ࡱ> O bjbj88 .RWiRWiM888<:t&T9999999$q<'?<:M M M ::"""M F9"M 9""(8@9z v89:0:8^c@ !c@,@9c@@9m^"L6::"@:M M M M c@8X : Multiple and Single Survival Surgery. Complete this section for each species and surgical procedure, or procedures as part of a multi-stage process. SPECIES FORMTEXT       Describe the surgical procedure(s). (See  Requirements for Survival Surgery and Aseptic Techniques and  Preparation of the Operative Site. ) FORMTEXT       Describe the pre-operative care of the animal: (e.g., fasting, anesthesia, antibiotics) FORMTEXT       Aseptic Techniques: (See the attached guidelines.) Preparation of the surgical space: FORMTEXT      Preparation of the surgeon(s): FORMTEXT      Preparation of the animal(s): FORMTEXT      Sterilization of the instruments: FORMTEXT      Techniques to reduce likelihood of infection: FORMTEXT       Surgical anesthesia and analgesia. Please summarize below.DrugDose/FrequencyRoutePre-anesthesia FORMTEXT       FORMTEXT       FORMTEXT      Maintenance Anesthesia FORMTEXT       FORMTEXT       FORMTEXT      Paralytic Agents FORMTEXT       FORMTEXT       FORMTEXT      Post-operative Analgesia FORMTEXT       FORMTEXT       FORMTEXT       Describe how the depth of anesthesia will be determined and monitored, including what special precautions will be taken if paralytic drugs will be used: FORMTEXT       Will more than one major survival surgery be conducted on each animal?Yes  FORMCHECKBOX No  FORMCHECKBOX If the answer to #4 is YES, how many? FORMTEXT       Scientific Justification. Provide scientific justification for more than one major, survival surgery on each animal. The Animal Welfare Act states that "no animal will be used in more than one major operative procedure from which it is allowed to recover, unless justified for scientific reasons by the principal investigator, in writing." FORMTEXT       Site of operating room: FORMTEXT       Site of recovery room: FORMTEXT       Describe the post-operative care: (until suture removal or healing) FORMTEXT       Name and phone number of person(s) responsible for postoperative care. FORMTEXT       Name and phone number of surgeon(s). FORMTEXT       Qualifications of the surgeon. Describe the surgeon s experience with the techniques used in this surgical procedure. FORMTEXT       Requirements for Survival Surgery and Aseptic Techniques Survival Surgery: Broadly requires adequate veterinary care (see the IACUC Handbook, Chap. 27). Areas of concern: Use of appropriate anesthesia and analgesia. (Including pre-anesthetic, anesthetic, analgesic, doses, routs and frequency of administration.) Use of aseptic technique. (Details below.) Occurrence of multiple survival surgeries. Qualifications of surgical personnel. Perioperative care: Preoperative: fasting, anesthesia, other drugs (i.e. antibiotics). Operative: monitor anesthesia, vital organ support if needed, proper surgical technique. Postoperative: monitor recovery from anesthesia, temperature, hydration, pain, administration of other drugs (i.e. antibiotics). Daily monitoring until suture removal in 10-14 days. For rodents, a visual check, not physical assessment, is sufficient. #2 from above: Aseptic technique requires: Aseptic technique is defined by the Handbook, 18:8 as involving four steps. Note that both major and minor surgery require aseptic technique, Guide, p. 62. Preparation of the patient, such as hair removal and disinfection of the operative site. Preparation of the surgeon, such as the provision of decontaminated surgical attire, surgical scrub, and sterile surgical gloves. For rodent surgery: surgical gloves and masks are necessary; sterile gown is optional. Handbook, 18:10. Sterilization of instruments, supplies, and implanted materials. For rodent surgery: one sterile instrument pack may be used for up to five rodents incorporating techniques to maintain sterility between animals. Handbook, 18:10. The use of operative techniques to reduce the likelihood of infection. The Guide (p. 63) identifies characteristics of rodent surgery as: small incision sites, one-person surgical teams, surgery performed on multiple animals at one sitting, and procedures of shorter duration. Handbook, 18:10. Preparation of the Operative Site Dietary Restrictions Food intake is generally restricted 6-12 hours before anesthesia to avoid intra- or post-operative emesis and aspiration pneumonia. Access to water is generally not curtailed. Treatment of Hair A general guideline is to clip at least 20 mm on each side of the incision. The hair can be removed most effectively with an electric clipper and a No. 40 clipper blade; the higher the blade numbers, the shorter the remaining hair. Clippers should be held using a pencil grip and initial clipping should be done with the hair growth pattern. Subsequent clipping should be against the pattern of hair growth to obtain a closer clip. Razors are occasionally used for hair removal (e.g., around the eye), but may cause micro lacerations in skin that may increase irritation and promote infection. After hair removal is completed, loose hair can be removed using a vacuum. Sterile Skin Preparation Sterile preparation begins after the animal has been transported and positioned in the surgical suite. Gauze sponges are sterilized in a pack along with bowls into which the germicides can be poured. 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Frequently, when using povidone-iodine and alcohol, the site is scrubbed alternatively with each solution three times to allow five minutes of contact time. However, using alcohol between povidone-iodine scrubs decreases contact time of povidone-iodine with the skin, and thus, may decrease efficacy. Excess solution on the table or body should be blotted with a sterile towel or sponge. When final povidone-iodine scrub is completed, a 10% povidone-iodine solution should be sprayed or painted on the surgical site. A 4% chlorhexidine gluconate can be used as well. If chlorhexidine is the preparation solution it remains in contact with the skin at the end of the preparation procedure or may be rinsed with saline. Because chlorhexidine binds to keratin, contact time is less critical than with povidone-iodine. Two 30-second applications have been advocated as being adequate for antimicrobial activity. Use of a 1-minute alcohol cleansing and application of an antimicrobial film provides equivalent bactericidal activity to a 5-minute iodophor scrub and paint (Geelhoed et al. 1983). Comparison of three skin preparations (povidone-iodine or 4% chlorhexidine gluconate with either saline or 70% isopropyl alcohol rinse) showed no significant difference in percentages of bacterial reduction for up to 8 hours in dogs (Osuna et al. 1990); however, significantly more skin reactions occurred with povidone-iodine than with chlorhexidine. The authors concluded that povidone-iodine and chlorhexidine with a saline rinse were equally effective under clinical conditions; however, 4% chlorhexidine with 70% isopropyl alcohol rinse was inferior because it resulted in fewer negative cultures after surgery.     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