CAL 1: Principles of aseptic and operative technqiue Flashcards Preview

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Flashcards in CAL 1: Principles of aseptic and operative technqiue Deck (44):
1

Give the NRC classification for a cystotomy with UTI

Contaminated Give prophylactic ABs Therapeutic post-op for established infection UTI should be resolved prior to elective procedures

2

Give the NRC classification for an elective OVH, 6 month old bitch

Clean-contaminated No ABs

3

Give the NRC classification for small flank excision of middle aged dog

Clean - no ABs (quick procedure and area can be prepped aseptically)

4

Give the NRC classification for an ex lap in a dog with dehisence of an intestinal anastomosis --> peritonitis

Dirty Therapeutic ABs (confirm diagnosis via abdominal fluid aspiration but start empirical ABs and change later if needs be)

5

Give the NRC classification for an ex lap with pancreatic biopsy

Clean No ABs (clean + short)

6

Give the NRC classification for removal of FB from SI with subsequent spillage of intestinal contents

Contaminated (without spillage = clean-contaminated) Prophylactic ABs

7

Give the NRC classification for amputation of a cat's tail following traumatic sacro-coccygeal luxation

Clean - no ABs No open wound, close to anus BUT shouldn't affect outcome if aseptic procedure is performed correctly

8

Give the NRC classification for full thickness SI biopsies taken at laparotomy

Clean-contaminated Yes/no to giving prophylactic ABs. A first class surgeon wouldn't use them in a healthy patient. Decision influenced by patient risk factors and surgical wound factors

9

Give the NRC classification for lateral wall resection of the external ear canal in a dog with otitis externa

Contaminated Give prophylactic ABs - difficult to prepare ear canal aseptically to same effect as skin elsewhere. May have inflammation and established infection (=dirty) but this is elective so treat pre-existing infection before surgery

10

Give the NRC classification for SC abscess after a bite wound in a cat

Dirty Therapeutic ABs (an abscess is an established infection). with adequate lancing, draining and lavage, the wound may heal without AB therapy being mandatory

11

Give the NRC classification for placement of a cystotomy tube in a bitch with urethral obstruction

Clean-contaminated Yes/No prophylactic ABs - post-op AMs aren't indicated since there will be contamination of the bladder from the presence of the cystotomy tube and use of AMs will simply select for resistant bacteria.

12

Give the NRC classification for open fracture in radius of dog repaired the day after trauma

Dirty An open traumatic wound of >4-6 hours = dirty. With appropriate AB use and local wound care, wound infection should be no more likely than if a closed fracture were present.

13

When is the most useful time to take a wound sample (from a microbiologists point of view)?

after wound debridement, fracture fixation and lavage.

14

Give the NRC classification for placement of a lateral retinacular suture for stabilisation of the stifle after CCL rupture, performed by an experienced surgeon

Clean - no ABs Should be <60-90 minutes (experienced surgeon)

15

Give the NRC classification for a dog with a traumatic laceration wound 2 hours previously when jumping a barbed wire fence

Contaminated Give prophylactic ABs With appropriate local wound care, post-op therapeutic ABs NOT required. En bloc debridement of wound would convert it to a clean wound for which no AM use is appropriate

16

What are the 2 types of debridement?

En bloc and layered

17

Describe en bloc debridement

in areas where there is adequate normal tissue to allow closure after, the whole affected tissue can be excised with a border of healthy tissue. This is ideal for the trunk and proximal limb where there is plenty of available skin to close the deficit.

18

Describe layered debridement

more common than en bloc. Devitalised tissue is removed gradually in layers, to allow tissue conservation where possible. May be important for lower limbs where there is inadequate skin for en bloc.

19

Give the NRC classification for bitch with pyometra with subsequent uterine rupture

Dirty (it involves acute purulent discharge) Give therapeutic ABs

20

Give the NRC classification for resection of a gingival mass ina dog

Clean-contaminated Yes/no for giving prophylactic ABs Surgery of oral cavity is clean-contaminated. Not possible to prepare mucosal surfaces in the same way as skin. But excellent blood supply, antibacterial effects of saliva and warmth of oral cavity --> wound infections are rare in oral cavity

21

Give the NRC classification for dog castration

Clean No ABs (short procedure, skin can be prepared aseptically)

22

Give the NRC classification for cholescystectomy for a gallbladder mucocoele

Clean-contaminated (in absence of infection) Yes/no for prophylactic ABs

23

Give the NRC classification for an ureteronephrectomy for an animal with chronic pyelonephritis refractory to medical therapy

Contaminated (because UTI) Give prophylactic ABs If it had developed into a renal abscess, it would be a dirty procedure. Withhold ABs until sample can be culutred. Low risk of contamination (infected site only entered during transection of distal ureter). Post-op ABs may be indicated if the animal has an established infecteion in the contralateral kidney or bladder.

24

What is this instrument?

 

Mayo (Mayo-Hegar) needle holders

25

What is this instrument?

Army Navy Hand Held retractor

26

What is this instrument?

Aliis Tissue Forcep

27

What is this instrument?

Adson thumb forcep

28

What is this instrument?

Backhaus towel clip

29

What is this instrument?

Metzenbaum scissors

30

What is this instrument?

Poole suction tip

31

What is this instrument?

Halstead mosquite haemostat

32

What is this instrument?

No. 15 scalpel blade

33

What is this instrument?

Mayo scissors

34

What is this instrument?

DeBakey forceps

35

What is this instrument?

Kelly Haemostats

36

What is this instrument?

No. 11 scalpel blade

37

What is the most appropriate instrument? linea alba incision during laparotomy

straight Mayo scissors

38

What is the most appropriate instrument? making a long skin incision

scalpel handle 3 no.10 blade

39

What is the most appropriate instrument? suction of lavage fluid from abdomen

Poole suction tip

40

What is the most appropriate instrument? clamping a large tissue pedicle before ligation

Kelly haemostats

41

What is the most appropriate instrument? occlusion of GIT lumen

Doyen intestinal forceps

42

What is the most appropriate instrument? atraumatic bladder manipulatiion

stay suture (polypropylene) tagged with a haemostat

43

What is the most appropriate instrument? retraction of tissue to be excised from the patient

Allis tissue forceps

44

What is the most appropriate instrument? suction of thick fluid - e.g. mucous from a wound

Yankauer suction tip

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