Surgical nursing

Donna Brown; Romain Pizzi

doi:10.22233/9781910443132.9

Surgical nursing

British Small Animal Veterinary Association , 222 (2012); https://doi.org/10.22233/9781910443132.9

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Surgical nursing

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Authors: Donna Brown and Romain Pizzi
From: BSAVA Manual of Exotic Pet and Wildlife Nursing
Item: Chapter 9, pp 222 - 242
DOI: 10.22233/9781910443132.9
Copyright: © 2008 British Small Animal Veterinary Association
Publication Date: January 2012

Abstract

This chapter covers the role of the surgical nurse, hygiene and sterility procedures, the use and maintenance of equipment, sutures and wound dressing. Includes self-assessment questions.

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Figures

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9.1

Veterinary surgery safety checklist, modified from the World Health Organization (WHO) surgical safety checklist. (© Romain Pizzi, Zoological Medicine Ltd) © 2012 British Small Animal Veterinary Association

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9.1 Veterinary surgery safety checklist, modified from the World Health Organization (WHO) surgical safety checklist. (© Romain Pizzi, Zoological Medicine Ltd)

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9.2

Note the use of Micropore tape (3M), atraumatically holding feathers back, preventing them from protruding into the sterile field before draping in this galah parrot. (© Romain Pizzi, Zoological Medicine Ltd) © 2012 British Small Animal Veterinary Association

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9.2 Note the use of Micropore tape (3M), atraumatically holding feathers back, preventing them from protruding into the sterile field before draping in this galah parrot. (© Romain Pizzi, Zoological Medicine Ltd)

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9.3

(a) A chinchilla on a microwavable heat mat. Unlike most small mammal pets, chinchillas are prone to overheating under anaesthesia. (b) This ferret has been covered in bubble wrap to prevent heat loss before the start of surgery. (c) A hot water bottle and latex gloves filled with hot water are used to prevent hypothermia during surgery on this veiled chameleon. (d) This tortoise has been placed on a beanbag, pre-heated in a microwave oven, to help prevent perioperative hypothermia. Note that heat sources should be insulated to avoid thermal burns unless they are confirmed to be at a suitable temperature prior to use. (© Romain Pizzi, Zoological Medicine Ltd) © 2012 British Small Animal Veterinary Association

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9.3 (a) A chinchilla on a microwavable heat mat. Unlike most small mammal pets, chinchillas are prone to overheating under anaesthesia. (b) This ferret has been covered in bubble wrap to prevent heat loss before the start of surgery. (c) A hot water bottle and latex gloves filled with hot water are used to prevent hypothermia during surgery on this veiled chameleon. (d) This tortoise has been placed on a beanbag, pre-heated in a microwave oven, to help prevent perioperative hypothermia. Note that heat sources should be insulated to avoid thermal burns unless they are confirmed to be at a suitable temperature prior to use. (© Romain Pizzi, Zoological Medicine Ltd)

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9.4

The skin over this rabbit’s scrotum has been traumatized by poorly maintained clippers with broken teeth. Similar injuries can, however, be caused even by well maintained clippers if care is not taken. (© Romain Pizzi, Zoological Medicine Ltd) © 2012 British Small Animal Veterinary Association

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9.4 The skin over this rabbit’s scrotum has been traumatized by poorly maintained clippers with broken teeth. Similar injuries can, however, be caused even by well maintained clippers if care is not taken. (© Romain Pizzi, Zoological Medicine Ltd)

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9.5

(a) Clear plastic drapes can cover the patient and table for this endoscopic procedure, but still allow visual monitoring of this ornate monitor lizard. (b) For smaller patients, such as this bearded dragon, clear plastic drapes are particularly useful for monitoring anaesthesia under the large draping needed for endoscopic procedures. (© Romain Pizzi, Zoological Medicine Ltd) © 2012 British Small Animal Veterinary Association

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9.5 (a) Clear plastic drapes can cover the patient and table for this endoscopic procedure, but still allow visual monitoring of this ornate monitor lizard. (b) For smaller patients, such as this bearded dragon, clear plastic drapes are particularly useful for monitoring anaesthesia under the large draping needed for endoscopic procedures. (© Romain Pizzi, Zoological Medicine Ltd)

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9.6

Adhesive draping is useful for the transplastron coeliotomy in this tortoise. It prevents strike-through despite flushing of the diamond cutting disc with sterile water during the procedure. (© Romain Pizzi, Zoological Medicine Ltd) © 2012 British Small Animal Veterinary Association

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9.6 Adhesive draping is useful for the transplastron coeliotomy in this tortoise. It prevents strike-through despite flushing of the diamond cutting disc with sterile water during the procedure. (© Romain Pizzi, Zoological Medicine Ltd)

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9.7

Magnification loupes are useful for visualizing small incisions and structures, such as during the initial placement of the laparoscopic surgery ports in this seal pup. They also allow the surgeon to see over the top, similar to bifocal spectacles. (© Romain Pizzi, Zoological Medicine Ltd) © 2012 British Small Animal Veterinary Association

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9.7 Magnification loupes are useful for visualizing small incisions and structures, such as during the initial placement of the laparoscopic surgery ports in this seal pup. They also allow the surgeon to see over the top, similar to bifocal spectacles. (© Romain Pizzi, Zoological Medicine Ltd)

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9.8

Ventriculotomy to remove a lead weight in a swan. The low-profile autoclavable Lone Star ring retractor avoids interference from hands holding larger retractors. (© Romain Pizzi, Zoological Medicine Ltd) © 2012 British Small Animal Veterinary Association

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9.8 Ventriculotomy to remove a lead weight in a swan. The low-profile autoclavable Lone Star ring retractor avoids interference from hands holding larger retractors. (© Romain Pizzi, Zoological Medicine Ltd)

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9.9

(a) Use of bipolar radiosurgery and sterile cotton tips to ensure accurate haemostasis in a rabbit undergoing spinal surgery. (b) Monopolar radiosurgery for accurate haemostasis during removal of an abdominal abscess from a rabbit. (© Romain Pizzi, Zoological Medicine Ltd) © 2012 British Small Animal Veterinary Association

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9.9 (a) Use of bipolar radiosurgery and sterile cotton tips to ensure accurate haemostasis in a rabbit undergoing spinal surgery. (b) Monopolar radiosurgery for accurate haemostasis during removal of an abdominal abscess from a rabbit. (© Romain Pizzi, Zoological Medicine Ltd)

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9.10

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9.10 Monopolar electrosurgery groundplate burn in a rabbit, due to poor contact from the dense fur. (© Romain Pizzi, Zoological Medicine Ltd)

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9.11

The use of microsurgical instruments in a gerbil (atraumatic loop-tipped forceps and Castroviejo needle-holders). (© Romain Pizzi, Zoological Medicine Ltd) © 2012 British Small Animal Veterinary Association

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9.11 The use of microsurgical instruments in a gerbil (atraumatic loop-tipped forceps and Castroviejo needle-holders). (© Romain Pizzi, Zoological Medicine Ltd)

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9.13

This rabbit had self-traumatized its scrotum after castration, due to the irritation caused by catgut ligatures. (© Romain Pizzi, Zoological Medicine Ltd) © 2012 British Small Animal Veterinary Association

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9.13 This rabbit had self-traumatized its scrotum after castration, due to the irritation caused by catgut ligatures. (© Romain Pizzi, Zoological Medicine Ltd)

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9.14

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9.15

A tortoise with a chronic carapacial abscess, demonstrating a multi-drug-resistant Pseudomonas infection, treated by applications of silver nanocrystalline dressings. (© Romain Pizzi, Zoological Medicine Ltd) © 2012 British Small Animal Veterinary Association

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9.15 A tortoise with a chronic carapacial abscess, demonstrating a multi-drug-resistant Pseudomonas infection, treated by applications of silver nanocrystalline dressings. (© Romain Pizzi, Zoological Medicine Ltd)

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9.16

Bandaging a fracture. (a) Carrion crow with figure-of-eight bandage supporting a closed fracture of the ulna (the bandage holds only the carpal and elbow jointed flexed; it does not include the body). (b) Conforming bandage used to form a figure-of-eight support for a fractured humerus. The bandage is holding the carpal and elbow joints flexed. (c) The humerus is then immobilized by passing the bandage completely around the body, passing beneath the opposite wing. (Reproduced from the BSAVA Manual of Wildlife Casualties) © 2012 British Small Animal Veterinary Association

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9.16 Bandaging a fracture. (a) Carrion crow with figure-of-eight bandage supporting a closed fracture of the ulna (the bandage holds only the carpal and elbow jointed flexed; it does not include the body). (b) Conforming bandage used to form a figure-of-eight support for a fractured humerus. The bandage is holding the carpal and elbow joints flexed. (c) The humerus is then immobilized by passing the bandage completely around the body, passing beneath the opposite wing. (Reproduced from the BSAVA Manual of Wildlife Casualties)

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9.17

Ball bandage. A simple bandage with a large wad of cotton wool (some prefer to use half a squash ball) held in place with elasticated cohesive dressing. The bandage must be kept dry and the talons must protrude such that the toes are able to flex and extend slightly, thus preventing adhesions between healing bone and tendon. The bandage should be removed after 3–5 days. (Reproduced from the BSAVA Manual of Raptors, Pigeons and Passerine Birds ) (© John Chitty) © 2012 British Small Animal Veterinary Association

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9.17 Ball bandage. A simple bandage with a large wad of cotton wool (some prefer to use half a squash ball) held in place with elasticated cohesive dressing. The bandage must be kept dry and the talons must protrude such that the toes are able to flex and extend slightly, thus preventing adhesions between healing bone and tendon. The bandage should be removed after 3–5 days. (Reproduced from the BSAVA Manual of Raptors, Pigeons and Passerine Birds ) (© John Chitty)

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9.18

Type II Kirschner-Ehmer external fixator used to repair a transverse fracture of the tibia in a chinchilla. Small non-threaded K wires were connected using hand-rolled polymethylmethacrylate bars. (Reproduced from the BSAVA Manual of Exotic Pets, 4th edn). © 2012 British Small Animal Veterinary Association

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9.18 Type II Kirschner-Ehmer external fixator used to repair a transverse fracture of the tibia in a chinchilla. Small non-threaded K wires were connected using hand-rolled polymethylmethacrylate bars. (Reproduced from the BSAVA Manual of Exotic Pets, 4th edn).

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