Surgery

Question 1

pros and cons of monofilament

Answer 1

smooth passage through tissue

Question 2

pros and cons of multifilament

Answer 2

stronger than mono, but has drag/damages tissue

absorbs faster than absorbable monos

Question 3

pros and cons of absorbable suture and name some

Answer 3

loses tensile strength faster than non-absorb

e.g. maxon, PDS - absorb in 6 mo

Question 4

pros and cons of rapidly absorbable suture and name some

Answer 4

rapid - good for oral tissue
monocryl, biosyn - absorb in 3 mo
vicryl rapide - 6 wks

Question 5

pros and cons of non-absorbable suture

Answer 5

stronger, eventually loses some tensile strength but not degraded

Question 6

Brands/types of synthetic absorbable monofilament

Answer 6

Maxon (polyglyconate), PDS (PDX, polydioxanone)

Biosyn (Glycomer 631), Monocryl (Poliglecparone 25)

Question 7

Brands/types of synthetic absorbable multifilament

Answer 7

Polysorb, Dexon, Vicryl (polyglactin 910), Vicryl rapide,

Question 8

Brands/types of synthetic non-absorbable monofilament

Answer 8

Nylon (=Polyamide) Novafil, Dermalon, Ethilon, Monosof, Prolene, gore-tex, surgilene, surgipro

Question 9

Appropriate suture size for visceral closure in small animals

Answer 9

5-0 to 3-0

Question 10

when would you use a taper suture needle (circular body)

Answer 10

minimal effort needed to enter tissue b/c make smallest holes

Question 11

when would you use a cutting needle (triangle body)

Answer 11

thick tissue (e.g. fascia, skin, intradermal)

Question 12

characteristics of simple interrupted

Answer 12

appositional

not tension relieving

Question 13

characteristics of cruciate

Answer 13

appositional

tension relieving

Question 14

characteristics of vertical mattress

Answer 14

everting

tension relieving

Question 15

characteristics of cushings

Answer 15

minimally inverting

not tension relieving

Question 16

suture plan for SQ closure

Answer 16

4-0 to 3-0 (usually 3-0) absorbable suture (e.g. biosyn)
taper needle
continuous appositional pattern - simple continuous or continuous horizontal mattress

Question 17

suture plan for skin closure

Answer 17

4-0 to 3-0 (usually 3-0) non-absorbable suture (e.g. nylon)
cutting needle
ford interlocking pattern (modified simple continuous, less likely to fail, good apposition/tissue stability)

Question 18

suture plan for gastrotomy closure

Answer 18

5-0 to 3-0 (usually 3-0) absorbable suture (e.g. biosyn/monocryl, PDS)
taper needle
double layer continuous inverting pattern: cushing/connell/simple continuous then a lembert (partial thickness)

Question 19

antimicrobial plan for a clean-contaminated sx

Answer 19

prophylactic antimicrobials indicated

post-op therapeutic depends on case - “just in case” is not an indication

Question 20

Between Maxon, PDS, Biosyn, and Monocryl, which are from the same company and which behave like eachother

Answer 20

Maxon, biosyn are from Medtronics
PDS, Monocryl are from Ethicon
Maxon and PDS are similar, Monocryl and biosyn are similar

Question 21

what is the use of topical antiseptics and wound cleaning?

Answer 21

Don’t use in the wound - impairs healing by killing recovery cells –> more necrotic tissue to harbor bacteria
Use on intact skin around wound only

Question 22

best antiseptics to use with wound cleaning? Which to avoid?

Answer 22

acetic acid (vinegar) or surfactant-based cleaners
avoid iodine, chlorohex, hydrogen peroxide

Question 23

Color scheme for wound assessment

Answer 23

Black (or exposed bone) - necrotic
yellow (or grey, green, etc) - fibrinous
red - granulation
pink - epithelium

Question 24

What wound colors mean debridement is necessary?

Answer 24

Black or yellow - fibrinous or necrotic means infection is present

Question 25

what dressing should you use for a necrotic, heavily exudative wound?

Answer 25

Must debride | saline, hypertonic saline, kerlix aMD (antimicrobial woven gauze) or honey

Question 26

what dressing should you use for a dry wound?

Answer 26

Must re-moisturize | gel dressing

Question 27

what dressing should you use for a wound with granulation tissue?

Answer 27

``` Must get wound contraction, granulation tissue enhancement calcium alginate (curasorb) ```

Question 28

what dressing should you use for a wound with epithelialization

Answer 28

semi-occlusive foam dressings - COPA, hydrasorb

Question 29

what dressing should you use for an exposed bone wound?

Answer 29

calcium alginate - stimulates soft tissue coverage

Question 30

CSU's general preferred suture material for bowel closure

Answer 30

Biosyn (good initial strength, then absorbed quickly

Question 31

CSU's general preferred suture material for urinary bladder or uterus closure?

Answer 31

Monocryl - high starting strength & at 50% of strength loss, bladder has regained 50% of it's strength

Question 32

What is the concern with using an inverting suture pattern in the gut? everting?

Answer 32

``` inverting = stricture - if must use, cushing is preferred pattern b/c doesn't penetrate lumen everting = leakage, adhesions, don't use ```

Question 33

What suture pattern is preferred in the gut?

Answer 33

Appositional pattern preferred - simple continuous (or modified gambee - invert mucosa, oppose serosa)

Question 34

What is the holding layer for the ventral midline abdominal approach?

Answer 34

linea alba

Question 35

What is the holding layer for the paramedian abdominal approach?

Answer 35

external rectus sheath

Question 36

What is the holding layer for the paralumbar/flank abdominal approach?

Answer 36

external abdominal oblique fascia

Question 37

Where is the incision placed for a foreign body enterotomy?

Answer 37

aboral to the foreign body b/c healthier tissue

Question 38

How do you initially stabilize an injury distal to stifle or elbow?

Answer 38

robert jones bandage +/- splint | leave for NO MORE than 1-3 days

Question 39

How do you initially stabilize an injury proximal to stifle or elbow

Answer 39

crate rest

Question 40

Why do you avoid coaptation in tiny dog breeds?

Answer 40

poor blood supply to distal radius/ulna = slow healing, re-fx common

Question 41

what can occur if part of the ovary is left behind during an ovariectomy?

Answer 41

pyometra d/t ovarian remnant syndrome

Question 42

benefits of neutering a female dog

Answer 42

decreased risk for mammary neoplasia (MGT) if before 2.5 yo | no risk of pyometra

Question 43

cons of neutering a female dog

Answer 43

increased risk for cancers, obesity | early spay may cause incontinence, delayed closure of long bone growth plates, possible ortho issues

Question 44

arthroscopy vs. arthrotomy

Answer 44

arthroscopy - scope | arthrotomy - same, but larger incision - for larger fragments or fracture, sepsis

Question 45

3 common complications to fracture repairs in EQ

Answer 45

implant failure infection support limb laminitis - put foot support on non-injured foot

Question 46

What is the most common EQ fracture

Answer 46

ulna/olecranon - characteristic dropped elbow appearance

Question 47

Name some commonalities with tendon injuries

Answer 47

flexor tendons > extensors SDFT > DDFT (b/c SDF is more external, smaller, less vascular) forelimb > hind

Question 48

If you see mild hyperextension of the fetlock, you can expect ___ to be transected

Answer 48

SDF

Question 49

If you see moderate hyperextension of the fetlock, you can expect ___ to be transected

Answer 49

SDF & DDF

Question 50

If you see no fetlock support, you can expect ___ to be transected

Answer 50

SDF, DDF, suspensory ligament