage becomes wet or soiled, in which case it should be changed immediately.
Photo: Jess Hallas-Kilcoyne
Knee & Hock
The knee and hock are particularly challenging to bandage due to their shape and high degree of mobility, which can cause the bandage to loosen and slip down. Applying standing bandages to both of the front legs or the hind legs (depending on whether you are bandaging the knee or the hock) can provide the knee or hock bandage with support and help prevent slippage.
It is also very important when wrapping the knee or hock to avoid pressure on the bony prominences of the joint, particularly the accessory carpal bone at the back of the knee and the point of the hock, as these areas are prone to pressure sores. This is best achieved by wrapping the bandage around the joint in a figure-8 pattern (see Figure 2: Applying a Figure-8 Bandage), which ensures that tension from the bandage is applied only across the front of the knee or hock, and not the back.
The padding material for a hock bandage can also be applied in a figure-8 pattern, leaving the point of the hock uncovered altogether (see Figure 3: Bandaging the Hock). For the knee, however, the padding should be applied around the entire joint and a relief hole cut over the back of the knee after the figure-8 bandage is applied to alleviate any pressure on the carpal accessory bone.
The layer of padding for both the knee and the hock should be especially generous, at least two inches in thickness, to minimize pressure on the bony prominences on the inside and outside of the joint. When you have finished a knee or hock bandage, always slide two fingers under the bandage at the back of the leg to make sure it is not too tight.
The shape of the equine forearm and gaskin, as they taper down toward the knee and hock, is such that bandages in these areas tend to succumb to gravity and slip down. Applying a few vertical strips of double-sided medical or masking tape to the leg beneath the padding (avoiding the wound) can help to anchor the bandage in place and prevent it from sagging down. Another option for holding a bandage in place over the forearm or gaskin is to fashion “suspenders” out of duct tape, vet wrap, or stretch netting that run over the horse’s withers or back and attach to the upper leg on either side.
Forearm & Gaskin
This article originally appeared in the March 2014 issue of Canadian Horse Journal.
Main article photo: Pam Mackenzie