GRH Surgery Principles

How can Halsted’s Principles help me improve my surgical skills? Conceived in the late 19th century, Halsted’s Principles are as relevant for us in our surgeries today as they were then. Their central axiom is all about promoting wound healing; this seminar outlines some simple guidelines for incorporating the kind of tissue sympathy in our surgical technique that favours optimal wound healing.

Maximising the use of a scrubbed assistant in surgery: A scrubbed assistant benefits everyone involved in a surgical procedure, including the patient. As nurses we have a key role and need to understand how to support the surgical team. Developing our skills under schedule 3 of the Veterinary Surgeons Act 1966, also helps with our career progression and job satisfaction. It must be remembered though that all surgical procedures, however minor, have associated risk to the patient. This means it is important that nurses are fully trained and competent at performing surgical skills and understand the legality and limitations within their professional remit.

Appropriate tissue handling is an essential part of good surgical technique. Indeed, ‘gentle tissue handling’ is one of Halstead’s principles of surgery. Tissue handling involves respecting the tissues during surgery to ensure that they are not damaged. This can be achieved by the prevention of crushing, drying out, haemorrhage and damage to the vascular supply. An understanding and appropriate use of instruments and other techniques to aid tissue handling is essential. Good tissue handling is important as it will reduce or prevent complications such as surgical site infection (SSI), wound dehiscence, haemorrhage and seroma formation. The first step of improving tissue handling is to understand the basic principles. This can then be refined through practise and experience. It is vital that the surgeon reflects on their performance and strives for ongoing improvement. This can be enhanced by observation of peers, advice from an appropriate mentor and good planning prior to surgery. Refinement of tissue handling should improve surgical outcomes. Good surgical technique is characterised by accuracy and security rather than speed and apparent ease of performance.

Alison Moores covers the commonly seen diseases of the anus that can be addressed surgically, including a video of surgery of anal sacculectomy. This one-hour webinar was first broadcast as part of BSAVA’s Learn@Lunch series. Learn@Lunch broadcasts are available to BSAVA members only and are free to attend - visit the education page of the BSAVA website for details of future Learn@Lunch webinars. Recordings will be available for 3 years via the BSAVA Webinar Library.

Hayley Carne reviews the common drains and tubes used in veterinary practice and post-operative management, including vascular access catheters, thoracotomy tubes, wound drains, tracheostomy tubes and urinary catheters. This one-hour webinar was first broadcast as part of BSAVA’s Learn@Lunch series. Learn@Lunch broadcasts are available to BSAVA members only and are free to attend - visit the education page of the BSAVA website for details of future Learn@Lunch webinars. Recordings will be available for 3 years via the BSAVA Webinar Library.

For any animal, motion is required for it to function and enjoy a reasonable quality of life; the aim of orthopaedic surgery is to restore this function with minimal associated pain. This chapter details patient assessment, clinical decision-making, surgical principles, preparation for surgery and execution of a range of articular surgeries.

Open wound management in small animals is a common event in veterinary practice. It is economically significant and can cause considerable distress and pain to the animal. The aim of wound management is to provide conditions that allow for optimal wound healing or to prepare the wound for definitive closure by reconstructive techniques. However, every wound is unique and this problem is reflected in the paucity of published studies analysing the effectiveness of wound dressing products in the management of small animal wounds. Wounds must be properly evaluated at the first presentation in order to plan a treatment protocol and to give the owner an indication of the expected duration of treatment and ultimately the prognosis. This chapter considers how to manage open wounds and how to use dressings and bandages to optimize the healing process. The following topics are addressed: Principles of wound management; Wound lavage; Wound debridement; Systemic treatments; Bandages and dressings; Topical medications; Primary (contact) layer wound dressings; Bandaging; and Wound management strategy and planning. This chapter also includes case examples focusing on Open wound management of a chronic shear injury prior to skin grafting; and Management of an acute road traffic shear injury. Case examples: Open wound management of a chronic shear injury; Management of an acute road traffic shear injury