Veterinary Clinical Procedures Surgeries

The Surgery Team Surgery Team consists of a surgeon, an anesthetist (or a few sterile assistants-scrub nurse), and a few non-sterile assistants (called circulators). Scrub Nurse Assists the surgeon while performing surgery (passing instruments, keeping things sterile, retracts/holds organs, assists in suturing) Circulators prepares patient and surgery site sets out the sterile equipment packs gathers supplies the surgeon will need

Surgical Log Book Keeps track of all important surgical notes Dates Patient name/number Client name Breed/species Gender Weight Procedures performed Pre-anesthetic medications administered (dosage and route of administration) Anesthetic administered (dosage and route of administration) Surgical assessment score Technician and assistant initials Veterinary Initials Approx. length of surgery Lab specimens taken Surgical comments

Ceiling Sanitation (yes, the ceiling) Should be spot cleaned daily Entire ceiling should be mopped once a week One bucket should be used only for the surgical suite Debris can collect on the ceiling during surgeries & be unsanitary for the next patient Wall Sanitation Should be spot cleaned after every surgery by use of disinfecting cleaner and paper towel Must be sponge mopped daily

Shelf/Counter Sanitation Should be cleaned between surgeries All surfaces must stay disinfected Floor Sanitation Should be mopped on a daily basis, or as necessary Two bucket system: one with warm soapy water for rinsing, and one containing disinfectant Empty buckets immediately after use

Patients should be admitted in early morning to complete pre- surgery procedures Fasting: Dogs & Cats: 12 hours Ruminants, rodents, and horses do not require fasting Physical examination is done during this time along with pre-surgical blood work. The choice of blood testing depends on the classification assessment

Main Parts of Anesthesia Machine: Vaporizer - converts liquid anesthesia to gas form Oxygen tanks – hold compressed forms of liquid to keep patient oxygenated Flow meter – measured in ml/minute, regulates the proper amount of oxygen a patient needs. Most common rate of flow is 30 ml/kg/minute Soda lime – a granular white substance that traps CO 2 exhaled from patient that can’t be let back out into the facility. Starts white may turn pink, blue or purple when used. “Y” connector – tubing that connects to the inhalation and exhalation valve to regulate breathing.

Patients should be prepared in a way that makes the surgical area sterile Surgical Margin: 2-4 inches beyond anticipated incision borders Incision area is shaved and washed First wash is soapy warm water to rid excess hair, second is a surgical scrub (Chlorhexidine is common) Surgical scrub is used 2-3 times using scrub-soaked gauze

Surgery Packs: Include everything you will need when performing a surgery. All packs are sanitized prior to surgery. Include: Instrument pack (for whatever you are performing surgery on) ½ surgical drape ¼ surgical drape Towel packs instrument envelopes bowel packs gauze sponges Laparotomy towel suture material Surgical blades

Scalpel Handle/Blade Used to made a surgical incision into an animal Different blades are used for different surgeries/incisions Handles come in a variety of lengths

Towel Clamps Used to hold surgical drape in place over the patient during surgery Attached lightly to the skin on the animal and four corners of the drape Locking forceps, most common is the Backhaus Towel Clamp

Needle Holders Used to hold the needle in place during surgery. Hinged, locks into place to hold the needle. Have scissor like blades, be cautious to not cut the suture material.

Tissue Forceps Toothed Used for grasping tissue

Dressing Forceps Used to grasp tissue Not toothed Can have a curved or straight tip

Adson Forceps Have several small delicate teeth Used for handling light tissues, like eyes and mouth

Allis Tissue Forceps Used for grasping and holding bowel & intestinal tissues Have inter-locking teeth Lock in place

Babcock Tissue Forceps Intestinal forceps Broad, flat, flared ends with smooth tips Hold intestine/bladder tissue

Straight or curved tip Sponge Forceps Used to hold gauze / sponges to clear bleeding areas Circular tip for even pressure to an area

Hemostatic forceps Hinged Locking Designed to hold off blood vessels

Surgical Scissors Used to remove tissue during surgery May have rounded or pointed ends

Used to locate the uterus and uterine horns in small female animals Spay Hook