PATIENT PREPARATION

Hair RemovalClip 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 RemovalProper hand position

•Use a #40 blade andhold 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• Low tissue toxicity• 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 solution1:9

•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 cordFour stays on surgical table

Secure Patient to Table

Abdominal surgery

Secure Patient to Table

Castration in a dog

Dorsal recumbencyOr modifiedDosal recumbency

Castration in a cat

Secure Patient to Table

Secure Patient to Table

Orthopedic and extremity surgery

Secure Patient to Table

Tail and perianal surgery

Secure Patient to Table

Back surgery

General rulefor shaving forback surgeryis 2 vertebrae above and 2 vertebrae belowthe proposed incisionsite

Final (Sterile) Surgical Site Preparation

Solutions (Paint)