#1 VETERINARY SURGERY Flashcards
– is that branch of medicine, in which diseases are treated wholly or in part by manual or operative procedures.
SURGERY
Attributes of a good surgeon:
- Eye of an eagle-
- Heart of a Lion
- Hand of a woman
There is a system of rules by which the art of surgery is practiced. Such rules applies to:
Asepsis
Anesthesia
Tissue manipulation
Suturing
Otherwise known as complete asepsis, it refers to exclusion of all micro-organisms, this degree of asepsis is impossible. (e.g. it impossible to sterilize skin or the environment)
Integral Asepsis
Involves the relative exclusion of micro-organisms and careful handling of tissues to preserve an inherent defenses
Surgical Asepsis
How much less than ideal aseptic tech. can be & still preclude infection depends on:
Species involved
Susceptibility of tissues to become inflamed
The type and number of micro-organisms present
How to protect tissue defenses?
-Limit exposure.
-Minimize imposition of foreign materials (sutures, blood clots etc.).
-Preservation of circulation.
Relative Asepsis
It implies that all practical steps are taken to achieve complete asepsis. In this context, micro-organisms can gain access to surgical wound without resulting an infection.
Sources of Contamination:
Surgical Instruments
Environment
Personnel
Animal patient
: Sterilization can be divided into 2 types:
Cold Sterilization process-
Heat sterilization process
the use of chemical solutions.
Cold Sterilization process-
Other factors that influence wound infection include:
Duration of surgery
Surgical technique
Impaired host resistance
Contamination of the wound
dry heat (oven), autoclave (steam under pressure), moist heat (boiling)
Heat sterilization process
What is the most widely used and efficient method of sterilization
Autoclave -
Items w/c may be sterilized:
surgical instruments
drapes
gowns
swabs
most rubber articles
glasswares
some plastic goods
Items which may be damaged in the autoclave:
- fibre-optic equipment
- lenses and plastics
- dispossable items like catheters
The surgical team
Surgeon
Assistant surgeon/Scrubbed nurse
Anesthetist
Circulating assistant
Duties of the Asst. Surgeon
Prepare the instrument trolley.
Assist in draping the patient.
Pass instruments, swabs, etc. to the surgeon.
Assist with surgery: retract tissue, cut sutures, etc.
Be responsible for all equipment, swabs, sutures, needles etc.
Duties/responsibilities of the Surgeon
Considered as the team of captain.
Take responsible in the pre-op, intra-op and post-op.
Take responsible in the surgical judgment.
Duties of the Anesthetist:
Responsible in the objective assessment of the surgical patient.
Administer the appropriate pre-anesthetic and anesthetic drugs. Has the authority on what anesthetic agents to use to a particular patient and type of operation.
Responsible in monitoring the vital signs, maintenance & level of surgical sleep.
Duties of the Circulating Assistant
Help prepare theatre, instruments & equipment for surgery.
Tie the surgical team into gowns.
Help position the patient on the table.
Preparation of the surgical site.
Connect apparatus (diathermy, suction, etc).
Open packs of sutures/instruments etc.
Count swabs, sutures etc. with the asst. surgeon.
Scrubbing-up
Putting on a Surgical gown
Back-tie
Side-tie
Putting on Surgical gloves
Closed gloving
Open gloving
Plunge method
Surgical cases may be categorized as
follows
Elective & Non-urgent- healthy & often young.
* Necessary or Urgent- not immediately life
threatening but require prompt attention.
* Emergency surgery- life threatening condition.
Pre-operative preparation of the
Patient:
- Starvation – food is usually withheld for 12
hrs prior to surgery. - Clipping – clipping the surgical site is
necessary in most procedures (except intra
oral). - Bathing – ideally all patient should be
bathed before surgery to decrease the risk
of contamination but this is not always
feasible
- Administration of Enema – for some surgery
(e.g rectal/colonic, intestinal anastomosis) - Preparation of the skin – skin & coat are the 2
greatest sources of wound contamination as it is
not possible to remove all bacteria from the skin.
Common bacteria found in the skin (Staph. spp.,
Bacillus spp., and ocasionally Streptococcus spp.)
Potent scrub solutions: chlorhexidine,
Care of the patient during surgery:
- Careful positioning of towel clips.
- Attention should be paid in the conservation
of heat esp. in the small or very young patient. - Careful positioning of the patient on the
operating table
- Preparation of the eyes & mucous
membranes – for surgery in this area 0.1-0.2%
diluted povidone iodine are commonly used to
irrigate as antiseptic. - Positioning the patient for surgery – there are
standard position for specific operation. - Draping the patient – Plain drapes, Fenestrated
drapes, Adhesive barrier drapes
Immediate post-operative care:
Recovery from anesthesia
Recovery from anesthesia
Recognition of Pain
Application of Dressings or Cast
Comfort
Commonly performed surgeries in
dogs and cats
SPAY/OVH
* CASTRATION
* lump removal
* digit amputation
* exploratory
laparotomy
* orthopaedics
* enucleation
The pre-operative procedure of the
surgical team:
These includes:
1. Scrub suit/ OR gown
2. Theatre footwear
3. Headwear/OR cap
4. Mask & Goggle
5. OR gloves
With this method the sterile glove is hald open by a
scrubbed assistant and the hand inserted. There is a
risk of contaminating both personnel involved. This
technique is not commonly employed in vet.
operating theatre.
Complications:
Haemorrhage
* Infection
* Anaesthetic problems - death!!
* Pain
* Self inflicted trauma
* Wound dehiscence
