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Surgical nursing
/content/chapter/10.22233/9781910443064.chap13
Surgical nursing
- Authors: Karen Scott and Alasdair Hotston Moore
- From: BSAVA Manual of Practical Veterinary Nursing
- Item: Chapter 13, pp 315 - 370
- DOI: 10.22233/9781910443064.13
- Copyright: © 2007 British Small Animal Veterinary Association
- Publication Date: January 2007
Abstract
This chapter is designed to give information on preparation of the surgical environment and surgical equipment, including theatre clothing and drapes; asepsis and sterilization, instrument cleaning and maintenance, preparation of small animals for surgery; providing the veterinary surgeon with general intraoperative assistance; providing postoperative care to promote rapid recovery; recognition and management of pre-, peri-, and postoperative problems; and common surgical conditions of small animals and their nursing.
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Figures
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A veterinary nurse using Cheatle forceps to lay out sterile surgical instruments on a trolley in an aseptic manner. © 2007 British Small Animal Veterinary Association
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A veterinary nurse using Cheatle forceps to lay out sterile surgical instruments on a trolley in an aseptic manner.
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Indicators of sterilization in common use. (a) Chemical indicator strip for steam autoclave (TST strip). Blue = sterile; yellow = not sterile. (b) Browne’s tube. (c) Indicator adhesive label for ethylene oxide (yellow; turning blue on exposure). (d) Autoclave (Bowie Dick) tape after (top) and before (bottom) exposure to steam. (e) Peel-and-seal bags after (top) and before (bottom) exposure to steam. © 2007 British Small Animal Veterinary Association
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Indicators of sterilization in common use. (a) Chemical indicator strip for steam autoclave (TST strip). Blue = sterile; yellow = not sterile. (b) Browne’s tube. (c) Indicator adhesive label for ethylene oxide (yellow; turning blue on exposure). (d) Autoclave (Bowie Dick) tape after (top) and before (bottom) exposure to steam. (e) Peel-and-seal bags after (top) and before (bottom) exposure to steam.
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Examples of commonly used instruments. (Courtesy of Veterinary Instrumentation.) © 2007 British Small Animal Veterinary Association
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Examples of commonly used instruments. (Courtesy of Veterinary Instrumentation.)
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Suture needle shapes. © 2007 British Small Animal Veterinary Association
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Suture needle shapes.
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Needle point and shaft designs. © 2007 British Small Animal Veterinary Association
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Needle point and shaft designs.
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Final skin scrub of a patient in theatre. © 2007 British Small Animal Veterinary Association
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Final skin scrub of a patient in theatre.
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How to drape a patient with four plain drapes. © 2007 British Small Animal Veterinary Association
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How to drape a patient with four plain drapes.
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A patient draped with a disposable adhesive fenestrated drape. © 2007 British Small Animal Veterinary Association
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A patient draped with a disposable adhesive fenestrated drape.
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How to put on sterile gloves – closed gloving method. © 2007 British Small Animal Veterinary Association
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How to put on sterile gloves – closed gloving method.
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A scrub nurse (front right) assisting the surgeon and managing the instrument trolley. The trolley is raised over the patient, allowing the nurse to access the trolley and assist without moving around the table. © 2007 British Small Animal Veterinary Association
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A scrub nurse (front right) assisting the surgeon and managing the instrument trolley. The trolley is raised over the patient, allowing the nurse to access the trolley and assist without moving around the table.
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Two Penrose drains placed to manage a seroma after skin reconstruction in the groin of a cat. © 2007 British Small Animal Veterinary Association
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Two Penrose drains placed to manage a seroma after skin reconstruction in the groin of a cat.
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Active suction drain placed to manage a large subcutaneous abscess in the neck of a kitten. © 2007 British Small Animal Veterinary Association
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Active suction drain placed to manage a large subcutaneous abscess in the neck of a kitten.
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Elizabethan collar applied to prevent a patient from interfering with a wound. © 2007 British Small Animal Veterinary Association
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Elizabethan collar applied to prevent a patient from interfering with a wound.
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Body brace applied to prevent a patient interfering with a bandage over the pelvic area. © 2007 British Small Animal Veterinary Association
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Body brace applied to prevent a patient interfering with a bandage over the pelvic area.
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Equipment for fracture treatment. (a) Radiograph of intramedullary pin positioned to repair a long bone fracture (lateral view of femur). (b) Radiograph of Kirschner wires used to reconstruct multiple small bone fragments (fracture of femoral neck and trochanteric osteotomy). (c) Radiograph of cerclage wires combined with intramedullary pin to repair comminuted fracture of long bone (feline tibia). (d) Radiograph of bone plate and screws used to repair long bone fracture (comminuted canine femoral fracture). (e) Bone plate kit, consisting of plates, screws and the specialist equipment used to place them. This is the Mini Fragment set of the AO/ASIF system of internal fixation. (f) Radiograph of external fixator used to repair severely comminuted feline femoral fracture. (g) Same cat as in (f) with external fixator in place. This will be removed 6–8 weeks after surgery, once the fracture has healed. (All except (e) courtesy of Dr Martin Owen, University of Bristol) © 2007 British Small Animal Veterinary Association
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Equipment for fracture treatment. (a) Radiograph of intramedullary pin positioned to repair a long bone fracture (lateral view of femur). (b) Radiograph of Kirschner wires used to reconstruct multiple small bone fragments (fracture of femoral neck and trochanteric osteotomy). (c) Radiograph of cerclage wires combined with intramedullary pin to repair comminuted fracture of long bone (feline tibia). (d) Radiograph of bone plate and screws used to repair long bone fracture (comminuted canine femoral fracture). (e) Bone plate kit, consisting of plates, screws and the specialist equipment used to place them. This is the Mini Fragment set of the AO/ASIF system of internal fixation. (f) Radiograph of external fixator used to repair severely comminuted feline femoral fracture. (g) Same cat as in (f) with external fixator in place. This will be removed 6–8 weeks after surgery, once the fracture has healed. (All except (e) courtesy of Dr Martin Owen, University of Bristol)
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Hanging limb preparation for limb surgery. © 2007 British Small Animal Veterinary Association
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Hanging limb preparation for limb surgery.
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Use of an automated needle core biopsy device to obtain a sample from the liver of a dog under ultrasound guidance. © 2007 British Small Animal Veterinary Association
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Use of an automated needle core biopsy device to obtain a sample from the liver of a dog under ultrasound guidance.
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Laryngeal neoplasia in an elderly dog. Examination with a laryngoscope under anaesthesia reveals a soft tissue mass (m) between the arytenoid cartilages. © 2007 British Small Animal Veterinary Association
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Laryngeal neoplasia in an elderly dog. Examination with a laryngoscope under anaesthesia reveals a soft tissue mass (m) between the arytenoid cartilages.
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Stenotic nares in an English bulldog during surgical correction. © 2007 British Small Animal Veterinary Association
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Stenotic nares in an English bulldog during surgical correction.
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Foreign body removed from nasal chamber of a dog under endoscopic guidance. © 2007 British Small Animal Veterinary Association
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Foreign body removed from nasal chamber of a dog under endoscopic guidance.
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Cleft of the hard palate in a puppy (under anaesthesia, immediately before surgery). © 2007 British Small Animal Veterinary Association
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Cleft of the hard palate in a puppy (under anaesthesia, immediately before surgery).
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Sharpei recovering from upper respiratory tract surgery. Note the sternal position the animal is placed in and the use of nasal prongs for supplemental oxygen therapy without causing distress. © 2007 British Small Animal Veterinary Association
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Sharpei recovering from upper respiratory tract surgery. Note the sternal position the animal is placed in and the use of nasal prongs for supplemental oxygen therapy without causing distress.
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Cat following resection of the rhinarium for treatment of squamous cell carcinoma (5 days after surgery). © 2007 British Small Animal Veterinary Association
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Cat following resection of the rhinarium for treatment of squamous cell carcinoma (5 days after surgery).
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Thoracic radiograph of a cat showing a radiodense foreign body in the distal trachea. A pebble was later removed endoscopically. © 2007 British Small Animal Veterinary Association
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Thoracic radiograph of a cat showing a radiodense foreign body in the distal trachea. A pebble was later removed endoscopically.
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Primary lung tumour in right middle lobe of a dog, seen during lateral thoracotomy. This was removed by a lobectomy. © 2007 British Small Animal Veterinary Association
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Primary lung tumour in right middle lobe of a dog, seen during lateral thoracotomy. This was removed by a lobectomy.
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(a) Excised specimen of a mandibular neoplasm from a dog managed by bilateral rostral mandibulectomy. (b) Postoperative appearance of the dog. © 2007 British Small Animal Veterinary Association
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(a) Excised specimen of a mandibular neoplasm from a dog managed by bilateral rostral mandibulectomy. (b) Postoperative appearance of the dog.
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Lateral thoracic radiograph of a dog with a foreign body (tennis ball) in the caudal thoracic oesophagus. © 2007 British Small Animal Veterinary Association
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Lateral thoracic radiograph of a dog with a foreign body (tennis ball) in the caudal thoracic oesophagus.
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Partial gastrectomy using a surgical stapler (thoracoabdominal device) to remove a gastric neoplasm. © 2007 British Small Animal Veterinary Association
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Partial gastrectomy using a surgical stapler (thoracoabdominal device) to remove a gastric neoplasm.
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Linear foreign body (pair of tights) being removed from a dog through an enterotomy. © 2007 British Small Animal Veterinary Association
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Linear foreign body (pair of tights) being removed from a dog through an enterotomy.
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Ventral view of 180-degree rotation of stomach. (a) Pylorus moves ventrally from right to left. (b) Pylorus and body of stomach move clockwise. (c) Pylorus lies to left of stomach. (d) Pylorus moves more dorsally. (Reproduced from BSAVA Manual of Canine and Feline Abdominal Surgery.) Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2007 British Small Animal Veterinary Association
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Ventral view of 180-degree rotation of stomach. (a) Pylorus moves ventrally from right to left. (b) Pylorus and body of stomach move clockwise. (c) Pylorus lies to left of stomach. (d) Pylorus moves more dorsally. (Reproduced from BSAVA Manual of Canine and Feline Abdominal Surgery.) Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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Extensive anal furunculosis on the perineum of a German Shepherd Dog. © 2007 British Small Animal Veterinary Association
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Extensive anal furunculosis on the perineum of a German Shepherd Dog.
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A dog placed in the perineal position for repair of a right-sided perineal rupture (the rupture has been reduced and appears as a large depression). A purse-string suture has been placed in the anus. © 2007 British Small Animal Veterinary Association
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A dog placed in the perineal position for repair of a right-sided perineal rupture (the rupture has been reduced and appears as a large depression). A purse-string suture has been placed in the anus.
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Thoracoabdominal surgical stapler used to carry out liver lobectomy in a cat. © 2007 British Small Animal Veterinary Association
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Thoracoabdominal surgical stapler used to carry out liver lobectomy in a cat.
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LDS device (Autosuture) used during splenectomy in a dog. © 2007 British Small Animal Veterinary Association
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LDS device (Autosuture) used during splenectomy in a dog.
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Ureteronephrectomy to manage a case of ectopic ureter with hydronephrosis. © 2007 British Small Animal Veterinary Association
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Ureteronephrectomy to manage a case of ectopic ureter with hydronephrosis.
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Large scrotal haematoma that developed during the 24 hours after castration of a dog. © 2007 British Small Animal Veterinary Association
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Large scrotal haematoma that developed during the 24 hours after castration of a dog.
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Intraoperative view of canine penis that has been reconstructed after traumatic partial amputation. The penis has been held out of the prepuce with a Penrose drain tightened around the base and a urethral catheter is in place. © 2007 British Small Animal Veterinary Association
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Intraoperative view of canine penis that has been reconstructed after traumatic partial amputation. The penis has been held out of the prepuce with a Penrose drain tightened around the base and a urethral catheter is in place.
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Puppies recovering in an incubator after Caesarean section whilst surgery is completed. © 2007 British Small Animal Veterinary Association
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Puppies recovering in an incubator after Caesarean section whilst surgery is completed.
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Surgical field for ear canal surgery. The pinna is included in the draped area (photo taken at completion of surgery and the towel clips have been removed). © 2007 British Small Animal Veterinary Association
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Surgical field for ear canal surgery. The pinna is included in the draped area (photo taken at completion of surgery and the towel clips have been removed).