Surgical technique

What is Halstead’s principle of surgery

• Gentle tissue handling and anatomical dissection of tissue- follow the anatomical planes 

• Control of haemorrhage 

• Preservation of blood supply- important to preserve blood supply to tissue to avoid necrosis and wound breakdown 

• Strict asepsis 

• Minimise tissue tension 

• Accurate tissue apposition 

• Elimination of dead space 

What are the roles of nurses under code of conduct

• Under the Schedule 3 exemption in the Veterinary Surgeons act of 1966 RVNs and SVNs are permitted to carry out certain tasks under the direction/supervision of a Veterinary Surgeon (VS) 

• The tasks relating to surgical nursing include:  

• Performing minor surgery not entering a body cavity  

• Dental hygiene work not included tooth extractions requiring instruments  

What are the procedures SVNs or RVNS can perform

• Suture wound 

• Minor mass removal 

• Dental (no instrument extractions) 

• Aural haematoma 

• RVNs must only undertake Schedule 3 tasks under the direction of the VS  

• SVNs must only undertake Schedule 3 tasks under the direction of a VS and under the supervision of either a VS or an RVN. For minor surgery the supervision must be direct, continuous and personal 

According to RCVS what does direction mean

The veterinary surgeon instructs the veterinary nurse or student veterinary nurse as to the tasks to be performed, but is not necessarily present. 

According to RCVS what does supervision mean

The veterinary surgeon is present on the premises and able to respond to a request for assistance if needed. 

According to RCVS what does direct, continuous and personal supervision mean

The veterinary surgeon or veterinary nurse is present and giving the student veterinary nurse his/her undivided personal attention  

What is the use of hand held tissue retractors

• Use only as directed by the veterinary surgeon and maintain sterility. 

What is the purpose of hand held retractors

• To facilitate the visualisation of the underlying structures

When would we need tension

• As required by the surgeon.  

• If passed to you keep the same tension. 

• Do not crush the tissues.  

How should we position retractors

• Do not crush any tissues or organs.  

• Not obscuring the surgeon’s view.  

• Resting the hand on the drape reduces movement.  

• If prolonged retraction is required, reposition regularly 

How do we pass surgical instruments

• Pass into the surgeon’s palm- curve upwards (if applicable)   

• One click closed (for the ratchet is standard) or open (depending on individual preference) 

What does anastomosis mean

The technique used to re-join the intestine after a resection  

How should we hold the intestine

• Use the flats of the hand and the thumb. 

• Do not let go! 

What should we use for abdominal lavage

• Warm saline

What are general precautions for surgical nursing (maintain sterility)

• A culture of sharing concerns in relation to sterility should be encouraged  

• Checking sterility indicators on equipment before use  

• Staff initials on packed items  

• Sorting equipment to avoid strike through  

What are some general precautions for surgical nursing (surgical swabs)

• Swab counts  

• X-ray swabs  

• Weighing swabs (1ml of blood = 1g weight increase) 

What are some general precautions of surgical nursing (instruments)

• Regularly check for damage and send of sharpening  

• Label kits with the number of instruments   

What are some general precautions of surgical nursing (protocols)

• Staff theatre attire  

• Surgical check lists   

• Theatre cleaning