Preparation of the surgical field according to Pirogov N. Preparation of the surgical field algorithm

Preparation of the operation field consists of four stages: mechanical cleaning; degreasing; antiseptic treatment (aseptization); isolation of the operation field.

The surgical field is prepared as follows: start from the center (incision site, puncture site) and go to the periphery: in the presence of a purulent process (especially opened), do the opposite - start from the periphery and end in the center.

Mechanical cleaning is to remove contaminants. The area of ​​skin is washed with soap (preferably household soap), the hair is shaved or cut. In this case, the size of the prepared surgical field must be sufficient to ensure sterile operating conditions.

Degreasing. The surgical field is wiped with a sterile gauze swab soaked in a 0.5% solution ammonia or gasoline, for 1...2 minutes. The degreased surgical field is treated with an antiseptic using one of the methods listed below.

Antiseptic treatment (aseptization). Several methods have been developed antiseptic treatment surgical field.

Grossikh-Filonchikov method. Proposed in 1908. The defatted surgical field is “tanned” and asepticized with a 5% iodine solution, first after mechanical cleaning, and then immediately before the incision or after infiltration anesthesia. In this case, the interval between treatments should be at least 5 minutes. This method was first used by N.I. Pirogov (in 1847), so it should be called Pirogov's method.

Myta method. After shaving, mechanical cleaning and degreasing, the surgical field is treated with 10% aqueous solution potassium permanganate.

Borchers method. Proposed in 1927. After mechanical cleaning, shaving and degreasing, the skin is treated with a 5% solution of formaldehyde in 96% alcohol. This allows, unlike most other methods, to achieve sterility in a protein environment (when contaminated with pus), since formalin retains its antiseptic properties.

Catapol treatment. The method was proposed in 1986 (V.N. Vision, 1986) and consists in the fact that after traditional mechanical cleaning, the surgical field is thoroughly washed with a 1% aqueous solution of catapol for 1...2 minutes. Sterility is maintained for up to 1 hour.

Aethonium treatment. The method was proposed in 1986 (V.N. Vision, 1986). After mechanical cleaning, the surgical field is treated with 0.5...1% aqueous solution of ethnium for 1...2 minutes. In addition to the antimicrobial effect, skin degreasing is achieved.

Operation Field Isolation. Sterile sheets or oilcloths are fastened with special clips (Backhouse clamps), surrounding the surgical field and isolating it from adjacent tissues. Currently, it is recommended to use special adhesive films (protectors) that more reliably protect surgical wound from pollution.

Methods for preparing the surgical field using a 1% solution of iodopirone, degmin, chlorhexidine (hibitate), pervomur, decamethoxin (in particular, the decamethoxin-containing drug amosept) (G.K. Paliy et al., 1997), asepura, sagrotan may be promising. .

Treatment of mucous membranes. The conjunctiva is washed with a solution of ethacridine lactate (rivanol) at a dilution of 1: 1000. The mucous membrane of the mouth and nasal cavity is treated with the same solution, and the skin around the entrance to these cavities is treated with a 5% iodine solution. The gums are lubricated with a 5% iodine solution.

The vaginal mucosa is treated with a solution of ethacridine lactate diluted 1: 1000 or a 2% solution of Lysol, a 1% solution of lactic acid. The skin of the labia is lubricated with a 5% iodine solution.

The rectal mucosa is treated from an Esmarch mug with a 1% solution of potassium permanganate or a 2% solution of Lysol, and the skin around the anus is treated with a 5% solution of iodine.

IN last years Antiseptics appeared in the form of aerosols (Septonex, Kubatol, Lifuzol, etc.). This allows you to treat hard-to-reach areas of the body with antiseptic drugs, since the aerosol easily penetrates the skin through thick fur. This form of the drug is extremely convenient for performing injections, punctures, and minor surgical procedures in transhumance pastures, barnyards, etc.

If you find an error, please highlight a piece of text and click Ctrl+Enter.

And changes his underwear. Before surgery, it is recommended to apply sterile antiseptic solutions or use antiseptic baths for several days on areas of the body that are susceptible to contamination (feet, hands). In the presence of furunculosis, dermatitis, preparation of O. p. begins long before the planned operation. At emergency operations perform partial sanitization. For 1-1 1/2 h Before surgery, the area in the O. area is shaved off and the skin is wiped with alcohol. Immediately before the operation (on the operating table), the surgical site is treated with antiseptic solutions.

When using the Grossikh-Filonchikov method, the skin is lubricated with 5% alcohol solution iodine four times (before fencing off the area with sterile linen, before making an incision, before suturing the wound, after sutures on the wound). This treatment is combined with rubbing the skin with alcohol. This method has limited use in connection with frequent complications (allergic reactions, dermatitis). When treating the surgical field with a 1% iodonate solution, the skin is lubricated before surgery and again before suturing the wound. Prepare a 1% solution of iodonate by diluting 5 times with sterile water the original solution of the drug containing 4.5% free iodine. A 1% solution of iodopyrone is also used to treat O. p. Skin treatment with a 0.5% aqueous-alcohol solution of chlorhexidine digluconate is carried out twice over 2 min. The working solution is prepared by diluting a 20% chlorhexidine solution with 70% alcohol in a ratio of 1:40. Skin treatment with 1% degmin solution is carried out twice, 3 times. min using a cotton pad or sponge. The required solution is prepared by mixing 1 part of a 30% degmicide solution with 29 parts tap water. Treatment with a 1% rokcal solution consists of lubricating the skin for 2 min using a tampon. Treatment of the skin with a 14% solution of pervomur (C-4) is carried out twice for 30 With. Prepare a solution by mixing 17.1 ml 33% hydrogen peroxide and 6.9 ml 100% formic acid and adding up to 1 l distilled water. The most effective methods for treating O. p. are solutions of chlorhexidine, iodonate, or iodopyrone.

Regardless of the method of processing O. p. during clean operations, the skin is lubricated with an antiseptic, first in the area of ​​​​the intended incision, and then to the periphery of it. In the presence of purulent wounds or fistulas, treatment is performed from the periphery to the center. With a vertical or oblique arrangement of the O. p., processing begins from the top and continues downwards. Thanks to this, the contaminated solution flowing down does not fall on the treated areas

O. p. After processing O. p., the skin is covered with sterile linen, leaving the area open at the site of the intended incision. The surgical wound is additionally isolated with sterile material. During the operation, if necessary (for example, before opening the intestine), gauze swabs or napkins are used to isolate the area of ​​the intestine. The fencing material is replaced when it is contaminated and when moving to the clean stage of the operation. Before replacing the insulating surgical linen, the skin is re-treated, gloves and instruments are changed. For more complete isolation of the O. p. skin from the surgical wound, smoldering synthetic films are used.

Bacteriological control of the effectiveness of O. p. treatment is carried out selectively once a week. The skin wash is taken with a sterile gauze pad, which is then placed in a wide test tube with saline solution. Shake the test tube for 10 min, then the liquid is sown in depth at 0.5 ml on a Petri dish with meat peptone agar. A gauze pad is placed in a 0.5% sugar broth solution. The crops are cultivated for 48 h at a temperature of 37°. considered sterile if there is no growth of microflora on both media.

Bibliography: Gostischev V.K. Guide to practical classes By general surgery, With. 19, M., 1987; Struchkov V.I. and Struchkov Yu.V. General, p. 75, M., 1988.

1. Small medical encyclopedia. - M.: Medical encyclopedia. 1991-96 2. First health care. - M.: Great Russian Encyclopedia. 1994 3. encyclopedic Dictionary medical terms. - M.: Soviet encyclopedia. - 1982-1984.

See what “Operational field” is in other dictionaries:

The area of ​​the body surface through which quick access … Large medical dictionary

I; pl. fields, her; Wed 1. Treeless plain. Walk across the field and across the field. Collect flowers in the village. Run through the field. Otezzhee village (obsolete; a hunting area remote from the estate). 2. Land cultivated for sowing, cultivated area. Plow, fertilize,... ... encyclopedic Dictionary

field- I; pl. fields/, e/th; Wed see also little pole 1) Treeless plain. Walk along the field and along the field. Collect flowers in the field. Run across the field. Departure by/… Dictionary of many expressions

Primary debridement wounds in conditions surgical hospital dissection and excision of the edges of the wound are carried out, if necessary, drainage of all kinds of “pockets” and cavities is performed, excision of non-viable tissue... ... Wikipedia

LUNGS- LUNGS. Lungs (Latin pulmones, Greek pleumon, pneumon), the organ of air terrestrial respiration (see) of vertebrates. I. Comparative anatomy. The lungs of vertebrates are already present as additional organs of air respiration in some fish (bibreathing,... ...

UTERUS- (uterus), organ that is the source menstrual blood(see Menstruation) and place of development ovum(see Pregnancy, Childbirth), occupies a central position in the woman’s reproductive apparatus and in the pelvic cavity; lies at the geometric center... ... Great Medical Encyclopedia

OPERATING ROOM- OPERATING ROOM, a room specifically designed for operations. Such premises are provided for in the plan for the construction of a general hospital institution, a special surgical facility. departments or surgeons clinics; a room for O. can be allocated and... ... Great Medical Encyclopedia

I, plural fields, cf. 1. Treeless plain. The hare jumped out of the forest and ran across the field. Pushkin, Young Peasant Lady. The sun descended on the grove, illuminating the field unbearably brightly. M. Gorky, The Life of Klim Samgin. || A plot of land sown or cultivated for sowing... Small academic dictionary

Active ingredient ›› Iodine + [Potassium iodide + Alkylsulfonate + Phosphoric acid] (Iodide + ) Latin name Iodonatum ATX: ›› D08AG03 Iodine Pharmacological groups: Local irritant... ... Dictionary medical supplies

- (lat. punctio prick) puncture of the wall of a vessel (usually a vein) or any organ with medicinal or diagnostic purpose. Often done for both purposes at once. Contents 1 Diagnostic puncture 2 Therapeutic puncture ... Wikipedia

Treatment of the surgical field carried out in 2 stages.

Stage I of processing the surgical field- this is hygienic washing with soap and water, shaving the hair.

Stage II of treatment of the surgical field- immediately before the operation.

Currently, iodonate, iodoperine, chlorhexidine digluconate, 70° alcohol, pervomur, AHD, and brilliant green are used for treatment.

Wide treatment is carried out from the center to the periphery 2 times before limiting the surgical field with sterile linen, immediately before the incision, before suturing the wound and after suturing.

Preparation of the surgical field(5% iodine solution is prohibited):

1% iodonate solution;

1% iodine-pyrone;

0.5% alcohol solution of chlorhexidine

Rokkal 2 minutes;

Pervomur 1 minute.

Grossikh-Filonchikov method:

The surgical field is extensively processed three times;

We cover ourselves with surgical linen;

We process immediately before the cut;

During the operation when changing linen;

Before suturing the skin;

After suturing.

Sanitary and hygienic treatment is carried out in advance (washing in a bath or shower, changing bed and underwear). On the operating table, the surgical field is treated with chemical antiseptics (organic iodine-containing preparations, 70° alcohol, chlorhexidine, Pervomur, AHD, sterile adhesive films). At the same time, following rules:

● wide processing,

● sequence “from the center to the periphery”,

● multiple processing during the operation (Filonchikov-Grossikh rule): skin treatment is performed before restriction with sterile linen, immediately before the incision, periodically during the operation, as well as before and after applying skin sutures,

● contaminated areas are treated last.

Surgical field - the area of ​​the body within which the surgery. Before surgery, the skin of the surgical field needs careful preparation; on its surface, as well as in depth sebaceous glands and hair follicles always contain microbes, the entry of which into the surgical wound can lead to its suppuration. Before any operation, a hygienic bath or shower and a change of linen are required. During operations on the limbs, if they are heavily soiled, repeated foot or hand baths are needed. During emergency operations, partial sanitation and washing of the skin of the surgical field with gasoline or a solution of ammonia (0.25-0.5%) can be performed. On the day of surgery, it is necessary to shave the hair in the area of ​​the surgical field and adjacent areas of the body. For shaving, use sharp razors that do not cause skin irritation. You should not shave on the eve of surgery, as small skin cuts may become infected.

Immediately before the operation, the skin of the surgical field is mechanically cleaned and degreased, rubbing it for 1-2 minutes. gasoline or ether; then treat the skin with alcohol and lubricate it twice with a 5% alcohol solution of iodine. This causes thickening (tanning) of the skin and prevents the entry of microbes from deep into the surgical wound. The skin of particularly sensitive areas of the body (neck, groin areas, genitals) are lubricated with a 5% alcohol solution of iodine, diluted with alcohol in half. At hypersensitivity patient's skin to iodine, as well as in patients after radiation therapy the skin of the surgical field is treated with a 5% alcohol solution of tannin, 1% alcohol solution of brilliant green, 96% wine alcohol. Regardless of the solution used, the skin of the surgical field is treated from the line of the intended incision to the periphery. After treatment, the surgical field is delimited from the surrounding skin, covering it with sterile sheets or napkins, and after the incision is made, the napkins protect the wound tissue and organs (stomach, intestines) from contact with the edges of the skin incisions. When moving from one stage of the operation to another, the linen and napkins delimiting the surgical field are changed, and the skin is re-treated with a 5% alcohol solution of iodine, alcohol or another solution.

PREVENTION MEASURES FOR BEDSORES

Patients suffering from various severe debilitating diseases that force them to lie on their backs for long periods of time and who are poorly cared for often develop bedsores. The most common place for bedsores to form is the sacrum, the area of ​​the shoulder blades, the heels, i.e. in those places where the skin is subjected to prolonged compression between the bone and the bed. Skin necrosis gradually develops. The addition of an infection causes inflammation, the bedsore increases in size and deepens. In severe cases, the depth of the bedsore reaches the bone and the inflammation can spread to the bone. Contributes to the appearance of bedsores poor care for the sick

1) an uncomfortable, uneven, hard bed, which is also rarely remade and therefore folds form on the sheet and food crumbs accumulate;

2) scars on the sheet and shirt;

3) maceration of the skin in untidy patients due to the fact that the staff is late in changing linen and washing and drying the skin contaminated with urine and feces.

While making the bed, you need to examine the patient’s body, paying attention to Special attention to places where bedsores may occur in order to prevent their occurrence in time. To prevent bedsores, you need to try to eliminate the causes of their formation.

1. The bed should be comfortable and should be kept clean and dry.

2. Monitor the cleanliness of the patient’s skin: wipe the patient’s entire body daily, wash parts of the body contaminated with urine and feces with soap and water, and only clean skin wipe the back and sacrum camphor alcohol. The practice of wiping contaminated skin with camphor alcohol is not sufficient to prevent bedsores, since alcohol tans the skin, closing the pores with microbes trapped in them, and after some time the pores open and their contents join the external contamination of the skin.

3. To eliminate pressure, under the seats possible education For bedsores, place a rubber circle covered with a bedding or in a pillowcase. The circle is placed so that the sacrum is above its opening. For patients with fecal and urinary incontinence, a rubber bed is placed. To reduce pressure on the heels, tightly rolled towels are placed under the Achilles tendons. To reduce pressure on the back of the head, a cloth bagel is placed under the head.

4. The patient needs to be helped to change the position of the body several times a day, turning it on one side, then on the other, or on the back.

5. If redness of the skin is noticed at the site of the usual formation of a bedsore, it is necessary to intensify all the above measures, simultaneously starting treatment. A beginning bedsore is lubricated with a 5% or 10% solution 1-2 times a day potassium permanganate and brilliant green. Anti-decubitus mattresses are produced from rubberized fabric with an automatic air injection device. The principle of operation of the installation is based on periodic injection of air into one section of the air mattress and partial removal it from other sections under the influence of the patient’s weight. Changing bed linen In patients forced to remain on long-term bed rest, it is extremely important to monitor the cleanliness of the bed in order to prevent bedsores and skin maceration. If the patient cannot help the caregiver due to lack of consciousness or lack of active independent movements, changing bed linen is performed as follows. The patient turns on his side. If necessary, you need to massage your back and treat bedsores. An old sheet is collected under the patient's back. A fresh sheet is placed on the vacated space. The patient is turned onto the other side. Remove the old sheet and unroll a fresh one. The patient is again placed on his back. It is more convenient to carry out the manipulation together, although it can be performed by one caregiver.

1. Bedsores are often observed in patients with paralysis and sensory impairment. Most effective prevention- regular changes in body position, in particular - turning in bed. For tetraplegia, the Stryker frame is useful, with which you can easily turn the patient every 1-2 hours. Thus, the prevention of bedsores depends entirely on care.

2. Areas require special protection bony protrusions(heels, ischial tuberosities, sacrum). In children with chronic hydrocephalus, measures are taken against bedsores of the scalp.

3. To prevent bedsores, sheepskin pads, water mattresses and other soft materials are used. Do not use round pads, the central convex part of which can cause skin ischemia and contribute to the development of bedsores.

4. Skin should be dry. This is especially important to monitor in patients with urinary incontinence. In the absence of a permanent catheter, diapers are placed.

5. To prevent maceration, wet or sweaty areas of the skin are treated with emollient ointments (for example, Vaseline).

6. Prerequisite conservation healthy skin- complete nutrition.

7. With swelling, the skin becomes thinner and its blood supply deteriorates. To prevent skin cracks, prevention and treatment of edema of paralyzed limbs is necessary.

Treatment of bedsores

1. If compression of the affected area of ​​skin continues, then healing of the bedsore is impossible and, moreover, it may increase. Bedsores are treated with saline or hydrogen peroxide, after which necrotic tissue is carefully removed. For large bedsores, apply wet-dry dressings until fresh granulations form. Ointments with lytic enzymes are also used. These ointments are applied 2-3 times a day after pre-treatment. Enzymes are also used in the form of solutions, applying wet-dry dressings with them. For extensive bedsores, surgical treatment is necessary. After treatment, the wound should remain dry (to do this, apply gauze or another light bandage to it).

2. Occlusive dressings with Vaseline or zinc oxide are also used. You can prepare a paste from antacid solutions containing aluminum and magnesium hydroxide gels by draining the top layer of liquid from the bottle. When applied to an ulcerated area, this paste hardens to form a superficial protective layer. It is usually applied 3 times a day.

3. Important role microcirculation disorders play a role in the pathogenesis of bedsores. Moisturizing and lightly massaging the surrounding skin helps improve blood flow and more fast healing bedsore.

4. With insufficient nutrition and anemia, bedsores heal poorly.

5. For extensive and deep ulcers with undermined edges, surgical debridement and skin grafting are indicated.

6. Infection is not usually the cause of ulceration, but severe pressure ulcers may develop life-threatening sepsis. Local application Antibiotics are ineffective in this case.

7. Covering the bedsore with a film of synthetic material that is permeable to water and oxygen appears to speed up healing. The film is left until moisture appears on it. At first, the film has to be changed frequently, then (as it heals) less and less often, and finally, it is changed once a week. An extremely rare complication is inflammation of the subcutaneous tissue.

The surgical field is the area of ​​the body within which surgery is performed. Before surgery, the skin of the surgical field needs careful preparation; on its surface, as well as in the depths of the sebaceous glands and hair follicles, there are always microbes, the entry of which into the surgical wound can lead to its suppuration. Before any operation, a hygienic bath or shower and a change of linen are required. During operations on the limbs, if they are heavily soiled, repeated foot or hand baths are needed. During emergency operations, partial sanitation and washing of the skin of the surgical field with gasoline or a solution of ammonia (0.25-0.5%) can be performed. On the day of surgery, it is necessary to shave the area of ​​the surgical field and adjacent areas of the body. For shaving, use sharp razors that do not cause skin irritation. You should not shave on the eve of surgery, as small skin cuts may become infected.

Immediately before the operation, the skin of the surgical field is mechanically cleaned and degreased, rubbing it for 1-2 minutes. gasoline or ; then treat the skin with alcohol and lubricate it twice with a 5% alcohol solution of iodine. This causes thickening (tanning) of the skin and prevents the entry of microbes from deep into the surgical wound. The skin of particularly sensitive areas of the body (neck,) is lubricated with a 5% alcohol solution of iodine, diluted in half with alcohol. If the patient's skin is hypersensitive to iodine, as well as in patients after radiation therapy, the skin of the surgical field is treated with a 5% alcohol solution, 1% brilliant green alcohol solution, and 96% wine alcohol. Regardless of the solution used, the skin of the surgical field is treated from the line of the intended incision to the periphery. After treatment, the surgical field is delimited from the surrounding skin, covering it with sterile sheets or napkins, and after the incision is made, tissues and organs (stomach, intestines) are protected from contact with the edges of the skin incisions. When moving from one stage of the operation to another, the linen and napkins delimiting the surgical field are changed, and the skin is re-treated with a 5% alcohol solution of iodine, alcohol or another solution.

Surgical field is the area of ​​the body within which surgical intervention is performed.

The operating field requires special training, since its contamination threatens suppuration. Preparation of the surgical field is based on the same principles of mechanical cleaning, disinfection and tanning as hand treatment (see). Sometimes preparation of the surgical field begins long before the operation. For folliculitis and furunculosis it is prescribed ultraviolet irradiation, systematic hygienic baths, vitamins, autohemotherapy. For fistulas, the skin in the area of ​​the surgical field is lubricated with Lassara paste or a strong solution of potassium permanganate. Before plastic surgery preparation of the surgical field is especially thorough; it includes, in addition to daily baths, alcohol dressings.

Before a planned operation, the patient takes a bath or shower the night before and changes his underwear. If the patient's condition does not allow him to take a bath or shower, the body is wiped with a damp towel. 1-1.5 hours before surgery, the surgical field is shaved without water and soap. Shaving on the eve of surgery is contraindicated due to the possibility of infection of scratches and cuts caused during shaving.

Substances used to treat the surgical field should not damage the skin or damage linen and instruments. The most popular is the Filonchikov-Grossikh method - double lubrication of the surgical field. 10% alcohol tincture of iodine. To avoid burns, 5% iodine tincture is more often used, or after lubricating with 10% tincture, the surgical field is wiped with alcohol. It is dangerous to lubricate folds and those areas where the skin is thin and tender with iodine. Lubricating the surgical field with iodine after preoperative radiotherapy or in case of increased sensitivity to it is contraindicated. There are other methods that allow you to disinfect the surgical field. According to the Spasokukotsky-Kochergin method, the surgical field is wiped 2 times with a cotton or gauze ball moistened with a 0.5% solution of ammonia, then wiped dry with a sterile cloth and tanned with 96° alcohol, 5% picric acid solution, 5% chromic acid solution, 2% solution tannin, etc. When bone surgeries that require special asepsis, some surgeons lubricate the skin of the surgical field with cleol and seal it with one layer of gauze; the incision is made through gauze. During emergency operations, especially for industrial or street injuries, the surgical field is repeatedly wiped with gasoline, ether or a 0.5% solution of ammonia.

Regardless of the method, treatment of the surgical field is carried out from the incision line to the periphery; if on the surgical field there is purulent wound or fistula, then in reverse direction. The fistula opening or wound is covered with a napkin or sealed with cleol. The treated skin area should significantly exceed the size of the surgical field. After treatment, the surgical field is covered with sterile sheets, which are strengthened with special clamps.

When moving from one stage of the operation to another, the linen and napkins covering the surgical field are changed and the skin is re-lubricated with iodine and alcohol. To prevent contamination of the surgical field during surgery, the skin after treatment can be covered with a moisture-proof film (for example, BF-6 glue). The incision and suturing of the wound is made through this film.

The surgical field is illuminated using shadowless lamps so that the light is uniform and does not distort the true color of the tissue. For enhanced illumination of certain areas of the surgical field, side, portable or frontal lamps are used. Germicidal lamps can be built into the lamps.

Prevention of surgical infection.

Treatment of the surgeon's hands.

The preparation of the hands of the surgeon and his assistants consists of daily care of the skin of the hands and their treatment before surgery.

When treating hands, it is necessary to destroy the microflora on the surface of the skin and prevent germs from escaping from the pores. This is achieved by mechanical cleaning, processing antiseptic solutions, leather tanning.

Persons with injuries should not be allowed to participate in the operation. skin brushes, pustules and inflammatory processes. Fingernails should be cut short. The skin of your hands the night before is treated with Vaseline or lanolin to maintain elasticity and softness.

Methods aseptic processing Hands are divided into two groups: the first includes mechanical cleaning, disinfection and tanning, the second - only tanning of the skin of the hands.

Hand washing is done in a certain sequence: first brush the fingers, then the palms, back surfaces and move to the forearms. When washing off soap suds, hold your hands so as to remove the soap first from your hands and then from your forearms. Soap and brush cannot be placed on the washbasin; they must be held in your hand. Dry your hands sequentially, starting with your hands and moving to your forearms. dry sterile towel. In Krasnogvardeyskaya UVL they treat hands according to Olivekov’s method . After washing and mechanical treatment, hands are wiped twice with a swab soaked in iodized alcohol (1:3000) for three minutes.

Preparing the surgical field for surgery.

This stage has three parts:

· Mechanical cleaning. Hairline in the area of ​​operation, cut off with scissors and shave, wash off with a sponge and warm soapy water, wipe dry;

· Disinfection. In Krasnogvardeyskaya UVL they use the Filonchikov method: they lubricate the surgical field with a 5% alcohol solution of iodine, using circular movements, starting from the center to the periphery.

· Insulation. The surgical field is fenced off with a sterile sheet, which is fixed to the animal’s skin with special clamps - claws.

Sterilization of suture material

Suture material use sterile factory-made. (Ethilon, polyglycolide thread, polycone)

Silk, fishing line and other types of materials are stored in 70% alcohol.

Sterilization of instruments

After each operation, instruments are washed under running water with a brush and soap, placed in an open sterilizer and placed in a dry-heat oven.

Desmurgy

For dressings, use a sterile bandage, gauze pads, and cotton wool. Most often used:

· Circular bandage for minor wounds of the extremities and fixation of an intravenous catheter. They apply it like this: they make the first round tighter than the subsequent ones, which are applied in a circular motion.

· Spiral bandage. The first round of such a bandage is applied below the wound, subsequent rounds of the bandage half cover the previous round.

· Special bandage. Special postoperative blankets for factory-produced animals were used as a special dressing. They were used after operations in the area abdominal wall or chest(castration of cats and bitches, mastectomy, hernias). This dressing ensures the cleanliness of the wound surface, prevents infection, and provides good access to the wound if necessary, the wound is inaccessible to animals.

· Langeta applied to the sites of bone fractures and cracks. Impose plaster bandage in 3-5 layers per damaged area, form along the limb, line with cotton wool the places of greatest friction of the limb with the splint and fix with a spiral bandage.

Injections

Injections must be carried out according to all the rules of asepsis and antisepsis. To do this, use disposable sterile syringes and needles, sterile solutions and preparations for parenteral administration. It is also necessary to ensure that there are no air bubbles in the syringe.

· Intramuscular injections performed in the gluteal region, in the posterofemoral muscle group, trying not to touch sciatic nerve. The needle is inserted perpendicular to the surface of the body. At the end of the injection, the needle is removed by pressing the skin with your fingers and treated with cotton wool moistened with 70% alcohol.

· Subcutaneous injections . Pull back the skin in the withers area with three fingers. Between average and index fingers, into the formed skin fold insert the needle at an angle of 45 degrees and inject the solution. At the end of the injection, the skin is lubricated with 70% alcohol and lightly massaged to medicinal substance absorbed better.

· Intravenous infusions. The animal, fixed in a lateral position, has its limb clamped in the upper third of the shoulder and waits for the vessel to fill. An intravenous catheter is then inserted through the bloodstream. If it enters a vein - from the catheter opening there will be blood. Stop squeezing the limb, close the catheter with a cap and secure it with a bandage. Solutions can then be injected through the catheter to intravenous administration, install an IV, administer anesthesia, etc. This method provides easy and quick access to the vein if necessary.

Operation technique

Removing a cat's uterus

Indications: uterine tumors, endometritis.

The uterus is located in the abdominal cavity. It has a body, a neck and two horns, which are 4-6 times longer than the body of the uterus and diverge cranially.

The animal is not fed before the operation. The operation is performed under general anesthesia. As sedative and a muscle relaxant, Rometar solution (2%) is administered intramuscularly at the rate of 0.1-0.2 mg/kg of live weight of the animal. After 15 minutes, Zoletil is administered intramuscularly at the rate of 1-2 mg/kg of live weight of the animal. Fixed in a dorsal position on the operating table. The surgical field is prepared: the hair in the umbilical area is shaved, washed with a warm soapy solution, then disinfected using the Filonchikov method. Cover with sterile gauze napkins or a sterile sheet and fix them with clips to the skin. The surgeon treats the hands using the Olivkov method and puts on sterile surgical gloves.

An incision is made along the linea alba, 1-2 cm caudal from the navel. Using a scalpel, the tissues of the linea alba, except the peritoneum, are cut layer by layer. The peritoneum is grabbed into a fold with two tweezers, between which an incision is made, through which abdominal cavity two fingers are inserted and, under their control, the peritoneal incision is lengthened with scissors. Then a hand is inserted into the abdominal cavity and the uterus is found. Carefully remove the uterine horns from the abdominal cavity and straighten them on the operating sheet. Then, two ligatures are placed on the cranial part of the uterine horns, closer to the ovary, between which they are cut. As the uterine horns separate from the broad uterine ligament, its vessels are ligated. After the uterine horns are separated, two ligatures are placed on her body and she is cut between them. The uterine stump is treated with iodine solution. Antibiotics are injected into the abdominal cavity. The abdominal wall wound is sutured and treated with aluminum spray or terramycin spray, and a postoperative blanket is put on.

Amputation of the dog's penis

Indications: paralysis, gangrene, fracture of the penis bone.

The operation is performed under general anesthesia. Rometar solution (2%) is administered intramuscularly at a dose of 0.5-1.5 ml/10 kg of live weight of the animal. Then zoletil 3 mg/kg live weight is administered intramuscularly. The animal is fixed in a dorsal position. prepare the surgical field in the area preputial sac from the ventral side.

Along the medial line in the posterior part of the preputial wall, the preputial cavity is opened and the penis is removed through the wound. IN urethra a catheter or grooved probe is inserted. A bandage ligature is applied to the root of the penis (above the amputation site). The urethra is dissected within healthy tissues over a distance of 1.5-2 cm from the penis bone. The edges of the urethral wound are sutured to the skin of the penis with interrupted sutures on the corresponding side, creating a urethrostomy. A stitching ligature is placed on the body of the penis behind the bone. Then the penis is cut off along the back end of the bone and the bandage ligature is removed from the remaining part. The operation is completed by suturing the preputial wound and suturing the stump of the penis to the skin in the posterior corner of the incision of the preputial sac. The wound is treated with aluminum spray without touching the urethrostomy, put on postoperative blanket or diaper.