Small Animal Surgical Emergencies. Группа авторов

administration set

       Pressure bag

       ± Three‐way stopcock^a

       ± 60‐cc syringe^a

^a To be considered as a general guideline. There are many variables which could alter the clinician's decision. The clinician is responsible for selecting the appropriate size and items used.

Figure 2.40 Ingress needle shown delivering pressurized fluid into affected stifle joint via an intravenous administration set as the egress needle expels lavage fluid.

      Source: Courtesy of K.A. Agnello, School of Veterinary Medicine, Philadelphia, PA.

An arthroscopy tower set‐up is listed in Box 2.40. Instruments and supplies are listed in Box 2.41.

      Arthrotomy

Arthrotomy is the most invasive therapeutic intervention for joint sepsis and rarely performed on an emergent basis unless the clinician suspects there is an overabundance of gross material within the joint. Instruments and supplies recommended for arthrotomy are listed in Box 2.42.

      Open Fracture

Open fractures are complicated by a contaminated soft tissue wound resulting from the fractured bone penetrating through the epidermis. Wound debridement of any necrotic tissue or gross debris and lavage should be the priority prior to fracture fixation. This will help to reduce the risk of infection. Regardless, the fractured limb must be stabilized promptly by first, applying a sterile dressing over the open wound, followed by a Robert Jones bandage (Box 2.43).

Box 2.40 Arthroscopy Tower Set‐Up

       Arthroscopy tower (Figure 2.41)

       Arthroscopy pump

       Sterile light cable

       Camera head

       Sterile shaver

       Universal foot pedal for shaver

       USB port to upload procedure images/recordings

Figure 2.41 Components of a portable arthroscopy tower, including an imaging display system, light source and shaver console.

Box 2.41 Instruments and Supplies for Arthroscopy

       Sterile arthroscopy drape

       Sterile camera sleeve

       Arthroscopes:1.9‐mm (elbow)^a2.3‐mm (elbow/shoulder/small canine/cat stifle)^a2.7‐mm (canine stifle)^a

       Abrader (2.5 mm, 3.5 mm)^a

       0.9% sodium chloride irrigation (3‐liter bags)

       Arthroscopic cautery pencil

       Bulb syringe

       Sterile VetWrap (2 in)

       Scalpel blades (no. 10, 11, and 15)

       Scratch pad

       Floor suction

       Sterile basin

       Culturette

       Allis tissue forceps (2)

       Kelly hemostats (2)

       Mosquito hemostats (2)

       Small towel clamps (6)

       Large towel clamps (4)

       Mayo scissors

       #3 scalpel blade handle

       Rat‐tooth forceps

       Adson forceps

       DeBakey forceps

       Metzenbaum scissors

       Needle holder

       X‐ray detectable gauze (10)

       Hook knife

       Obturators for cannulas

       Arthroscopy cannula (3.2 mm/4.0 mm)

       Cup curette (small)

       Graduated black probe

       Push knife (2)

       Meniscal knife

       Kelly hemostat (straight)

       Chondro pick (surgical tip, 40 degree, straight)

       Ventura stifle distractor

       Joint retractor

       Joint probe (90‐degree, small)

       Stainless steel probe

       Spratt curette

       Knives handles

       Double edge curette

       Osteotome (4 mm)

      Specialty instruments:

       Hook probe

       Straight round spoon curette

       Alligator grasper

       SILCUT® punch (KARL STORZ Endoscopy‐America, Inc., El Segundo, CA)

       0.5‐mm scissors punch

       Straight cartilage grasper

       Articulated lever

       3.2 mm × 7 mm Egress cannula

       Right and left curve punch

       2.75‐mm slender straight punch

       2.75‐mm 15‐degree up‐curved straight grasper

       Stifle distractor

       Double‐edge