Several layers of 2.5 cm thick cotton wool are wrapped snugly around the limb from foot (bulbs of heel) up to the elbow for a full limb bandage, to the carpus or hock for a half-limb bandage . This first layer of cotton wool should be about 3cm thick. Splitting a roll into half improves the ability to apply it evenly to the leg.
Wrap gauze bandage firmly and evenly over the cotton wool to compress it the same over the entire bandage. Each width of the gauze should overlap the next by 50%.
The surface should have a firm and even appearance but easily indent on finger pressure .
Step 1 - Apply several more layers
Repeat the cotton wool and gauze layering , maintaining firm even pressure, until the diameter of the bandage is about three times that of the limb.
The cotton wool often tends to build up in the middle of the bandage and narrows at the end. This should be compensated for by adding additional layers at the ends which are then covered by another layer of cotton to incorporate them into the overall bandage. This stops any weak points where the additional material meets the rest of the bandage material.
At least 3 layers are usually used (minimum thickness of 6-8 cm) to give maximum support, but some people will use one or two layers where lesser support is required.
Finish with a layer of gauze.
After the final layer is applied the bandage should make a sound like a ripe watermelon when tapped with a finger.
For full limb bandages of the fore or hind limb particular care has to be taken of the accessory carpal bone in the fore limb or the point of the hock/calcaneal tendons in the hind limb. In these locations the layer of conforming bandage should be placed in a figure-of-eight conformation to avoid placing excessive pressure on the bony prominences in these anatomical areas. The final outside layer can also be placed in a similar manner or, alternatively, an incision made into the layer over the prominences after application. In addition, a doughnut-shaped cotton ring can be placed over the accessory carpal bone, or soft cotton pads applied medially and laterally between the tibia and gastrocnemius tendon in the hindlimb.
Splints help stabilize and support the limb further within the bandage thereby improving the results of first aid treatment and lessening further trauma.
Positioning of the splints in relation to the injury is very important.
Step 1 - Apply non-elastic adhesive tape
Secure the splints, if applied with non-elastic tape.
If no splints are to be used, just wrap the limb after a final gauze layer, with a single layer of overlapping 7.5 cm non-elastic tape , eg Elastoplast, maintaining even firm pressure. The entire length of the bandage is incorporated, including above and below the ends, to prevent dirt and bedding material entering the bandage. Distally this means underneath the heel bulbs where it can be sealed by an impervious tape to prevent increased contamination.
When finished the bandage should be an even tubular structure around the limb.
In the full limb versions in the fore and hind limb it is essential the bandage finishes high enough to prevent the carpus and tarsus flexing and limiting the bandage’s effectiveness.
Twice daily assessment of the bandage and horse to identify any change in use of the leg or change in fit of the bandage.
Any strike through of exudate or blood in the bandage should warrant an immediate change of bandage.
Replace bandage every 2-3 days or sooner if it loosens.
Change dressings at each bandage change.
Bandage-induced skin rubs or pressure sores.
Twisting or change in position of bandage and/or splints warrants an immediate replacement of the bandage/splints.
Inadequate stability leads to movement at wound or fracture site.
Long term Aftercare
Robert Jones bandages can be kept in place for prolonged periods with careful application and followup.
Skin rubs and pressure sores.
Inadequate support to limb.
Problems relating to splint application and maintenance.