PATIENT PREPARATION

Clip after patient has been stabilized under anesthesia Hair Removal Clip after patient has been stabilized under anesthesia Appearance of the clip Clipping at a 90° angle gives a sharp, straight edge 2 clipper blade widths in every direction

Hair Removal Proper hand position Use a #40 blade and hold in a pencil grip Consult the doctor for clipping margins General rule of thumb for orthopedic procedures is to shave one joint above and one joint below the proposed incision site.

Next Steps Vacuum hair Express bladder

Surgical Site Preparation Antiseptics-The skin of the patient cannot be “sterilized” Scrub product: A soap or detergent base Povidone-iodine – bactericidal, virucidal, fungicidal, fungistatic Diluted 50:50 with tap water Low tissue toxicity Inexpensive Stains Chlorhexidine gluconate-bactericidal, virucidal, fungicidal Diluted 60:40 with tap water More expensive Does not stain Residual activity

Surgical Site Preparation Rinsing agents – remove the detergents Common agent is 70% isopropyl alcohol Alcohol coagulates proteins so is contraindicated in open wounds and mucous membranes Inexpensive, readily available Increases residual activity of chlorhexidine Contributes to hypothermia Sterile water or sterile saline can be used as an alternative No antibacterial effects Applicators Gauze, cotton-tipped applicators, cotton balls, spray bottle

Surgical Site Preparation Special Male dog preparation Dilute povidone- Iodine solution 1:9 Dilute chlorhexidine 1:20

Patterns for Scrubbing Target Create a small contact surface with the gauze square Start at the incision site and work outward in a circle until the hair is reached Alternate between chlorhexidine and alcohol at least 3 cycles Orthopedic Perineal Possible reactions: clipper and chemical

Secure Patient to Table Sturdy, flexible cord Four stays on surgical table

Secure Patient to Table Abdominal surgery

Secure Patient to Table Castration in a dog Dorsal recumbency Or modified Dosal recumbency

Secure Patient to Table Castration in a cat

Secure Patient to Table Orthopedic and extremity surgery

Secure Patient to Table Tail and perianal surgery

Secure Patient to Table Back surgery General rule for shaving for back surgery is 2 vertebrae above and 2 vertebrae below the proposed incision site

Final (Sterile) Surgical Site Preparation Solutions (Paint)