Setting-up for Surgery

Question 1

– used with glasses

Answer 1

• Antifog mask

Question 2

used for people with facial hair

Answer 2

• Surgeons hood

Question 3

main scrub products used at this institution

Answer 3

povidone-iodine
chlorhexidine gluconate
alcohol

Question 4

Adult animals are generally fasted up to _______ hours prior to surgery, to reduce the risk of regurgitation or vomiting during or after surgery and development of aspiration pneumonia.

Answer 4

12 hours

Question 5

Adult animals are generally fasted up to 12 hours prior to surgery, to?

Answer 5

reduce the risk of regurgitation or vomiting during or after surgery and development of aspiration pneumonia

Question 6

Surgical procedures involving the large intestine may require ______hours of fasting to allow emptying of the intestinal tract.

Answer 6

48 hours

Question 7

Young animals can become ________ if fasted for too long and food intake restriction should be adjusted according to the patient.

Answer 7

hypoglycemic

Question 8

Free access to water is allowed during fasting and dogs are walked just prior to surgery, to promote defecation and urination. If the animal cannot be walked, the bladder may need to be expressed manually before abdominal surgery.

Question 9

The most common position is

Answer 9

dorsal recumbency

Question 10

dorsal recumbency is used in?

Answer 10

several abdominal procedures such as
1. ovario-hysterectomy
2. canine castration
3. gastro-intestinal foreign body removal or cystotomy.

Question 11

The bladder should be palpated and expressed if full prior to abdominal procedures. If the patient did not urinate before surgery, it may be helpful to empty the urinary bladder manually before an abdominal procedure.

Question 12

This should not be done in pyometra patients as excess pressure on the abdomen may rupture the uterus.

Answer 12

Emptying the Bladder

Question 13

clip from xiphoid to pubis and beyond the level of the mammary chain for an ovariohysterectomy

Question 14

Hair is usually removed from _______ cm on either side of the proposed incision site using clippers and a number 40 blade

Answer 14

10-15 cm

Question 15

(using a razor) in small animals causes excessive trauma to the skin (microlacerations) and irritation releasing increased numbers of normal bacteria from the cornified layers of the skin. This can increase the risk of incisional infection.

Answer 15

Shaving

Question 16

Typical skin preparation includes a 5 minute soap scrub followed by the application of alcohol and finally an alcohol based disinfectant such as chlorhexidine.

Question 17

Commonly used soaps for preparing surgical patients contain __________ as the main antibacterial agent.

Answer 17

chlorhexidine or povidone-iodophors

Question 18

Two types of preparation patterns:

Answer 18

1) Concentric Preparation:
2) Horizontal Preparation

Question 19

Skin preparation generally begins at the center of the shaved area, (at the proposed incision site), and continues using a concentric circular pattern until the edges of the shaved area are contacted. Remember never to return towards the incision site with a used gauze. Once hair is touched, the gauze or cotton is discarded and a new gauze is used. This action is repeated over the entire field a minimum of three times.

Answer 19

Concentric Preparation

Question 20

Skin preparation generally begins at the center of the shaved area, (at the proposed incision site), and continues using a horizontal pattern on either side of the shaved area. One must remember to never return towards the incision site with a used gauze. If hair is touched (at the top or the sides of the incision), the gauze or cotton is discarded and a new gauze is used. This action is repeated over the entire field a minimum of three times.

Answer 20

Horizontal Preparation

Question 21

Remember: Surgically prepared skin is very clean but is never sterile.

Question 22

Final Skin Preparation (Performed After Scrubbing, Gowning and Gloving)

Question 23

The first drape is generally applied at the _____ of the proposed incision site.

Answer 23

cranial edge

Question 24

Drape 2 is generally applied at the _________ of the proposed incision site since it can usually remain in place without falling until towel clamps are applied. The drape is applied in the same manner as drape 1.

Answer 24

caudal edge

Question 25

Drapes # 3 & # 4

Answer 25

Clamping Drapes to Skin

Question 26

Limb draping is often performed in a hanging limb position.

Answer 26

Limb draping

Question 27

While gowned, the surgeon generally stands. If sitting to perform a procedure, the surgeon should sit on a stool (without back support) to prevent contamination of the elbow area of the gown. Furthermore, the surgeon should prevent contamination of the elbows on the knees.

Question 28

WHAT NOT TO DO:
* Gloved hands should never drop below the level of the waist line or below the level of the draped surgery table.
* Gloved hands should never be placed close to the neck line, shoulder area or head to prevent inadvertent contamination. Hands should remain at the level of the chest (below the neck line and above the waist line).
* The underarm area of the gown is considered unsterile. Gloved hands should never be rested under the arm pit.
* While draping the patient or moving about the surgery suite, the surgeon should be careful not to contaminate the sterile gown or gloves on unsterile surfaces.
* A stool without back support will prevent contamination if the surgeon sits during a procedure. The elbows are considered sterile and the can be easily contaminated on the back of a stool.

Question 29

Tips to Remember
* Clip from the xiphoid to the pubis. Remove all hair around the mammary glands. In male dogs, remove all hair around the prepuce and flush the prepuce with an aqueous solution (not alcohol).
* Remember to express the urinary bladder. Palpate the bladder and maintain constant pressure while expressing the urinary bladder rather than applying pulsatile pressure.
* After clipping and vaccuming, remove your labcoat to perform patient preparation.
* Try not to touch the solution bottle tips with gauzes when pouring the preparation solutions. This potentially contaminates the gauze and the bottle tip.
* Remember to wear a hat and mask to enter the surgery suite. Your labcoat should already have been removed.