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Book Details
Abstract
With detailed coverage of surgical procedures, Veterinary Surgery: Small Animal is an authoritative, two-volume reference on the art and science of small animal surgery. Expert contributors discuss surgical principles and procedures for topics ranging from surgical biology and perioperative care, to neurosurgery orthopedic surgery, and soft tissue surgery, always supported by evidence-based research and complete surgical instructions. More procedures are covered with greater detail than in comparable books, and a greater emphasis on pathophysiology shows how it relates to diagnosis, treatment, and overall case management. Experienced Coeditors Karen Tobias and Spencer Johnston provide the definitive reference for veterinary surgery, invaluable preparation for the ACVS and ECVS board examinations.
- Blend of clinical and basic science information provides the best possible understanding of clinical issues surrounding operative situations.
- Specific procedures are covered in great detail and are brought to life with full-color drawings and photographs.
- Highly recognized contributors provide authoritative coverage that is useful for surgical specialists as well as practicing veterinarians who perform surgery or refer cases for surgery.
- Detailed coverage of small animal surgery provides excellent preparation for the written examination of the American College of Veterinary Surgeons, and the European College of Veterinary Surgeons.
- Comprehensive coverage includes surgical biology, surgical methods and perioperative care, neurosurgery, and orthopedics in Volume I; soft tissue surgery is covered in Volume II.
- Coverage of anatomy, physiology, and pathophysiology in chapters on specific organs includes information critical to operative procedures and patient management.
- In-depth chapters on anesthesia and pain provide indispensable resources for practicing surgeons.
- Treatment of cancers in small animals is covered in chapters on surgical oncology, tumors of the spine, and musculoskeletal neoplasia.
- Extensive references to published studies show the factual basis for the material.
- The companion website includes all of the images in the book for convenient access, plus references linked to original abstracts on PubMed.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| 9781437707465v1_WEB.pdf | 1 | ||
| Front Cover | 1 | ||
| Endsheet 4 | 2 | ||
| Veterinary Surgery: Small Animal | 3 | ||
| Copyright Page | 6 | ||
| Editors | 7 | ||
| Contributors | 8 | ||
| Dedication | 18 | ||
| Preface | 19 | ||
| About the Book | 20 | ||
| Website | 20 | ||
| Table Of Contents | 21 | ||
| History of Veterinary Surgery | 25 | ||
| The Hunted Animal | 25 | ||
| Animal Domestication | 25 | ||
| Companion Animals | 25 | ||
| “Horse Doctor” Label | 25 | ||
| Greco-Roman Period | 25 | ||
| Early AD period | 26 | ||
| Middle Ages | 26 | ||
| European Influence | 26 | ||
| The Influence of Anesthesia | 26 | ||
| Asepsis | 26 | ||
| The Hobday Era | 26 | ||
| Small Animal Surgery in North America | 27 | ||
| References | 27 | ||
| I Surgical Biology | 29 | ||
| 1 Inflammatory Response | 29 | ||
| Acute Inflammation | 29 | ||
| The Acute Vascular Response | 29 | ||
| Vasodilation | 29 | ||
| Permeability | 29 | ||
| Stasis | 30 | ||
| Leukocyte Extravasation | 30 | ||
| Cellular Components | 31 | ||
| Neutrophils | 31 | ||
| Macrophages | 31 | ||
| Lymphocytes | 31 | ||
| Mast Cells | 31 | ||
| Other Cell Types | 32 | ||
| Inflammatory Stimuli | 32 | ||
| Alarm Signals: Pathogen-Associated Molecular Patterns and Danger-Associated Molecular Patterns | 32 | ||
| Pattern-Recognition Receptors | 32 | ||
| Toll-like Receptors | 33 | ||
| Neurogenic Inflammation | 33 | ||
| Tachykinins | 33 | ||
| Mediators of Inflammation | 33 | ||
| Vasoactive Amines | 33 | ||
| Cytokines | 33 | ||
| Proinflammatory Cytokines | 34 | ||
| Tumor Necrosis Factor. | 34 | ||
| Interleukin-1. | 34 | ||
| Interleukin-6. | 34 | ||
| Chemokines. | 35 | ||
| Antiinflammatory Cytokines | 35 | ||
| Interleukin-10. | 35 | ||
| Lipid/Cell Membrane–Derived Mediators | 35 | ||
| Eicosanoids | 35 | ||
| Prostaglandins. | 35 | ||
| Leukotrienes. | 35 | ||
| Proresolution Eicosanoids. | 36 | ||
| Platelet-Activating Factor | 36 | ||
| Reactive Oxygen Species | 37 | ||
| Gaseous Mediators | 37 | ||
| Nitric Oxide | 37 | ||
| Carbon Monoxide | 38 | ||
| Hydrogen Sulfide | 38 | ||
| Acute Phase Proteins | 38 | ||
| Negative Acute Phase Proteins | 39 | ||
| Positive Acute Phase Proteins | 39 | ||
| C-Reactive Protein. | 39 | ||
| Serum Amyloid A. | 39 | ||
| Serum Amyloid P. | 39 | ||
| Complement Proteins. | 39 | ||
| Coagulation Factors. | 40 | ||
| Kininogen. | 41 | ||
| Mediators and Outcomes of Inflammation | 41 | ||
| Resolution | 41 | ||
| Systemic Inflammation | 41 | ||
| Multiple Organ Failure | 41 | ||
| Immunosuppression | 41 | ||
| Chronic Inflammation | 42 | ||
| References | 43 | ||
| References | 42 | ||
| 2 Molecular and Cellular Biology: | 50 | ||
| Genetics | 50 | ||
| Genes | 50 | ||
| Gene Identification | 50 | ||
| Gene Structure | 52 | ||
| Control of Gene Expression | 53 | ||
| Epigenetics | 53 | ||
| Genomics | 54 | ||
| Genetic Mutations | 54 | ||
| Gene Linkage | 55 | ||
| Studies of Association | 55 | ||
| Detection of Mutations | 56 | ||
| Molecular Cloning | 56 | ||
| Transcriptomics | 57 | ||
| RNA Silencing | 58 | ||
| Proteomics | 59 | ||
| Metabolomics | 61 | ||
| Bioinformatics | 61 | ||
| Systems Biology | 61 | ||
| Applications of Molecular Biology to Small-Animal Surgery | 62 | ||
| Pathogenesis | 62 | ||
| Pharmacogenomics | 62 | ||
| Stem Cell Development | 62 | ||
| Gene Therapy | 62 | ||
| Therapeutic Antibodies | 63 | ||
| References | 64 | ||
| References | 63 | ||
| 3 Biomarkers in Clinical Medicine | 67 | ||
| Biomarkers in Osteoarthritis | 67 | ||
| Noncollagenous Biomarkers of Osteoarthritis | 67 | ||
| Proteoglycan | 67 | ||
| 7D4, 3B3, CS846. | 68 | ||
| Keratan Sulfate, 5D4. | 69 | ||
| BC-3, BC-14. | 69 | ||
| OA-1. | 70 | ||
| Biomarkers of Collagen Turnover | 70 | ||
| Measurement of Type II Collagen Synthesis | 70 | ||
| PIICP. | 70 | ||
| PIIANP/ PIINP. | 70 | ||
| Measurement of Breakdown of Type II Collagen | 70 | ||
| CTX-II. | 71 | ||
| C2C/UC2C. | 71 | ||
| COL CEQ. | 71 | ||
| HELIX-II. | 71 | ||
| TIINE. | 72 | ||
| COLL-2-1/COLL-2-1NO2. | 72 | ||
| Noncollagenous, Nonproteoglycan Glycoproteins | 72 | ||
| Cartilage Oligomeric Matrix Protein | 72 | ||
| Summary of Biomarkers for Osteoarthritis | 72 | ||
| Biomarkers and Inflammation | 72 | ||
| Acute Phase Proteins and Inflammatory Biomarkers | 73 | ||
| The Acute Phase Response | 73 | ||
| Key Acute Phase Proteins in Dogs and Cats | 74 | ||
| Albumin | 74 | ||
| Alpha-1 Acid Glycoprotein | 74 | ||
| C-Reactive Protein | 74 | ||
| Ceruloplasmin | 74 | ||
| Haptoglobin | 74 | ||
| Serum Amyloid A | 75 | ||
| Biologic Variation in Acute Phase Protein Concentrations | 75 | ||
| Signalment | 75 | ||
| Pregnancy | 75 | ||
| Environmental Influences | 75 | ||
| Drug Therapy | 75 | ||
| Monitoring Disease Conditions Using Acute Protein Phases | 75 | ||
| Tumor Necrosis Factor-Alpha and Interleukin-6 | 76 | ||
| Biology of TNF-α | 76 | ||
| Biology of IL-6 | 76 | ||
| TNF-α and IL-6 in Companion Animal Disease States | 76 | ||
| Adipokines and Interactions With Systemic Inflammation | 76 | ||
| Adipokine Changes in Obesity | 76 | ||
| Adipokines and Associated Diseases | 77 | ||
| The Metabolic Syndrome and Insulin Resistance | 77 | ||
| Adipokines and Inflammatory Diseases | 77 | ||
| Adipokines and Orthopedic Disease | 77 | ||
| Adipokines as Biomarkers | 77 | ||
| References | 78 | ||
| References | 77 | ||
| 4 Stem Cells and Regenerative Therapy | 85 | ||
| Stem Cells in Regenerative Surgical Strategy | 85 | ||
| References | 88 | ||
| References | 87 | ||
| 5 Fluid Therapy | 89 | ||
| Body Fluid Compartments and Rehydration Versus Resuscitation | 89 | ||
| Perioperative Fluid Therapy | 91 | ||
| Fluid Types and Uses | 91 | ||
| Isotonic Crystalloids | 92 | ||
| Hypotonic Solutions | 93 | ||
| Hypertonic Solutions | 93 | ||
| Synthetic Colloid Solutions | 94 | ||
| Hypertonic Saline/Colloid Solutions | 96 | ||
| Hemoglobin-Based Oxygen-Carrying Fluids | 96 | ||
| Blood Products | 96 | ||
| Blood Types | 97 | ||
| Blood Storage and Administration | 98 | ||
| Electrolytes | 98 | ||
| Sodium | 98 | ||
| Hyponatremia | 99 | ||
| Hypernatremia | 100 | ||
| Potassium | 101 | ||
| Hypokalemia | 101 | ||
| Hyperkalemia | 102 | ||
| Calcium | 104 | ||
| Hypocalcemia | 104 | ||
| Hypercalcemia | 105 | ||
| Magnesium | 106 | ||
| Hypomagnesemia | 106 | ||
| Hypermagnesemia | 107 | ||
| Phosphorus | 107 | ||
| Hypophosphatemia | 107 | ||
| Hyperphosphatemia | 107 | ||
| Chloride | 108 | ||
| Hypochloremia | 108 | ||
| Hyperchloremia | 109 | ||
| Glucose | 109 | ||
| Hypoglycemia | 109 | ||
| Hyperglycemia | 110 | ||
| Acid-Base Homeostasis | 111 | ||
| The Hydrogen Ion and pH | 111 | ||
| Law of Mass Action and the Henderson-Hasselbalch Equation | 112 | ||
| Regulation of Acid-Base Balance | 112 | ||
| Buffers | 112 | ||
| Pulmonary and Renal Regulation of Acid-Base Balance | 113 | ||
| Total Carbon Dioxide Content | 114 | ||
| Base Excess | 114 | ||
| Anion Gap | 114 | ||
| Primary Acid-Base Disturbances | 115 | ||
| Respiratory Acidosis | 115 | ||
| Respiratory Alkalosis | 116 | ||
| Metabolic Acidosis | 116 | ||
| Metabolic Alkalosis | 117 | ||
| Mixed Acid-Base Disturbances | 117 | ||
| Interpretation of Blood Gases | 117 | ||
| Venous Blood Gas Analysis | 118 | ||
| Nontraditional Approach to Acid-Base Disturbances | 118 | ||
| References | 119 | ||
| References | 118 | ||
| 6 Shock | 122 | ||
| Pathophysiology of Impaired Oxygen Delivery and Oxygen Uptake | 122 | ||
| Oxygen Delivery | 122 | ||
| Determinants of Oxygen Delivery | 122 | ||
| Cardiac Output | 122 | ||
| Arterial Oxygen Content | 125 | ||
| Defects in Oxygen Delivery | 125 | ||
| Oxygen Uptake | 126 | ||
| Oxygen Extraction Ratio | 126 | ||
| DO2/VO2 Curve | 128 | ||
| Cellular Response to Hypoxia and Lactate | 128 | ||
| Pathophysiology of Shock | 129 | ||
| Diagnosis and Monitoring Systems | 130 | ||
| Clinical Assessment/Physical Examination | 130 | ||
| Hemodynamic Assessment and Monitoring | 131 | ||
| Arterial Blood Pressure. | 131 | ||
| Central Venous Pressure. | 132 | ||
| Cardiac Output. | 132 | ||
| Metabolic | 132 | ||
| Lactate. | 132 | ||
| SvO2 versus ScvO2. | 133 | ||
| Regional Perfusion | 133 | ||
| Rectal Temperature. | 133 | ||
| Gastric Tonometry/Sublingual Capnometry. | 133 | ||
| Near Infrared Spectroscopy. | 133 | ||
| Orthogonal Polarization Spectral Imaging | 133 | ||
| Oxygenation Status | 133 | ||
| Treatment | 134 | ||
| Distributive Shock and Sepsis | 138 | ||
| Pathophysiology | 138 | ||
| Diagnosis of Sepsis | 139 | ||
| Clinical Signs | 140 | ||
| Biomarkers | 140 | ||
| Treatment of Septic Shock | 140 | ||
| Early Goal-Directed Therapy | 141 | ||
| Source Control and Antibiotic Therapy | 141 | ||
| Adrenal Insufficiency | 141 | ||
| Other Uses of Steroids in Shock | 141 | ||
| Glucose Control. | 141 | ||
| Recombinant Human Activated Protein C (rhaPC). | 141 | ||
| Septic Shock in Cats | 142 | ||
| References | 143 | ||
| References | 142 | ||
| 7 Bleeding and Hemostasis | 146 | ||
| Hemostasis and Fibrinolysis | 146 | ||
| Primary Hemostasis | 146 | ||
| Secondary Hemostasis | 146 | ||
| The Cascade Model of Coagulation | 146 | ||
| A Cell-Based Model of Coagulation | 146 | ||
| Regulation of Hemostasis | 148 | ||
| Fibrinolysis | 148 | ||
| Hemostatic Testing | 149 | ||
| Platelet Enumeration and Estimation | 150 | ||
| Buccal Mucosal Bleeding Time | 150 | ||
| Prothrombin Time and Activated Partial Thromboplastin Time | 150 | ||
| Activated Clotting Time | 151 | ||
| Fibrin Split Products | 151 | ||
| d-Dimers | 151 | ||
| Fibrinogen | 151 | ||
| Thromboelastography | 151 | ||
| Bleeding | 152 | ||
| Causes of Surgical Bleeding | 152 | ||
| Technical Causes | 152 | ||
| Bleeding Disorders | 152 | ||
| Coagulopathy of Trauma and Hemorrhage. | 153 | ||
| Hemodilution. | 154 | ||
| Hypothermia. | 154 | ||
| Acidemia. | 154 | ||
| Shock. | 154 | ||
| Hypocoagulability in the Critically Ill Patient. | 155 | ||
| Preoperative Hemostatic Assessment | 155 | ||
| Hemostatic Screening | 155 | ||
| Indications. | 155 | ||
| Patient-associated factors. | 155 | ||
| Procedure-associated factors. | 155 | ||
| Screening Tests and Their Limitations. | 155 | ||
| Diagnostic Workup | 156 | ||
| Operative and Postoperative Bleeding | 156 | ||
| Diagnosis | 156 | ||
| Management | 157 | ||
| Basic Principles. | 157 | ||
| Plasma Component Transfusion. | 158 | ||
| Platelet Transfusion. | 158 | ||
| Prohemostatic Agents | 159 | ||
| Desmopressin. | 159 | ||
| Antifibrinolytics. | 160 | ||
| Recombinant Factor VIIa. | 160 | ||
| Prevention of Surgical Bleeding | 160 | ||
| Specific Disorders | 161 | ||
| Thrombocytopenia | 161 | ||
| von Willebrand Disease | 161 | ||
| Other Thrombopathies | 162 | ||
| Inherited Coagulopathies | 162 | ||
| Vitamin K Deficiency | 162 | ||
| Hepatic Disease | 162 | ||
| Thromboembolism | 163 | ||
| Thrombotic Tendency | 163 | ||
| Pathophysiology | 163 | ||
| Causes | 164 | ||
| Laboratory Assessment of Hypercoagulability | 164 | ||
| Postoperative Thromboembolism | 165 | ||
| Diagnosis of Venous Thromboembolism | 165 | ||
| General Principles | 165 | ||
| Diagnosis of Pulmonary Thromboembolism | 166 | ||
| Initial Assessment. | 166 | ||
| Secondary Assessment. | 166 | ||
| Definitive Diagnosis. | 167 | ||
| Management | 167 | ||
| Overview of Antithrombotic Agents | 167 | ||
| Anticoagulants | 167 | ||
| Unfractionated Heparin. | 167 | ||
| Low-molecular-weight heparin. | 167 | ||
| Warfarin. | 168 | ||
| Antiplatelet Drugs | 168 | ||
| Aspirin. | 168 | ||
| Clopidogrel. | 168 | ||
| Treatment of Venous Thromboembolism | 168 | ||
| Initial Therapy. | 169 | ||
| Maintenance Therapy. | 169 | ||
| Prevention of Thromboembolism in Surgical Patients | 170 | ||
| Risk Assessment. | 170 | ||
| Prophylactic Regimens. | 170 | ||
| Disseminated Intravascular Coagulation | 170 | ||
| Etiopathogenesis | 171 | ||
| Diagnosis | 171 | ||
| Clinical Presentation | 171 | ||
| Laboratory Testing | 171 | ||
| Management | 172 | ||
| References | 173 | ||
| References | 172 | ||
| 8 Metabolism and Nutritional Needs of Surgical Patients | 183 | ||
| Metabolic Changes Related to Illness and Disease | 183 | ||
| Metabolic Changes Related to Surgical Injury | 183 | ||
| Pathophysiology of Malnutrition | 183 | ||
| Implications of Obesity for the Surgical Patient | 184 | ||
| Nutritional Assessment and Planning | 184 | ||
| Meeting Nutritional Requirements | 185 | ||
| Calculation of Nutritional Requirements | 186 | ||
| Monitoring and Reassessment | 186 | ||
| Summary | 186 | ||
| References | 187 | ||
| References | 186 | ||
| 9 Wound Healing | 188 | ||
| Phases of Wound Healing | 188 | ||
| Inflammation and Debridement | 188 | ||
| Proliferation | 190 | ||
| Remodeling and Maturation | 191 | ||
| Healing of Specific Tissues | 192 | ||
| Gastrointestinal Healing | 192 | ||
| Fascial Healing | 194 | ||
| Urinary Bladder Healing | 194 | ||
| Bone Healing | 194 | ||
| Species Differences in Healing | 194 | ||
| Impediments to Wound Healing | 195 | ||
| Local Factors | 195 | ||
| Wound Perfusion | 195 | ||
| Tissue Viability and Wound Fluid Accumulation | 195 | ||
| Wound Infection | 195 | ||
| Mechanical Factors | 196 | ||
| Systemic Factors | 196 | ||
| Primary Immunodeficiencies and Conditions That Impair Immune Function | 196 | ||
| Cancer | 196 | ||
| Age | 196 | ||
| References | 198 | ||
| References | 197 | ||
| 10 Wound Infections and Antimicrobial Use | 201 | ||
| Definition of Surgical Site Infection | 201 | ||
| Risk Factors for Surgical Site Infection | 201 | ||
| Degree of Bacterial Contamination | 201 | ||
| Clipping of the Surgical Site | 201 | ||
| Duration of Surgery | 201 | ||
| Duration of Anesthesia | 201 | ||
| Propofol | 202 | ||
| Endocrinopathies | 202 | ||
| Number of People in the Operating Room | 203 | ||
| Sex | 203 | ||
| Other Potential Risk Factors | 203 | ||
| Prophylactic Perioperative Antibiotic Use | 203 | ||
| Selection of the Antimicrobial Agent | 203 | ||
| Timing of Antibiotic Administration | 204 | ||
| Discontinuation of Antibiotic Administration | 204 | ||
| Risk/Benefit Determination | 204 | ||
| Surgical Site Infection Management | 205 | ||
| Antibiotic Use | 205 | ||
| Drainage | 205 | ||
| References | 206 | ||
| References | 205 | ||
| 11 Evidence-Based Medicine and Outcomes Assessment | 208 | ||
| Outcome Measures | 208 | ||
| Outcome Assessment in Veterinary Medicine | 208 | ||
| Stepwise Development of a Health Measurement Instrument* | 209 | ||
| Step One: Devising the Items (Questions) | 209 | ||
| Step Two: Selecting the Items (Questions) | 211 | ||
| Step Three: Assessing Reliability and Validity | 212 | ||
| Study Design and Subjective Versus Objective Measures | 212 | ||
| Process Measures | 213 | ||
| Conclusions | 213 | ||
| References | 214 | ||
| References | 213 | ||
| II Surgical Methods and Perioperative Care | 216 | ||
| 12 Sterilization | 216 | ||
| Cleaning of Surgical Instruments and Materials | 216 | ||
| Manual Cleaning of Surgical Instruments | 216 | ||
| Mechanical Cleaning of Surgical Instruments | 217 | ||
| Wrapping Materials | 217 | ||
| Types of Sterilization | 218 | ||
| Liquid Chemical Germicides (Cold Sterilization) | 218 | ||
| Steam Sterilization | 218 | ||
| Ethylene Oxide Sterilization | 219 | ||
| Ozone Sterilization | 219 | ||
| Plasma Sterilization | 219 | ||
| Sterilization by Radiation | 219 | ||
| Indicators of Sterilization | 219 | ||
| Storage of Sterilized Materials | 220 | ||
| References | 221 | ||
| References | 220 | ||
| 13 Instrumentation | 222 | ||
| Surgical Instruments | 222 | ||
| Cutting Instruments | 222 | ||
| Scalpel | 222 | ||
| Scissors | 222 | ||
| Rongeurs | 222 | ||
| Periosteal Elevators | 224 | ||
| Bone-Cutting Instruments | 224 | ||
| Grasping Instruments | 224 | ||
| Needle Holders | 224 | ||
| Tissue Forceps | 225 | ||
| Retractors | 228 | ||
| Hand-Held Retractors | 229 | ||
| Self-Retaining Retractors | 229 | ||
| Suction Tips | 229 | ||
| Miscellaneous Instruments | 231 | ||
| Microsurgical Instruments | 231 | ||
| Instrument Care | 232 | ||
| Instrument Problem Solving | 233 | ||
| References | 234 | ||
| References | 233 | ||
| 14 Preparation of the Patient, Operating Team, and Operating Room for Surgery | 235 | ||
| Antiseptics | 235 | ||
| Alcohols | 235 | ||
| Iodophors | 235 | ||
| Chlorhexidine | 235 | ||
| Triclosan | 236 | ||
| Other Agents | 236 | ||
| Preparation of the Patient | 236 | ||
| Draping | 237 | ||
| Preparation of Surgical Personnel | 237 | ||
| Scrub Suits | 237 | ||
| Scrubbing Hands | 238 | ||
| Gloves | 238 | ||
| Gowns | 238 | ||
| Footwear | 239 | ||
| Headcovers | 239 | ||
| Surgical Face Masks | 239 | ||
| Facilities | 239 | ||
| References | 241 | ||
| References | 240 | ||
| 15 Monitoring for Surgical Infection | 245 | ||
| Surveillance as Part of the Infection Control Program | 245 | ||
| Purpose of Surveillance | 245 | ||
| Surveillance in Human Medicine | 246 | ||
| Surveillance in Veterinary Medicine | 246 | ||
| Surveillance Options | 247 | ||
| Passive Surveillance | 247 | ||
| Active Surveillance | 247 | ||
| Syndromic Surveillance | 248 | ||
| Environmental Surveillance | 248 | ||
| Current Use of Surveillance in Veterinary Hospitals | 249 | ||
| Personnel | 249 | ||
| Use of Standard Definitions | 250 | ||
| Costs of Surveillance | 250 | ||
| Surveillance Programs for Veterinary Hospitals | 250 | ||
| Monitoring Surgical Site Infection Rates | 252 | ||
| Comparing Infection Rates | 252 | ||
| Communications | 252 | ||
| Surgical Site Infection Investigation | 253 | ||
| Conclusion | 254 | ||
| References | 255 | ||
| References | 254 | ||
| 16 Surgical Modalities: Laser, Radiofrequency, Ultrasonic, and Electrosurgery | 256 | ||
| Radiofrequency Technology | 256 | ||
| Tissue Effects of radiofrequency Energy | 256 | ||
| Monopolar versus Bipolar | 256 | ||
| Laparoscopic Considerations | 258 | ||
| Argon Beam Coagulators | 258 | ||
| Electrothermal Bipolar Vessel Sealing Devices | 258 | ||
| Ultrasonic Energy—The Harmonic system | 259 | ||
| Lasers | 260 | ||
| Physics of Lasers | 260 | ||
| Lasers and Tissue Interaction | 260 | ||
| Types of Surgical Lasers | 260 | ||
| Argon Lasers | 260 | ||
| CO2 Lasers | 260 | ||
| Nd:YAG Lasers | 260 | ||
| Ho:YAG Lasers | 260 | ||
| Excimer Lasers | 260 | ||
| Lasers and Safety Considerations | 261 | ||
| Ocular Hazards | 261 | ||
| Toxic Smoke Production | 261 | ||
| Fire Hazard | 261 | ||
| Other Hazards | 262 | ||
| References | 263 | ||
| References | 262 | ||
| 17 Suture Material, Tissue Staplers, Ligation Devices, and Closure Methods | 264 | ||
| Suture Needles | 264 | ||
| Suture | 265 | ||
| General Suture Morphology | 266 | ||
| Suture Coating | 266 | ||
| Absorbable Suture | 267 | ||
| Common Types of Absorbable Suture | 267 | ||
| Catgut | 267 | ||
| Rapidly Absorbed Synthetic Suture | 268 | ||
| Polyglycolic Acid: Dexon | 268 | ||
| Polyglactin 910: Vicryl | 268 | ||
| Poliglecaprone 25: Monocryl | 268 | ||
| Polyglytone 6211: Caprosyn | 269 | ||
| Common Slowly Absorbed Synthetic Sutures | 269 | ||
| Polydioxanone: PDS II | 269 | ||
| Polyglyconate: Glycolic Acid Trimethylene Carbonate, Maxon | 269 | ||
| Glycomer 631: Biosyn | 269 | ||
| Common Nonabsorbable Sutures (Table 17-3) | 269 | ||
| Silk | 269 | ||
| Polypropylene | 269 | ||
| Nylon | 269 | ||
| Polymerized Caprolactam | 270 | ||
| Polyester: Polyethylene, Polybutester, and Composites | 270 | ||
| Stainless Steel | 271 | ||
| Surgical Mesh | 271 | ||
| Surgical Technique | 273 | ||
| Staples | 273 | ||
| Skin Staples | 273 | ||
| Vascular Clips | 274 | ||
| Linear Stapling Devices | 274 | ||
| Circular Stapling Devices | 274 | ||
| Adhesives | 275 | ||
| Cyanoacrylate | 275 | ||
| References | 278 | ||
| References | 277 | ||
| 18 Instrument and Tissue Handling Techniques | 283 | ||
| Instrument Handling | 283 | ||
| Use of Cutting Instruments | 283 | ||
| Scalpel | 283 | ||
| Scissors | 284 | ||
| Other Cutting Instruments | 286 | ||
| Use of Grasping Instruments | 286 | ||
| Needle Holders | 286 | ||
| Forceps | 286 | ||
| Crushing-Type Tissue Forceps | 286 | ||
| Noncrushing-Type Tissue Forceps | 286 | ||
| Hemostatic Forceps | 287 | ||
| Thumb Forceps | 287 | ||
| Microsurgical Forceps | 288 | ||
| Towel Clamps | 288 | ||
| Use of Retractors | 288 | ||
| Self-Retaining Retractors | 288 | ||
| Hand-Held Retractors | 288 | ||
| Suction Use | 289 | ||
| Tissue Dissection and Manipulation | 289 | ||
| Suturing | 289 | ||
| Interrupted Patterns | 289 | ||
| Continuous Patterns | 291 | ||
| Knot Tying | 291 | ||
| Ligation Techniques | 293 | ||
| Simple or Circumferential Ligations | 293 | ||
| Transfixation Ligations | 294 | ||
| References | 296 | ||
| References | 295 | ||
| 19 Surgical Hemostasis | 297 | ||
| Hemostatic Agents | 297 | ||
| Blood Flow Reduction | 297 | ||
| Pressure/Tamponade | 297 | ||
| Topical Vasoconstrictors: Epinephrine/ Adrenaline/Ephedrine | 298 | ||
| Hypotension/Hypothermia/Reduced Perfusion | 298 | ||
| Distant Control of Blood Flow | 298 | ||
| Tourniquets. | 299 | ||
| Topical Hemostatic Agents | 300 | ||
| Mechanical Hemostatic Agents | 300 | ||
| Gelatins. | 300 | ||
| Bovine Collagen. | 301 | ||
| Cellulose. | 301 | ||
| Polysaccharide Spheres. | 301 | ||
| Bone Wax and Ostene. | 301 | ||
| Active Hemostatic Agents | 301 | ||
| Thrombin. | 301 | ||
| Alginates. | 302 | ||
| Hemostatic Sealants | 302 | ||
| Fibrin. | 302 | ||
| Synthetic Sealants. | 302 | ||
| Antifibrinolytics | 302 | ||
| Serine Protease Inhibitor (Aprotinin) | 302 | ||
| Lysine Analogues | 302 | ||
| Miscellaneous Products | 303 | ||
| Desmopressin (1-desamino-8-D- arginine vasopressin) | 303 | ||
| Ethamsylate | 303 | ||
| Hemostatic Polymers/Minerals | 303 | ||
| Zeolite. | 303 | ||
| Chitosan. | 303 | ||
| References | 304 | ||
| References | 303 | ||
| 20 Bandages and Drains | 307 | ||
| Bandages | 307 | ||
| Contact (Primary) Layer | 307 | ||
| Guidelines for Circumferential Layers | 308 | ||
| Intermediate (Secondary) Layer | 308 | ||
| Outer (Tertiary) Layer | 309 | ||
| Pressure Relief | 309 | ||
| Anchoring the Bandage | 310 | ||
| Protecting the Bandage | 312 | ||
| Changing the Bandage | 312 | ||
| Costs | 313 | ||
| Drains | 313 | ||
| Mechanisms of Drainage | 313 | ||
| Open Passive Drains | 313 | ||
| Closed Active Drains | 314 | ||
| Drain Placement and Removal | 315 | ||
| Potential Complications of Drains | 316 | ||
| References | 317 | ||
| References | 316 | ||
| 21 Biopsy General Principles | 319 | ||
| Biopsy Methods | 319 | ||
| Needle-Core Biopsy | 319 | ||
| Punch Biopsy | 320 | ||
| Incisional Biopsy | 320 | ||
| Specific Tissues | 322 | ||
| Liver | 322 | ||
| Gastrointestinal Tract | 322 | ||
| Kidney | 322 | ||
| Bone | 323 | ||
| Endoscopic Biopsies | 323 | ||
| Tissue Processing | 324 | ||
| References | 325 | ||
| References | 324 | ||
| 22 Surgical Pain: | 326 | ||
| Transduction (Peripheral Nociceptors) | 326 | ||
| Heat Transduction | 327 | ||
| Cold Transduction | 328 | ||
| Mechanical Transduction | 328 | ||
| Chemical Transduction | 328 | ||
| Local Modulation of Transduction | 328 | ||
| Transmission and Projection | 328 | ||
| Dorsal Horn Neurons and Ascending Spinal Tracts | 328 | ||
| Thalamocortical System | 329 | ||
| Supraspinal Modulation of Sensory Input | 330 | ||
| Local Modulation of Sensory Input at the Spinal Cord | 330 | ||
| Plasticity of Nociception and Pain | 330 | ||
| Peripheral Changes | 330 | ||
| Central Nervous System (Spinal Cord) Changes | 331 | ||
| Why Treat Pain? | 332 | ||
| Assessment of Perioperative Pain | 333 | ||
| Recognition of Pain | 333 | ||
| Recommended Scale for Assessment of Perioperative Pain in the Clinic | 334 | ||
| Strategies | 334 | ||
| Preemptive Analgesia | 334 | ||
| Multimodal (Balanced) Approach | 335 | ||
| Surgical Technique | 336 | ||
| References | 337 | ||
| References | 336 | ||
| 23 Anesthesia Principles and Monitoring | 340 | ||
| Anesthesia Principles and Monitoring | 340 | ||
| Anesthetic Drug Delivery | 341 | ||
| Vaporizers | 341 | ||
| Vaporizer Output. | 342 | ||
| Methods of Vaporization. | 342 | ||
| Circle Systems. | 342 | ||
| Temperature Compensation. | 343 | ||
| Vaporizer Agent Specificity. | 343 | ||
| Anesthetic Circuits | 343 | ||
| Rebreathing System | 343 | ||
| Closed and Semi-Closed Circuit Rebreathing System | 344 | ||
| Nonrebreathing Systems | 344 | ||
| Endotracheal Tubes | 344 | ||
| Intubation and Preoxygenation | 345 | ||
| Difficult Intubation. | 345 | ||
| Fresh Gas | 346 | ||
| Carrier Gas | 346 | ||
| Pressure Regulation. | 347 | ||
| Gas Scavenging. | 347 | ||
| Anesthesia Ventilators | 347 | ||
| Anesthetic Monitoring Equipment | 347 | ||
| Physiologic Considerations | 347 | ||
| Anesthetic Depth | 348 | ||
| Blood Pressure Monitoring | 348 | ||
| Indirect Blood Pressure Measurement. | 349 | ||
| Direct Blood Pressure Measurement. | 350 | ||
| Electrocardiography | 350 | ||
| Monitoring of Ventilation | 350 | ||
| End-Tidal CO2 Monitors. | 350 | ||
| Pulse Oximeter. | 350 | ||
| Inhalant Anesthetic Monitoring | 352 | ||
| Peripheral Nerve Stimulator | 352 | ||
| Central Venous Pressure | 352 | ||
| Noninvasive Cardiac Output Monitoring | 353 | ||
| Thermodilution. | 353 | ||
| Lithium Dilution Cardiac Output (LidCO). | 353 | ||
| Pulse Contour Analysis (PulseCO). | 353 | ||
| Noninvasive Cardiac Output (NiCO). | 353 | ||
| Other Anesthetic Monitoring | 353 | ||
| Anesthetic Drugs | 354 | ||
| Opiates | 354 | ||
| Morphine | 355 | ||
| Hydromorphone | 355 | ||
| Oxymorphone | 355 | ||
| Meperidine | 355 | ||
| Methadone | 355 | ||
| Fentanyl | 355 | ||
| Buprenorphine | 356 | ||
| Butorphanol | 356 | ||
| Tramadol | 356 | ||
| Opioid Antagonism | 356 | ||
| Tranquilizers | 356 | ||
| Benzodiazepines | 356 | ||
| Diazepam | 356 | ||
| Midazolam | 357 | ||
| Phenothiazines | 357 | ||
| Acepromazine. | 357 | ||
| α2-Agonists | 357 | ||
| Xylazine. | 357 | ||
| Medetomidine. | 357 | ||
| Dexmedetomidine. | 357 | ||
| Drugs Used for Anesthetic Induction | 357 | ||
| Propofol | 357 | ||
| Dissociative Agents (Ketamine and Tiletamine) | 358 | ||
| Barbiturates | 358 | ||
| Thiopental. | 358 | ||
| Other Induction Agents | 359 | ||
| Etomidate | 359 | ||
| Alphaxalone | 359 | ||
| Inhalant Anesthesia | 359 | ||
| Minimum Alveolar Concentration | 359 | ||
| Local Anesthetics | 360 | ||
| Neuromuscular Blockade | 361 | ||
| Anticholinergic Agents | 361 | ||
| Nonsteroidal Antiinflammatory Drugs | 361 | ||
| Pressors and Inotropes | 362 | ||
| Anesthetic Practice | 362 | ||
| Patient Assessment | 362 | ||
| Designing an Anesthetic Protocol | 363 | ||
| Anesthesia of Pets with Preexisting Conditions | 363 | ||
| Anesthesia for Animals With Cardiac Disease | 363 | ||
| Relevant Physiology and Pathophysiology | 363 | ||
| Anesthetic Preparation | 364 | ||
| Anesthetic Guide | 364 | ||
| Premedication. | 364 | ||
| Induction. | 365 | ||
| Maintenance. | 365 | ||
| Postoperative. | 365 | ||
| Arrhythmias. | 365 | ||
| Anesthesia for Animals With Endocrine Disease | 365 | ||
| Thyroid Gland | 365 | ||
| Relevant Physiology and Pathophysiology. | 365 | ||
| 9781437707465v2_WEB | 1557 | ||
| Front Cover | 1557 | ||
| Veterinary Surgery: Small Animal | 1558 | ||
| Copyright Page | 1561 | ||
| Editors | 1562 | ||
| Contributors | 1563 | ||
| Dedication | 1573 | ||
| Preface | 1574 | ||
| About the Book | 1575 | ||
| Website | 1575 | ||
| Table Of Contents | 1576 | ||
| History of Veterinary Surgery | 1580 | ||
| The Hunted Animal | 1580 | ||
| Animal Domestication | 1580 | ||
| Companion Animals | 1580 | ||
| “Horse Doctor” Label | 1580 | ||
| Greco-Roman Period | 1580 | ||
| Early AD period | 1581 | ||
| Middle Ages | 1581 | ||
| European Influence | 1581 | ||
| The Influence of Anesthesia | 1581 | ||
| Asepsis | 1581 | ||
| The Hobday Era | 1581 | ||
| Small Animal Surgery in North America | 1582 | ||
| References | 1582 | ||
| V Skin and Reconstruction | 1584 | ||
| 75 Primary Wound Closure | 1584 | ||
| Skin Anatomy | 1584 | ||
| Skin Physiology | 1584 | ||
| Rate of Healing | 1584 | ||
| Wound Strength | 1584 | ||
| Species Differences | 1585 | ||
| Subcutaneous Tissues and Healing | 1585 | ||
| Skin Pathophysiology | 1585 | ||
| Tension | 1586 | ||
| Motion | 1586 | ||
| Self-mutilation | 1586 | ||
| Patient Health | 1586 | ||
| Primary Wound Creation | 1586 | ||
| Scalpel Blade | 1586 | ||
| Electrocautery and Laser | 1586 | ||
| Hemostasis | 1587 | ||
| Patient Selection for Primary Wound Closure | 1587 | ||
| Patient Characteristics | 1587 | ||
| Wound Characteristics | 1587 | ||
| Primary Wound Closure Techniques | 1589 | ||
| Suture Selection | 1589 | ||
| Knot Security | 1589 | ||
| Suture Patterns | 1590 | ||
| Subcutaneous Tissue Apposition | 1590 | ||
| Continuous Subcutaneous Closure. | 1590 | ||
| Cutaneous Suture Patterns | 1590 | ||
| External Cutaneous Suture Patterns. | 1590 | ||
| Suture bite placement. | 1591 | ||
| Buried Intradermal Patterns. | 1591 | ||
| Burying the knot. | 1592 | ||
| Continuous horizontal intradermal pattern. | 1592 | ||
| Continuous vertical intradermal pattern. | 1592 | ||
| Continuous Subcutaneous-to-Intradermal Closure. | 1593 | ||
| Tissue Adhesives | 1593 | ||
| Fibrin Sealants | 1593 | ||
| Skin Stapling | 1593 | ||
| Primary Wound Closure Challenges | 1593 | ||
| Dog Ears | 1593 | ||
| Step Defects | 1594 | ||
| Postoperative Care | 1594 | ||
| Wounds | 1594 | ||
| Pain Management | 1595 | ||
| Nonsteroidal Antiinflammatory Agents | 1595 | ||
| Local Anesthetic Agents | 1596 | ||
| Cold Packing | 1596 | ||
| References | 1597 | ||
| References | 1596 | ||
| 76 Open Wounds | 1599 | ||
| Pathophysiology | 1599 | ||
| Types of Wounds | 1599 | ||
| Abrasion | 1599 | ||
| Puncture Wound | 1599 | ||
| Laceration | 1599 | ||
| Degloving Injury | 1599 | ||
| Thermal Burn | 1599 | ||
| Decubital Ulcer | 1599 | ||
| Goals of Wound Management and Wound Classification | 1599 | ||
| Wound Classifications | 1600 | ||
| Types of Wound Management | 1600 | ||
| Primary Wound Closure (First Intention Healing) | 1600 | ||
| Delayed Primary Closure | 1600 | ||
| Healing by Contraction and Epithelialization (Second Intention Healing) | 1600 | ||
| Secondary Closure (Third Intention Healing) | 1600 | ||
| Decision Making | 1600 | ||
| Immediate Wound Care | 1601 | ||
| Irrigation Solutions | 1601 | ||
| Antimicrobial Treatment | 1602 | ||
| Wound Protection | 1602 | ||
| Definitive Wound Care | 1604 | ||
| Wound Preparation | 1604 | ||
| Wound Debridement | 1604 | ||
| Layered Debridement | 1605 | ||
| Nonsurgical Debridement | 1605 | ||
| Honey. | 1606 | ||
| Wet-to-Dry Bandages. | 1606 | ||
| Maggots. | 1606 | ||
| Moist Wound Healing | 1607 | ||
| Topical Antimicrobial Agents | 1607 | ||
| Topical Antibiotic Ointment | 1607 | ||
| Slow-Release Silver Dressings | 1607 | ||
| Bioscaffolds and Synthetic Matrix Dressings | 1608 | ||
| Chitosan | 1608 | ||
| Growth Factor–Containing Agents | 1608 | ||
| Negative-Pressure Wound Therapy | 1608 | ||
| References | 1610 | ||
| References | 1609 | ||
| 77 Tension-Relieving Techniques | 1612 | ||
| Surgical Principles | 1612 | ||
| Instrumentation | 1612 | ||
| Decision Making and Planning | 1612 | ||
| Tension, Shear, and Viscoelasticity | 1612 | ||
| Tension | 1613 | ||
| Shear | 1615 | ||
| Viscoelasticity | 1615 | ||
| Techniques for Relieving Tension | 1616 | ||
| Undermining | 1616 | ||
| Tension-Relieving Sutures | 1616 | ||
| Strong Subcutaneous Sutures | 1617 | ||
| Stent Sutures | 1618 | ||
| Far–Near–Near–Far and Far–Far–Near–Near Sutures | 1618 | ||
| Mattress Sutures | 1618 | ||
| Skin Stretching Techniques | 1618 | ||
| Pretensioning Sutures and Presuturing | 1618 | ||
| Acute (Intraoperative) Skin Stretching | 1623 | ||
| Walking Sutures | 1623 | ||
| Chronic Skin Expansion | 1623 | ||
| Relaxing Incisions | 1624 | ||
| Mesh Expansion (Multiple Punctate Relaxing Incisions) | 1624 | ||
| Simple Relaxing Incision | 1625 | ||
| V-Y Plasty | 1625 | ||
| Z-Plasty | 1625 | ||
| M-Plasty | 1625 | ||
| Closing Variously Shaped Wounds | 1625 | ||
| Crescent-Shaped Defects | 1629 | ||
| Triangular Defects | 1630 | ||
| Rectangular and Square Defects | 1630 | ||
| Circular Defects | 1630 | ||
| Dog Ears | 1633 | ||
| References | 1634 | ||
| References | 1633 | ||
| 78 Local or Subdermal Plexus Flaps | 1635 | ||
| Anatomy and Physiology | 1635 | ||
| Cutaneous Circulation | 1635 | ||
| Skin Elasticity | 1635 | ||
| Delay Phenomenon | 1635 | ||
| Patient Preparation | 1636 | ||
| Guidelines for Flap Development | 1636 | ||
| Types of Subdermal Plexus Flaps | 1637 | ||
| Advancement Flap | 1637 | ||
| Rotation Flap | 1637 | ||
| Transposition Flap | 1637 | ||
| Interpolation Flap | 1637 | ||
| Plasty | 1637 | ||
| Distant Flaps | 1639 | ||
| Composite Flaps | 1639 | ||
| Examples of Subdermal Plexus Flaps | 1640 | ||
| Skin Fold Flaps | 1640 | ||
| Scrotal Flap | 1642 | ||
| Preputial Reconstruction | 1642 | ||
| Phalangeal Fillet | 1642 | ||
| Labial Flaps | 1642 | ||
| Lip-to-Lid Flap | 1643 | ||
| Guidelines for Distant Flap Development and Transfer | 1644 | ||
| Complications of Subdermal Plexus Flaps | 1644 | ||
| References | 1648 | ||
| References | 1647 | ||
| 79 Axial Pattern and Myocutaneous Flaps | 1649 | ||
| Anatomy | 1649 | ||
| Advantages and Disadvantages | 1649 | ||
| Species Differences | 1649 | ||
| General Considerations For Reconstructive Flaps | 1649 | ||
| Patient Preparation | 1649 | ||
| Flap Size | 1652 | ||
| Patient Positioning | 1652 | ||
| Recipient Bed | 1652 | ||
| Flap Development | 1652 | ||
| Surgical Closure | 1652 | ||
| Drains | 1652 | ||
| Postoperative Care | 1652 | ||
| Specific Axial Pattern Flaps | 1652 | ||
| Cervical Cutaneous Branch of the Omocervical Axial Pattern Flap | 1653 |