Small Animal Surgical Emergencies. Группа авторов
Читать онлайн книгу.
administration set
Pressure bag
± Three‐way stopcocka
± 60‐cc syringea
a To be considered as a general guideline. There are many variables which could alter the clinician's decision. The clinician is responsible for selecting the appropriate size and items used.
Figure 2.40 Ingress needle shown delivering pressurized fluid into affected stifle joint via an intravenous administration set as the egress needle expels lavage fluid.
Source: Courtesy of K.A. Agnello, School of Veterinary Medicine, Philadelphia, PA.
An arthroscopy tower set‐up is listed in Box 2.40. Instruments and supplies are listed in Box 2.41.
Arthrotomy
Arthrotomy is the most invasive therapeutic intervention for joint sepsis and rarely performed on an emergent basis unless the clinician suspects there is an overabundance of gross material within the joint. Instruments and supplies recommended for arthrotomy are listed in Box 2.42.
Open Fracture
Open fractures are complicated by a contaminated soft tissue wound resulting from the fractured bone penetrating through the epidermis. Wound debridement of any necrotic tissue or gross debris and lavage should be the priority prior to fracture fixation. This will help to reduce the risk of infection. Regardless, the fractured limb must be stabilized promptly by first, applying a sterile dressing over the open wound, followed by a Robert Jones bandage (Box 2.43).
Box 2.40 Arthroscopy Tower Set‐Up
Arthroscopy tower (Figure 2.41)
Arthroscopy pump
Sterile light cable
Camera head
Sterile shaver
Universal foot pedal for shaver
USB port to upload procedure images/recordings
Figure 2.41 Components of a portable arthroscopy tower, including an imaging display system, light source and shaver console.
Box 2.41 Instruments and Supplies for Arthroscopy
Sterile arthroscopy drape
Sterile camera sleeve
Arthroscopes:1.9‐mm (elbow)a2.3‐mm (elbow/shoulder/small canine/cat stifle)a2.7‐mm (canine stifle)a
Abrader (2.5 mm, 3.5 mm)a
0.9% sodium chloride irrigation (3‐liter bags)
Arthroscopic cautery pencil
Bulb syringe
Sterile VetWrap (2 in)
Scalpel blades (no. 10, 11, and 15)
Scratch pad
Floor suction
Sterile basin
Culturette
Allis tissue forceps (2)
Kelly hemostats (2)
Mosquito hemostats (2)
Small towel clamps (6)
Large towel clamps (4)
Mayo scissors
#3 scalpel blade handle
Rat‐tooth forceps
Adson forceps
DeBakey forceps
Metzenbaum scissors
Needle holder
X‐ray detectable gauze (10)
Hook knife
Obturators for cannulas
Arthroscopy cannula (3.2 mm/4.0 mm)
Cup curette (small)
Graduated black probe
Push knife (2)
Meniscal knife
Kelly hemostat (straight)
Chondro pick (surgical tip, 40 degree, straight)
Ventura stifle distractor
Joint retractor
Joint probe (90‐degree, small)
Stainless steel probe
Spratt curette
Knives handles
Double edge curette
Osteotome (4 mm)
Specialty instruments:
Hook probe
Straight round spoon curette
Alligator grasper
SILCUT® punch (KARL STORZ Endoscopy‐America, Inc., El Segundo, CA)
0.5‐mm scissors punch
Straight cartilage grasper
Articulated lever
3.2 mm × 7 mm Egress cannula
Right and left curve punch
2.75‐mm slender straight punch
2.75‐mm 15‐degree up‐curved straight grasper
Stifle distractor
Double‐edge