Complications in Canine Cranial Cruciate Ligament Surgery. Ron Ben-Amotz

Complications in Canine Cranial Cruciate Ligament Surgery - Ron Ben-Amotz


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of the limb, the limb is suspended from an IV pole.

      The initial skin preparation is carried out using nonsterile gloves and gauze. This initial preparation is performed by alternating antiseptic soap and alcohol, three times, ensuring an appropriate total contact time. A final application of an alcohol‐based antiseptic paint may also be performed. Protection of the prepared surgical site with sterile drapes is recommended prior to transport to the operating room (OR), to decrease the risk of inadvertent contamination.

Images described by caption.

      2.3.1 Sources of Contamination

Photos depict (a) chlorhexidine gluconate 4% soap solution. (b) Povidone-iodine 10% solution, with 1% free iodine.

      2.3.2 Personnel

      As the majority of bacteria identified in contamination of surgical sites with and without SSIs arise from the microbiome of humans and animals within the OR, it is no surprise that an increasing number of OR personnel has been correlated with an increased SSI rate [2]. Reducing traffic in and out of the OR during clean orthopedic procedures may therefore reduce the amount of aerosolized bacterial contaminants and decrease contamination rates [53]. In academic settings, traffic in and out of the OR can anecdotally be higher, therefore in animals with inherent risk factors for SSI, attempts to reduce traffic in the OR are recommended. Both MRSA and MRSP have been identified in small animal hospital environments and among small animal employees [54]. It is possible that hospital personnel carrying MRSA and MRSP may cause direct or indirect transmission to animals [54].

      2.4.1 Surgeon Factors – Hand Hygiene, Glove Perforation, Surgical Technique

      Surgeon microbiome contributes to bacterial contamination of surgical sites and therefore surgeon hand and forearm preparation is recommended to reduce the microbial burden prior to donning sterile surgical gowns and gloves.

Photos depict (a) Avagard chlorhexidine gluconate 1% + ethyl alcohol 61%. (b) Sterillium ethyl alcohol 80%.
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