Flashcards
Surgery week 6
Cards in this deck (89)
- 1Functions of a bandage (5)Cover wounds and control bleeding
Provide clean environment for healing
Protect wound from further trauma
Keep the dressing in place
Restrict movement to reduce pain and inflammation - 2Primary layerProtects wound
Melolin held in place with soffban - 3Secondary layerAbsorbs exudates, controls swellings and protects injury
Cotton wool or gamgee
Followed by compression with conforming bandage eg. Vetwrap or paper bandage - 4Tertiary layerVetwrap and elastoplast + sleek tape
- 5Types of equine bandagesHalf limb bandage: Coronary band to proximal metacarpal or metatarsal bones
Robert Jones: Floor to proximal radius or tibia
Half limb Robert Jones: Floor to proximal metacarpal or metatarsal bones
Carpal & hock: figure 8 wrapping
Foot: Cotton wool + compression + vet wrap - 6Function of splintPrevent further injury
Stabilise injury
Allow horse to travel for treatment
Kimzey, monkey splints - 7Purpose of sutureStrand of sterile material used to close internal and external wounds by bringing tissue edges together while healing occurs or to ligate vessels
- 8Characteristics of an ideal suture materialMaintains tensile strength
Stimulates minimal inflammation
Discourages bacterial growth
Non capillary and predictable absorption
Non allergenic or carcinogenic - 9Properties of an ideal sutureMonofilament
Good knot security
Inexpensive and available
Appropriate absorption
No chatter or drag - 10Structural types of sutureMonofilament
Pseudomonofilament
Braided - 11Classifying suture materialsBehaviour: Absorbable/non absorbable
Origin: synthetic/natural
Structure: monofilament/braided - 12Characteristics of a monofilament sutureSingle strand, less chatter and drag
Less capillarity
NO SPACE for bacterial growth
Weaker stand, can be damaged and break
More memory than multifilament - 13Characteristics of multifilament sutureMore flexible than mono and less prone to damage, BUT
Has spaces for bacterial growth
More drag and chatter
Increased capillarity - 14How is absorbable suture degraded?Phagocytosed (natural materials, causing inflammation)
or hydrolysed (Synthetic materials)
Used internally, don't need to be removed - 15Characteristics of non absorbable sutureRemains in the tissue and does not dissolve eg. skin sutures
Needs removing, or used in procedures where support is needed and is not removed eg. implants and tendon repair - 16Natural sutureSilk and cat gut
Made of collagen fibres from intestinal mucosa of ruminants. Causes tissue reaction. Cheap and available - 17Synthetic fibreArtificially produced
Less tissue reaction
Easier to predict breakdown
Eg. PDS and nylon - 18Different systems for suture sizeMetric
USP - this is more important - 19Common size range used for USP suture4-0 to 0
- 20Synthetic absorbable suture (3)Monocryl - used for soft tissue ligation eg. intestines and bladder
PDS - used on soft tissue that takes longer to heal eg. linea alba and muscle
Vicryl - pliable with high tensile strengh, equine use - 21Synthetic non absorbable suture (2)Nylon - used for skin closure
Prolene - Monofilament with high tensile strength, used in implants, hernia and tendon repair - 22Natural absorbable sutureCat gut: moderate tissue reaction but fast absorbing, lasts 7-10 days
- 23Natural non absorbableSilk - multifilament, moderate tissue reaction
Used in ophthalmic and cardiac surgery - 24Factors affecting material choice1.Patient: age, breed, concurrent disease, temperament
2. Tissue type
3. Surgeon preference
4. Procedure and longevity required - 25Types of suture needlesRound body - pointed end for internal and delicate tissue
Cutting: triangular end for dense tissue eg. skin
Swathed or eyed - 26Alternatives to sutureStaples
Adhesives - 27Types of suture patterns (6)Simple interrupted
Simple continuous
Ford interlocking
Cruciate
Vertical and horizontal mattress
Purse string - 28Simple interruptedDoes not undo if one stitch is compromised
Used Internally and externally - 29Simple continuousOne knot and beginning and end only. Used for subcutaneous closing or on linea alba. Fast and less material used
- 30Ford InterlockingGood stability, but doesn't allow for tension adjustment, requires lots of material
Used for internal tissue layers or animals who can't remove own sutures - 31Cruciate suturesPrevents eversion and resists tension, but can be too tight and impair healing
Used on fascia and skin - 32Horizontal and vertical mattressUsed on areas under high tension to spread out pressure, everts skin
- 33Purse stringContinuous stitch to close off a lumen, usually the anus prior to surgery
DON'T FORGET TO REMOVE IT - 34Equipment used in LA surgerySx kits
Gowns, gloves, drapes, swabs
Suture
Clippers with spare blades and batteries
Drugs
Any other equipment - calving jacks, lights, positioning aids - 35Patient preparation before surgeryFull clinical exam, TPP/PCV, CBC and biochemistry
Food and water withholding
Restraint: Physical and chemical
Prevention of contamination of site by legs and tail - 36Field surgeryReduces nosocomial infections
Need to consider weather and light
Procedure in view of owner - 37In clinic surgeryUsually specialist referral cases for soft tissue injuries
Have specialist equipment available, but higher risk of nosocomial infection - 38Positioning in long proceduresPull distal forelimb cranially and place padding between limbs if lateral
Thick padding underneath animal
Eye protection - 39Eye enucleation surgery: patient preparationRestrain in head bale or in recumbency with sedation
Use local anaesthesia
Generously clip orbital area and do a surgical scrub - 40Closing the wound post removalLigate pedicle and pack orbital with sterile gauze. Remove before suturing eyelids or 2 days later if bleeding continuously
Non absorbable suture removed after 10-14 days - 41Post op careSwelling should subside within 7 days
Provide animal with antibiotics and anti-inflammatories - 42ComplicationsHaemorrhage
Incomplete removal of neoplasia
Abscess
Eyelid suture dehisence - 43AnkyloblepharonApposition of upper and lower eyelids
- 44Common abdominal proceduresExploratory laparotomy
Hernia repair
Navel abscesses - 45Clipping for abdominal surgeryAlways confirm with surgeon
Generally: Left side of flank from last rib til hip bone
Epidural: top of tail
Paravertebral anaesthesia: Top of lumbar vertebrae - 46Skin preparationInitial prep to clean patient and administer anaesthesia
Second prep: Start from incision site and move outwards
Final prep: Meths or tincture
Use scrub solution and water - 47Methods of analgesia for abdominal surgeryLine block
Inverted L block
Paravertebral block
Epidural - 48Indications and preparation for exploratory laparotomyIndications: Caesareans, displaced abomasum and abdominal pain of unknown origin
Prep: Standard clip and standard skin prep - 49Tech's role in caesareanSurgical preparation
Sterile assistant
Calf removal and resuscitation - 50Complications of laparotomyCollapse of patient from standing to recumbent on incision side
Dehiscence of wound
Purulent discharge from wound - 51Hernia and navel abscess repair: patient preparationWithhold food for 24 hours
Give antibiotics to patients with discharging wounds for 3-5 days
Pack preputial cavity in males
Clip from below teats to xiphoid process - 52Post op careRestrict movement and keep calf in small pen for 7 days
Give analgesia and antibiotics
-/+ belly wrap - 53ComplicationsHaematoma
Seroma
Dehiscence - 54Common reproductive surgeriesCastration
Prolapse
Bearing - 55CastrationsPerformed on animals over 6 months old, similar procedure among species
Use emasculator and scalpel blade - 56Patient prep for castrationRecumbent sedation
Clip scrotum
Iodine or chlorhex scrub
Local anaesthesia - 57Post op careKeep animal in a clean, dry and dust free environment
Wound left open for drainage, but check for haemorrhage
Pink or blue spray
Vaccinate for clostridial disease - 58ComplicationsInfection
Swelling
Haemorrhage
Clostridial disease - 59Types of prolapseVaginal
Uterine
Rectal - 60Vaginal prolapsesMore common in sheep before birth
Usually fixed by farmers - 61Uterine prolapseMore common post parturition in cattle
Emergency! Artery rupture can cause death - 62Pre replacement assessment of prolapseAssess what tissue is visible
Vagina, cervix or uterus
Determine viability of tissue
contamination, lacerations and necrosis - 63Replacement of prolapsesA lot of saline to flush and decontaminate wounds
Vaginal tape
Buhner needle or empty wine bottle
Have l=hind legs elevated - 64Post op careCheck animal within 12-24 hours
Remove sutures from vaginal prolapses before parturition, recommend ewe is not used for breeding again - 65ComplicationsRecurrence
Infection
Haemorrhage
Sepsis - 66Claw amputationDone for incurable lameness before advanced septic pedal arthritis occurs
- 67Patient preparationClip to mid cannon
Scrub with iodine or chlorhex
Use anaesthesia and tourniquet - 68Amputation procedure and after careCut between digits using embryotomy wire
Bandage for 1-3 days and leave up to two weeks plus topical wound cream and antibiotics for 5 days - 69Velvet removalMust use appropriate analgesia and haemeostatic principles
- 70Liver biopsiesFor analysis of trace elements and histology
Must use local and prep skin. Use trocar and liver punch to collect sample - 71DisbuddingPrevents horn from growing, done in calves from 6-8 weeks old, or kids between 2-9 days old
Use sedation and pain relief, legal requirement to use local - 72DehorningDone on adult cattle
Horns can't protrude past ears for transport
Not done with sedation or pain relief, but must apply haemostasis (cable tie tourniquet) Can expose frontal sinus. Use fly repellant as blood attracts insects - 73Patient prep for disbuddingCalves must be starved overnight as they require sedation. Good weather or under shelter only to prevent sinus infections
Need xylazine, local, clippers, gas disbudder and disinfectant spray - 74Disbudding anaesthesiaUse local on cornual block - takes 10 minutes
Bleb block - takes 2-3 minutes - 75Disbudding goat kidsPerform prior to 12 days of age
Fast for 1 hour only and give milk post op
Clip horns and give NSAID while equipment heats up
Use alfaxalone instead of xylazine, goats sensitive to lignocaine
12 seconds per horn bud only and less pressure than calves! delicate - 76Nerve blocks in KidsCornual brach of lacrimal and infratroclear nerve block
Ring block - 77Post op care in kidsPlace in warm environment and give milk immediately
Place an e-collar on them - 78Pig nose rings and clipsPrevent rooting
Requires overnight fasting as they need heavy sedation
Need to clip and scrub site - 79Post op care and advicePigs left to sleep off their sedation
Advise owners that clips are temporary and fall out as the pigs grow
Rings can tear out the nasal septum if stuck or pulled - 80Ring castrationsOnly done in animals <6months old
Ensure both testicles have descended
Clean area where ring will be placed with tincture
Can give NSAID and infra testicular local - 81Ring castration post op careClient should monitor animal for Excessive swelling, wet necrosis and any pain after 5 days
Will take a month to fall off, but will shrivel up after 1 week - 82Lamb dockingMust be done in animals < 6 months old
Easier for farmers to shear, but should be long enough to cover the vulva
Place in between vertebrae - 83Post op care of dockingClient must keep an eye out for wet necrosis, excessive swelling and pain after 5 days
Usually takes 2-3 weeks to fall off, but shrivelled after 1 week - 84Limitations for wound management in large animalsWet and dirty environments
Ability for client to see animal and be compliant with instruction
Patient compliance
Interference by mob mates - 85Wound management and normal healing (5)1. Exudate normal first few days, should be clear
2. Erythema normal for 2-3 days
3 Oedema normal for 2-3 days
4. Pain
5. Odour - should be none - 86Post op care of suturesWatch for wound breakdown and dehiscence
Apply fly repellent
Remove sutures in 2-3 weeks
+/- antibiotics
Monitor appetite and demeanour - 87Common topical pharmaceuticalsLiquid bandaging
Antibiotic spray
Antimicrobial spray
Chloromide: Antiseptic, disinfectant, antifungal and repellant
TriSolfen - anaesthetic and antiseptic - 88Limb bandagingDistal limb is bandaged after a claw amputation, changed 5 days post op and then 2-3 weeks later
- 89Applying a good limb bandageAdequate padding around dew claws to protect limb
Waterproof and breathable, non wicking
Stable/ durable but not too tight!!
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- Surgery and Imaging Flashcards on Surgery week 6, created by Kelly Scott on 02/03/2020.
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- Kelly Scott
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