Surgical Environment & Field Surgery Flashcards
Surgical Theatre…
Isolated from general traffic
- Has only one entry point
- Separate from, but close to the preparation room
- Adjacent to x-ray and pre- anaesthetic room
What are the surfaces and equipment like in theatre room?
- Easily cleaned surfaces
- Coved floors
- Flush fit cabinets
- Mobile equipment
What are some further aspects of theatre room design?
- Limit air entry
- Air filtration
- Laminar flow positive pressure ventilation
- Excellent lighting
What are the rules of theatre surgery?
- Prioritise the days caseload by sterility
- Clean procedures before contaminated ones
- Clean the theatre between patients
- Entry and exit from theatre during surgery must be minimised
What happens if the case is “too dirty” for the theatre?
- Not performed in theatre if possible
- Use prep area or wet bench for abscesses
- Last of the day
What is the difference in principle between field surgery and theatre surgery?
There is no difference
- Halsted’s principles of surgery still apply
What is the difference in practice between field surgery and theatre surgery?
- Most will be factors irrelevant to the actual procedure
- these factors decide whether it is an in the field procedure or not
What will help you decide whether a procedure will be in the field?
Intrinsic:
- Technical difficulty
Extrinsic:
- Personal skill level
- Available infrastructure
- Available help
- Economics
- Client Education
What can decide the technical difficulty of a procedure?
- Length of procedure?
- Number of layers of closure?
- Requirement of skilled scrubbed assistant?
- Orthopedics (e.g. implants left in place)?
What encodes personal skill level?
- Experience
- Honesty
What available infrastructure is needed to perform field surgery?
- Large, dry field
- Clean, dust free area
- Covered facility
- Animal restraint devices
- Running hot water
- Facilities to clean instruments
- Twitch, ropes, tackles etc.
What is important about field surgery economics?
It often determines whether a procedure will be performed or not
What is important about client education in the field?
- A lot can be prepared and facilitated by the owner
- Client education is the vet’s responsibility
- It will determine whether it will be pleasant between you and the owner
What should you think about before deciding whether a procedure can be done in the field or whether it should be referred?
- Procedure
- Personal skill
- Facilities
- Help
- Economics
- Client Education
How can a field procedure be safe and effective for the animal?
- Medicated pre-op with antimicrobials and analgesics
- Well restrained
- Local and/ or general anaesthesia
- Cleaned properly, clipped and aseptically prepared
- With post-op care organised
How can a field procedure be safe and effective for the vet?
- Non-vet work can be performed by non-vets
- Prep of surgery area
- Handling and restraining of the animal
- Clipping and cleaning of the surgery site
- Moving the animal back to housing
- Assistants: scrubbed assistant and anaesthesia support
How can a field procedure be safe and effective for the client?
- Vet is responsible for everyone’s safety
- Well-organised means safer, better, faster, cheaper
What are some commonly performed procedures on horses standing?
- Castration
- Wound repair
- Caslick’s procedure
- Rectovaginal lacertation
- Fistula repair
- Perineal Urethrostomy
What are some commonly performed procedures on cattle standing?
- Castration
- Wound repair
- Rectovaginal lacertation
- Fistula repair
- Perineal Urethrostomy
- Dehorning
- Caesarian
- Explorative laparotomy
- Rumenotomy
- Pyloropexy
- Abomasopexy
- Vasectomy
What are some commonly performed procedures on small ruminants standing?
Dehorning
What are some commonly performed procedures on cattle recumbent and restrained?
- Disbudding
- Abomasopexy
- Claw amputation
- Caesarian
- Teat laceration repair
What are some commonly performed procedures on Small ruminants recumbent and restrained?
- Disbudding
- Vasectomy
- Tail Docking
- Caesarian
What are some commonly performed procedures on Horses under general anaesthesia?
- Castration
- Wound repair
