Preparing animals for scheduled operations

Question 1

What should be done in preparation prior to surgery?

Answer 1

1. bathe their pets (elective procedures)
2. thorough history report, blood tests, physical exam

Question 2

What are important steps to take during the patient admission?

Answer 2

1. confirm procedure being performed
2. check with owner for; medications, recent changes, last meal, food status
3. advised owner of potential risks, tattoos with desexing, microchipping, amount of hair clipped
4. discharge procedure
5. sign consent form - estimated costs, deposit, risks

Question 3

What are the preparation steps for anaesthesia?

Answer 3

Preparation for anaesthesia – Pre Operative
* Basic blood tests
* More comprehensive blood tests (eg clotting profile etc)
* Urine tests
* Radiographs, ultrasound, more advanced imaging

Selecting pre-medication, setting up anaesthetic equipment, drugs,
monitors, placement of intravenous catheters, fluid therapy

Question 4

What are two types of medicines used during analgesic plan? and when should it be administered?

Answer 4

NSAIDS and opioids

pre-emptively and continued post-operatively

Question 5

What does prophylaxis prevent?

Answer 5

infection

Question 6

Do antibiotics have an advantage after 24hrs?

Answer 6

no

Question 7

what are important considerations when patient positioning for surgery?

Answer 7

head resting stable

anaesthetic tubing placed properly - connected and secure

patient in optimal position for lighting and instrument access

warming devices place

limbs tied to help stabilize the patient

Question 8

where should the clipping be avoided?

Answer 8

in theatre

Question 9

What clipping blade is used? and what size margin?

Answer 9

• Use No. 40 clipper blade
  hold clippers 90 degrees
• Clippers should be used gently, parallel to the skin
• Try not to cut skin!
• May need >20 cm margin (depending on surgery)
• Clip at the incision site extending 10 cm in all directions

Question 10

What is the steps for clipping hair?

Answer 10

First clipped along the same direction of hair growth, then again
against direction

remove hair with vacuum

wipe table down with moist cloth

change towel under patient before skin prep

Question 11

What is the aim of a skin prep?

Answer 11

major source of contamination through endogenous bacteria - skin cannot be sterilised just reduce amount of microbes

Question 12

How do you prep the prepuce?

Answer 12

Flush prepuce with dilute chlorhexidine solution
* Pinch prepuce closed around syringe tip before emptying syringe
* Gently massage solution in prepuce
* Place towel over end of prepuce and release solution
* Flush prepuce four to five times using 20 ml syringe

Question 13

What are the steps to preparing the skin?

Answer 13

Step 1
* Antibacterial and dirt remover
* Chlorhexidine or iodine detergent with water
* Dilute with warm water
* Repeat a total of 3 times after all gross debris has
been removed

Step 2
* Antiseptic
* Methylated spirits - remove the oils, rapid onset of action
* Kills most bacteria

Step 3
* Spray of chlorhexidine + methylated spirits alcohol
OR
* Methylated spirits spray
* 70% methylated spirit

Question 14

What are the contact times with chlorhexidine solutions, iodine solutions and chlorhexidine-alcohol solutions?

Answer 14

3-5 minutes with chlorhexidine solutions
* 2-5 minutes with iodine solutions
* 30 seconds with some chlorhexidine-alcohol
solutions

Question 15

What is the the dilution factor for dilute aqueous chlorhexidine?

Answer 15

Mix the surgical scrub with warm water in a 60:40 dilution

Question 16

What is in alcohol surgical spray?

Answer 16

Chlorhexidine mixed with 70% alcohol (synergistic effect)

Question 17

What is the difference between chlorhexidine and methylated spirits?

Answer 17

chlorhexidine
Wide spectrum, rapid effect, long residual effect, good cleansing capacity,
minimal or no skin irritation, broad spectrum activity, strong binding to skin, low
toxicity
* Very rapid onset of activity

methylated spirits
rapid bactericidal activity
rapid onset of action
not good gleaning agents - efficacy of alcohol is decreased substantially in the presence of organic debris
Synergistic effect with other agents

Question 18

What is the most effective concentration of methylated spirits?

Answer 18

60 - 70%

Question 19

What should be avoid when using methylated spirits?

Answer 19

mucous membranes and sensitive areas
* Anus, mouth, eyes, inside ears
* DO NOT USE ALCOHOL on open wounds/fractures = cytotoxic

Question 20

What is the minimum amounts of times you spray and wipe the skin with methylated spirits?

Answer 20

3 - final spray leave on alcohol to dry

Question 21

What is iodine used for and what dilution rate?

Answer 21

Available as solution and scrub
* For intact surfaces only
diluted 50:50 with tap water

Equal with chlorhexidine for lowering bacterial numbers on skin
* Iodine has loss of residual activity when lavage fluids, blood or pus present

Question 22

If you have sensitive areas to clean, what solutions do you use?

Answer 22

sterile isotonic saline

Question 23

What two solutions should not be mixed during the whole procedure?

Answer 23

chlorohexidine or iodine

Question 24

What is the purpose of the patient draping?

Answer 24

Goal is to create a barrier that prevents microbial spread from the patient into
the surgical field or onto surgical personnel

Question 25

Drapes should be readjusted towards the incision site

true or false?

Answer 25

false - translocated bacteria onto sterile surgical site

Question 26

How many drapes are used to isolate the unprepared/unsterile area?

Answer 26

4

Question 27

How do you apply drapes and what are factors to keep in mind?

Answer 27

Drapes should be placed evenly around clipped area and sterile surgical area
1. first drape - positioned closest to you (hold drape around hands so they are covered)