Page 24 - BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd Edition

Chapter 1 · Surgical principles and instrumentation

Preparation of the patient and aseptic spp., Klebsiella spp. and Bordetella bronchiseptica are
Streptococcus spp., Escherichia coli, Pseudomonas
technique
VetBooks.ir Clipping and surgical preparation of the surgical site are commonly isolated from the respiratory tracts of normal
dogs. Ampicillin or clavulanate-potentiated amoxicillin are
suitable choices for prophylaxis. Most canine respiratory
often postponed until after the patient has been anaesthe-
tract infections are due to Gram-negative organisms and
tized. This may be because:
many are resistant to commonly used antibiotics. The
• The surgical site is inaccessible (e.g. oral approach to choice of a therapeutic antibiotic should be determined by
the larynx) cytological examination and culture of specimens. Suitable
• The surgical site is painful (e.g. external ear canal in empirical choices whilst waiting for these results are ampi-
otitis externa) cillin, clavulanate-potentiated amoxicillin, trimethoprim/
• The patient is in a compromised state and further sulfadiazine and fluoroquinolones.
stress is to be avoided (e.g. pleural effusion).
Although strict adherence to the standard principles
of aseptic technique is ideal, for surgeries involving the References and further reading
external ear canal and the conducting airways aseptic
prepar ation of the surgical site is difficult or impossible. Baines S, Lipscombe V and Hutchinson T (2012) BSAVA Manual of Canine and
Feline Surgical Principles: A Foundation Manual. BSAVA Publications, Gloucester
Rather than performing repeated lavage of the external ear
Bellows J (2002) Laser use in veterinary dentistry. Veterinary Clinics of North
canal or swabbing of the mucosal surfaces, it is better to America: Small Animal Practice 32, 673–692
accept that surgical procedures in these locations are Boothe H (2012) Instrumentation. In: Veterinary Small Animal Surgery, ed. K
likely to be clean-contaminated, contaminated or dirty Tobias and S Johnston, pp. 152–163. Elsevier, St Louis
procedures. Hence, perioperative antibiotics are indicated. Bu a ES, ubbe AM, erstraete JM et al. (1997) he e ects of wound lavage
solutions on canine fibroblasts: an in vitro study. Veterinary Surgery 26,
Perioperative antibiotic use should consist of a single
460–466
intravenous bolus 30–60 minutes before the start of Duke-Novakovski T, de Vries M and Seymour C (2016) BSAVA Manual of Canine
surgery. Further doses may be given depending on the and Feline Anaesthesia and Analgesia, 3rd edn. BSAVA Publications, Gloucester
duration of the procedure and the nature of the surgery, Hedlund C and Taboada J (2002) Clinical Atlas of Ear, Nose and Throat Diseases
but patients with clean or clean-contaminated wounds will in Small Animals. Schlutersche, Hannover
not require further prophylaxis. However, some patients Holt TL and Mann FA (2002) Soft tissue application of lasers. Veterinary Clinics
of North America: Small Animal Practice 32, 569–599
will present with evidence of infection of a part of the
LaBagnara J (1995) A review of absorbable suture materials in head and neck
airway, and in these cases antibiotic use is warranted on a surgery and introduction of monocryl: a new absorbable suture. Ear Nose and
therapeutic basis. Throat Journal 74, 409–415
Most bacterial infections of the external ear canal Lane JG (1982) ENT and Oral Surgery of the Dog and Cat. John Wright, Bristol
involve Gram-positive Staphylococcus spp. and Gram- Luis-Fuentes V, Johnson LR and Dennis S (2010) BSAVA Manual of Canine and
Feline Cardiorespiratory Medicine, 2nd edn. BSAVA Publications, Gloucester
negative Pseudomonas spp. and Proteus spp. However,
Monnet E (2002) Cardiovascular monitoring. In: The Veterinary ICU Book, ed.
the patient presented for surgical management of ear
WE Wingfield and MR Ra e, pp. 66 8 . eton New Media, Jackson
disease is likely to have been treated with antibiotics Orton EC (1995) Small Animal Thoracic Surgery. Williams & Wilkins, Baltimore
topically or systemically, with resulting derangement of
Orton EC (2002) Respiratory system. In: The Veterinary ICU Book, ed. WE
the normal flora, inhibition of some pathogenic species Wingfield and MR Ra e, pp. 81 97. eton New Media, Jackson
and overgrowth of resistant bacteria. Hence, bacterial Reiter AM (2013) Equipment for oral surgery in small animals. Veterinary Clinics
culture and sensitivity testing may be the only way to of North America: Small Animal Practice 43, 587–608
identify the organisms. Suitable choices for empirical Reiter AM (2014) Open wide: blindness in cats after the use of mouth gags. The
Veterinary Journal 201, 5–6
therapy include clavulanate-potentiated amoxicillin for
Reiter AM and Gracis M (2018) BSAVA Manual of Canine and Feline Dentistry
Gram-positive organisms and a fluoroquinolone or gen- and Oral Surgery, 4th edn. BSAVA Publications, Gloucester
tamicin for Gram-negative organisms. Terpak CH and Verstraete FJM (2012) Instrumentation, patient positioning and
The oral cavity is populated primarily by Gram-positive aseptic technique. In: Oral and Maxillofacial Surgery in Dogs and Cats, ed. FJM
aerobes and anaerobes. Suitable choices for antimicrobial Verstraete and MJ Lommer, pp. 55–68. WB Saunders, Philadelphia
Tobias KM and Johnston SA (2012) Veterinary Surgery: Small Animal. WB
prophylaxis include ampicillin, amoxicillin, clavulanate-
Saunders, St Louis
potentiated amoxicillin or cefazolin. Similar recommenda-
Verstraete FJM (1999) Self-Assessment Color Review of Veterinary Dentistry.
tions are made for the oesophagus. Manson Publishing, London

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