href="#ulink_9f7ca1d4-6c62-5791-9512-8f55dacd1a8c">Box 2.18 Instruments for Pyometra Surgery
Routine soft tissue instrument set
Balfour retractor
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.
