Small Animal Surgical Emergencies. Группа авторов

       Sterile suction tubing

       Suction canister

       Monopolar cautery

       Additional mosquito hemostats and carmalt forceps

       Atraumatic clamp (e.g., Doyens)

       Extra laparotomy sponges

Wound Management

Wounds are commonly seen in veterinary practice and may occur secondary to dog or cat bites, penetrating foreign bodies, burn injury, necrotizing fasciitis, and degloving and shear injuries secondary to trauma. Following wound assessment and depending on the cause of injury, aggressive debridement and lavage may be necessary. Although some supplies may be unique to the specific injury, significant overlap exists with regard to the instrumentation and supplies recommended for initial wound management (Box 2.22). Positioning of the patient will be based on the location of the injury.

Box 2.19 Instruments and Supplies for Penile Surgery

       Routine soft tissue instrument set

       Monopolar and bipolar cautery

       Urethral catheters (size appropriate)

       Umbilical tape (may be used to help keep the penis retracted from the prepuce as well as act as a tourniquet; Figure 2.28)

       Bone cutters

       Absorbable suture material (4‐0)

Figure 2.28 For penile surgery, umbilical tape may be used to help keep the penis retracted from the prepucial cavity as well as act as a tourniquet.

Box 2.20 Instruments and Supplies for Prostatic Surgery

       Routine soft tissue instrument set

       Monopolar cautery

       Bipolar vessel sealing device (Ligasure®)

       Laparotomy sponges

       Balfour or Gossett retractor (appropriately sized)

       Gelpi retractors (Figure 2.29)

       Mixter forceps (Figure 2.25a,b)

       Babcock tissue forceps (Figure 2.30)

       Umbilical tape or Penrose drain

       Appropriately sized urethral catheter

       Passive (Penrose; Figure 2.31a) and active (JP; (Figure 2.31b) drains

       10‐ml syringe/25‐g needle (pressure testing of urethra following partial prostatectomy)

Figure 2.29 Gelpi retractors.

Figure 2.30 Babcock tissue forceps.

Figure 2.31 Drains: (a) passive (Penrose); (b) active (JP).

Box 2.21 Instruments and Supplies for Vaginal Prolapse

       Routine soft tissue instrument set

       Monopolar cautery

       Senn retractors

       Gelpi retractors

       Doyen atraumatic clamps

       Urinary catheter (size appropriate)

Ocular Emergencies

      Standard Surgical Preparation Protocol

      Preoperative preparation of the patient's periocular area, commonly referred to as “gross scrub,” should occur in a designated area outside of the surgical suite following anesthetic induction. A laboratory coat should be worn to shield operating room scrub attire from contact with hair and bodily fluids. Artificial tears or antibiotic ophthalmic ointment (without steroidal component) should be generously applied in both eyes to protect the corneas under anesthesia, unless corneal surgery is to be performed, and to prevent hair from entering the eyes. The periocular area is carefully clipped (2–3 inches around globe) using a #40 blade and a small pair of surgery clippers labeled solely for ophthalmic procedures. Presterilized clipper blades are preferred to eliminate the risk of harboring residual bacteria from a prior patient. Adhesive tape is recommended to gently collect residual hair from the surgical site. Superficial dirt and debris are removed using presoaked cotton balls of diluted baby shampoo.

The surgical site should be precleansed using povidone‐iodine solution, the standard antiseptic for ophthalmic surgery, for its ability to kill a broad spectrum of microbes and some spores. Isopropyl alcohol and chlorhexidine diacetate should be avoided. Chlorhexadine diacetate can cause extensive corneal damage and irreversible deafness if used as a facial antiseptic. Betadine‐soaked cotton balls (5% dilution) are applied to cleanse the eyelids and surrounding skin in a concentric manner, carefully with very minimal pressure. Cotton‐tipped applicators are used to remove residual debris and ocular discharge from the conjunctiva and under the eyelids. This process should be repeated twice followed by rinsing with copious amounts of 0.9% saline. Equipment recommended for preoperative periocular surgical preparation and final surgical preparation is listed in Boxes 2.23 and 2.24, and shown in Figures 2.34 and 2.35, respectively.

      Surgical Supplies

Ophthalmic surgical instrumentation must be handled, disinfected, and reprocessed with care. Microsurgical instruments are particularly delicate and expensive. Instruments should only be used for their intended purpose as improper usage may cause irreparable damage. It is thus advantageous to have dedicated sterile surgical instrument sets for procedures related to anatomic ocular