Selection and Preparation of the Surgical Area Flashcards
This room should be close, but not adjacent, to the surgery room. The surgical patients are anesthetized and prepared for surgery in this room. The equipment kept in the preparation room will include drugs used for anesthesia and materials needed to prepare the patient. This room should always be clean and tidy
Preparation Room
When performing surgeries on rodents, this type of sterilizer may be used in between animals when doing more than one.
hot bead sterilizer
options available to sterilize surgical equipment and supplies:
- Autoclave
- Ethylene oxide
- Cold sterilant solutions
- Hot bead sterilizer
- Pre-sterilized items
- Implanted Items
Relies on pressurized steam, is extremely reliable, and cost effective. However, instruments must be durable (e.g., stainless steel) and the process is relatively slow, from 15 to 60 minutes. Instruments are typically wrapped or sealed in packs that are opened as needed on the day of surgery
Autoclave
Autoclave time requirement
15 to 60 minutes
A gaseous sterilant that requires specialized containment equipment.
Ethylene oxide
Ethylene oxide
This is a good sterilization method for supplies that cannot tolerate high heat such as plastics and catheters.
Ethylene oxide
It is more costly than autoclaving and typically is performed overnight
Ethylene oxide
Cold sterilant solutions
hypochlorite, glutaraldehyde
Cold sterilant solutions contact time
15 - 60 minutes
have prolonged contact time (15 - 60 minutes) to sterilize surgical equipment. In addition, the instruments must be rinsed completely with a sterile solution like saline to prevent tissue irritation.
Cold sterilant solutions
This device is a small tabletop unit, approximately 6 x 6 x 8 inches. The appliance heats a small container of Pyrex beads to approximately 250 C and can sterilize the tips of metal surgical instruments in 10-20 seconds.
Hot bead sterilizer
Hot bead sterilizer contact time
10-20 seconds
. It is very useful for sterilizing instruments between rodents when performing surgeries on multiple animals.
Hot bead sterilizer
Many instruments and supplies can be purchased in sterilized packaging. Such items must be used prior to the label expiration date.
Pre-sterilized items -
Special consideration needs to be made for items that will be implanted (i.e. left in the animal after surgery is completed). Many of these items are “sensitive and/or fragile” and can be difficult to sterilize. Possibilities include use of ultra-short autoclave cycle, ethylene oxide, or use of a cold sterilant. Note: Use of alcohol alone is not a sterilant.
Implanted Items
If the surgery is elective the animal should be admitted to the hospital ________ hours prior to the operation
24-hours
Food should be withheld on the day of surgery and ______ hours fasting for gastro-intestinal operation.
24 hours
Hair should be removed from the surgical site, preferably with electric clippers (# ______ blade) or depilatory rather than a razor.
40 blade
Position for surgery in the perineal area (lying on its chest)
Sternal recumbency
Position for surgery in the ventral parts of the abdomen (e.g. ventral midline laparotomy)
Dorsal recumbency
Position for the surgery of the dorsal parts of the animal (e.g. thoracotomy).
Ventral recumbency
Position for the surgery of the right lateral side of the animal.
Left lateral recumbency
Position for the surgery of the left lateral side of the animal.
Right lateral recumbency
The 4 drapesare held in place by this instrumebnt
Backhaus towel clips
Recommended Hard Surface Disinfectants
Alcohols
Quaternary Ammonium
Chlorine
Glutaraldehydes
Phenolics
Chlorhexidine
Hydrogen peroxide Peracetic acid Acetic acid
Recommended Sterilants for Surgical Instruments & Equipment
Steam Sterilization (moist heat)
Dry Heat
Gas sterilization
Chlorine
Glutaraldehydes
Hydrogen peroxide Acetic acid
Alcohol
Skin Disinfectants
Iodophors
Chlorhexidine
Wound Closure Selection
- Polyglactin 910 (Vicryl®), Polyglycolic acid (Dexon®)
- Polydiaxanone (PDS®) or, Polyglyconate (Maxon®)
- Polypropylene (Prolene®)
- Nylon (Ethilon ®)
- Silk
- Stainless Steel Suture/Wound Clips/Wound Staples
- Cyanoacrylate (Vetbond®, Nexaband®, Tissue Mend®)
Contact time required is 15 minutes. Contaminated surfaces take longer to disinfect. Remove gross contamination before using.
Alcohols
(70% ethyl alcohol85% isopropyl alcohol)
Rapidly inactivated by organic matter. Compounds may support growth of gram negative bacteria.
Quaternary Ammonium
(Roccal®, Quatricide®)
Corrosive. Presence of organic matter reduces activity. Chlorine dioxide must be fresh; kills vegetative organisms within 3 minutes of contact.
Chlorine
(Sodium hypochlorite (Clorox ® 10% solution) Chlorine)
Rapidly disinfects surfaces.
Glutaraldehydes
(Glutaraldehydes (Cidex® Cetylcide®, Cide Wipes®))
Less affected by organic material than other disinfectants.
Phenolics
(Lysol®, TBQ®)
Presence of blood does not interfere with activity. Rapidly bactericidal and persistent. Effective against many viruses.
Chlorhexidine
(Nolvasan® , Hibiclens®)
Contact time 10 minutes.
Hydrogen peroxide Peracetic acid Acetic acid
(Spor Klenz, Virkon®)
Effectiveness dependent upon temperature, pressure and time, e.g. 121°C for 15 min vs 131°C for 3 min. Appropriate sterilization indicators should be used to ensure sterility.
Steam Sterilization (moist heat)
Steam Sterilization (moist heat) required temperature & time
121°C for 15 min.
131°C for 3 min.
Fast Instruments must be cooled before contacting tissue. Only tips of instruments are sterilized with hot beads.
Dry Heat
Requires 30% or greater relative humidity for effectiveness against spores. Irritating to tissue; all materials require safe airing time. Appropriate sterilization indicators should be used to ensure sterility.
Gas sterilization
(Ethylene Oxide)
Corrosive to instruments. Items must be clean and free of organic material. Instruments must be rinsed with sterile saline or sterile water before use.
Chlorine
(Sterilant Levels of Chlorine dioxide (Clidox®, Alcide®) Sodium hypochlorite (Clorox® 10% solution))
Several hours required for sterilization. Corrosive and irritating. Instruments must be rinsed with sterile saline or sterile water before use. Product expiration dates must be adhered to as per manufacturer’s instructions.
Glutaraldehydes
(Glutaraldehyde (Cidex®, Cetylcide®, Metricide®))
Several hours required for sterilization. Corrosive and irritating. Instruments must be rinsed with sterile saline or sterile water before use.
Hydrogen peroxide Acetic acid
(Actril®, Spor-Klenz®)
is neither a sterilant nor a high-level disinfectant.
Alcohol
(Ethanol or Isopropanol)
Reduced activity in presence of organic matter. Wide range of microbicidal action. Works best in pH 6-7.
Iodophors
Iodophors works best in what pH level
pH 6-7
Presence of blood does not interfere with activity. Rapidly bactericidal and persistent. Effective against many viruses. Excellent for use on skin.
Chlorhexidine
(Nolvasan®, Hibiclens®)
Multifilament, Absorbable in 60-90 days; 25-50% loss of tensile strength in 14-21 days. Ligate or suture subcutaneous tissues where an absorbable suture is desirable. Not routinely recommended for skin closure due to high capillarity.
Polyglactin 910 (Vicryl®), Polyglycolic acid (Dexon®)
Not routinely recommended for skin closure due to high capillarity
Polyglactin 910 (Vicryl®), Polyglycolic acid (Dexon®)
Monofilament, Absorbable in 6 months; 40% loss of tensile strength in 30-42 days. Ligate or suture tissues especially where an absorbable suture and extended wound support is desirable.
Polydiaxanone (PDS®) or, Polyglyconate (Maxon®)
Monofilament, Non-absorbable. Inert.
Polypropylene (Prolene®)
Monofilament, Non-absorbable. Inert. General closure.
Nylon (Ethilon ®)
Multifilament, Non-absorbable. (Caution: Tissue reactive and may wick microorganisms into the wound, so silk is not recommended for skin closure). Excellent handling. Preferred for cardiovascular procedures.
Silk
Non-absorbable. Requires instrument for removal.
Stainless Steel Suture/Wound Clips/Wound Staples
Skin glue. For non-tension bearing wounds.
Cyanoacrylate (Vetbond®, Nexaband®, Tissue Mend®)
Multifilament materials in Wound Closure Selection
- Polyglactin 910 (Vicryl®), Polyglycolic acid (Dexon®)
- Silk
Absorbable materials in Wound Closure Selection
- Polyglactin 910 (Vicryl®), Polyglycolic acid (Dexon®)
- Polydiaxanone (PDS®) or, Polyglyconate (Maxon®)
Non-absorbable materials in Wound Closure Selection
- Polypropylene (Prolene®)
- Nylon (Ethilon ®)
- Nylon (Ethilon ®)
- Stainless Steel Suture/Wound Clips/Wound Staples
used in Steam Sterilization (moist heat)
Autoclave
used in Dry Heat
Hot Bead Sterilizer Dry Chamber
used in Gas sterilization
Ethylene Oxide
The period which an animal recovers from anesthesia may be more critical than during the actual operation.
Postoperative Care