Guidelines for Surgery

Surgery is classified in several ways:

Surgery is major if it enters a body cavity (thorax, abdomen, calvarium), or has the potential for having significant complications. Included would be orthopedic procedures and extensive cannulation procedures. The use of aseptic technique is mandatory in these surgeries to minimize the possibility of post surgical infection i.e. sterile instruments, gloves, clothing as well as aseptic preparation of the surgical site. (Major surgical procedures on rodents, hamsters, and guinea pigs must also be performed using aseptic procedures)

• Other surgery is classified as minor. Minor procedures include peripheral vessel cannulations and skin incisions.


• Surgery is also classified as survival vs. nonsurvival. An individual animal should only undergo one major recovery surgical procedures unless approved by the IACUC.

Post surgical observation

According to the Guide, appropriate facilities and equipment should be available for post surgical care. An important component of post-surgical care is observation of the animal and intervention as required during recovery from anesthesia and surgery. Adequate care (the responsibility of the PI) requires close monitoring during the acute postoperative period. All animals should be observed continuously until they are conscious (to an alert and responsive state). Monitoring is critical for identifying immediate complications such as hemorrhage, dehiscence of surgical incisions, pain, etc. The immediate postoperative periods should also be used to assess comfort and identify those animals requiring postoperative analgesics. At minimum animals should be monitored at least every 30 minutes until the animal is conscious. Thereafter, animals must be observed daily for at least 7 days following any surgical procedure. Animals may be monitored more frequently, and for a longer postoperative period, as the situation requires, and at the discretion of the attending veterinarian and/or the IACUC.

Surgical facilities

Non-survival surgery, minor surgery or rodent/non-mammal surgery may be performed in an approved lab. The IACUC will review and approve all surgical areas.

The LAS Surgery Suites are to be used for major survival surgery in large animals (rabbits, dogs, pigs, NHP). The suites are designed and maintained in such a way that they help prevent the development of post-procedural infections. In the LAS surgical suites area there is one suite dedicated for rodent procedures and can be used for rodent surgery.

Preparation of the surgeon and personnel involved in the surgery

• Sterile gloves should be used for all procedures. Examination gloves are not sterile. Gloves may be disinfected between surgeries with a cold sterilant for rodent and non-mammal surgeries. Large animal surgeries should be performed with a new pair of gloves for each patient.


• The surgeon's hands and arms should be scrubbed for 3 minutes with a disinfectant such as povidone iodine or chlorhexidine, rinsed with water and dried prior to gloving for any large animal survival surgery. As much as 30% of the time gloves become perforated during surgery, exposing the animal's tissues directly to the surgeon's skin.


• A cap, facemask, shoe covers and sterile gown must be worn for all large animal major survival surgeries.


• A clean lab coat is recommended when performing rodent surgeries. A hair cover and facemask will reduce the risk of gross contamination of the surgical site.


• Minimizing traffic flow and conversation in the operating room significantly reduces the risk of contamination of the surgical site.
  • Expired medical materials such as drugs, fluids and sutures may not be used on any research animal who is unanesthetized or who is to recover from an anesthetic procedure

The surgical suites are located on the first floor of the Research and Education building in room numbers 1404B,C, and D. These rooms, including the rodent procedure room, should be reserved at least two weeks in advance. Investigators should contact

Cedric Bouey (721-0201) or cbouey@mcg.edu) to schedule any procedures requiring the suites for large animals; a sign in sheet is posted on the rodent procedure area.

Surgical facilities should be kept clean and foot traffic minimized.

Pre-Operative Prep Room

The prep room, room 1320, is located down the hall from the surgery suites. This is where pre-operative procedures such as intubation, IV catheter placement, and surgical site clipping should take place. If the subject animal is a dog, pig or NHP, lab animal services will be responsible for pre-operative duties. If the animal is a rabbit, those responsible for pre-operative procedures can vary based on investigator experience. Two animals can be brought to the prep room (2 prep tables) at a time and subsequently to the surgical suite if the size of the animal permits.

Records

For procedures involving rabbits or chinchillas, a pink surgery card must be filled out. These cards are supplied by Lab Animal Services and can be obtained in the Veterinary Technician office (CB 1325). Once completed, these cards must be maintained in the animal room for the veterinary staff to review. Lab Animal Services will generate a post-operative form for all dogs, pigs, and non-human primates. All rodent surgery dates should be written on the cage cards clearly visible.

Investigators Responsibilities or designee/checklist

• Investigator to provide surgical equipment


• Investigator to provide gowns, gloves, shoe covers (LAS can order but need advance notice, 2 months)


• Investigators must provide their scrubs and any special equipment (i.e. latex free gloves).


• Schedule surgery room with veterinarian or veterinary technician 2-3 months in advance to make sure LAS staff will be available for assistance and that the surgical space is available.