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PATIENT PREPARATION
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Clip after patient has been stabilized under anesthesia
Hair Removal Clip after patient has been stabilized under anesthesia Appearance of the clip Clipping at a 90° angle gives a sharp, straight edge 2 clipper blade widths in every direction
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Hair Removal Proper hand position Use a #40 blade and
hold in a pencil grip Consult the doctor for clipping margins General rule of thumb for orthopedic procedures is to shave one joint above and one joint below the proposed incision site.
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Next Steps Vacuum hair Express bladder
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Surgical Site Preparation
Antiseptics-The skin of the patient cannot be “sterilized” Scrub product: A soap or detergent base Povidone-iodine – bactericidal, virucidal, fungicidal, fungistatic Diluted 50:50 with tap water Low tissue toxicity Inexpensive Stains Chlorhexidine gluconate-bactericidal, virucidal, fungicidal Diluted 60:40 with tap water More expensive Does not stain Residual activity
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Surgical Site Preparation
Rinsing agents – remove the detergents Common agent is 70% isopropyl alcohol Alcohol coagulates proteins so is contraindicated in open wounds and mucous membranes Inexpensive, readily available Increases residual activity of chlorhexidine Contributes to hypothermia Sterile water or sterile saline can be used as an alternative No antibacterial effects Applicators Gauze, cotton-tipped applicators, cotton balls, spray bottle
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Surgical Site Preparation
Special Male dog preparation Dilute povidone- Iodine solution 1:9 Dilute chlorhexidine 1:20
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Patterns for Scrubbing
Target Create a small contact surface with the gauze square Start at the incision site and work outward in a circle until the hair is reached Alternate between chlorhexidine and alcohol at least 3 cycles Orthopedic Perineal Possible reactions: clipper and chemical
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Secure Patient to Table
Sturdy, flexible cord Four stays on surgical table
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Secure Patient to Table
Abdominal surgery
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Secure Patient to Table
Castration in a dog Dorsal recumbency Or modified Dosal recumbency
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Secure Patient to Table
Castration in a cat
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Secure Patient to Table
Orthopedic and extremity surgery
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Secure Patient to Table
Tail and perianal surgery
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Secure Patient to Table
Back surgery General rule for shaving for back surgery is 2 vertebrae above and 2 vertebrae below the proposed incision site
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Final (Sterile) Surgical Site Preparation
Solutions (Paint)
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