Preparation of the Patient for Surgery
Preparation of the patient for surgery include withholding of feed and water, Administration of laxative, purgative or enema etc. these described in detail below.
Make the patient an indoor one to accustom with the environment of ward In ruminants rest for couple of hours lowers the stress (Travel of animal long distances on feet) Emergency case should be attempted immediately General physical examinations should be carried to assess prognosis.
Severe dehydration and debilitation with prominent ribs indicate poor prognosis if general anaesthesia or major surgery is indicated.
Colour of the mucous membrane and capillary refill time are the useful aids in dealing seriously ill patients.
Rectal temperature, pulse and respirations should be recorded.
Palpation, percussion and auscultation help to arrive diagnosis, In a febrile state surgery should be postponed.
Fluid therapy particularly in case of dehydrated and worm-infested animals should be done.
With holding of feed and water in animals before the surgery-
- Large animals: 24-48 Hrs; 12-24 hrs
- Small animals: 12 Hrs.; 4-6 hrs
Administration of laxative, purgative or enema for 2-3 days before operation to evacuate the bowels and fit for general anaesthesia (not recommended in Ruminants).
Surgeons preparation for the patient for surgery
A surgeon must develop his surgical skills and learn from each and every surgical procedure which forms a basis for sound judgment. Judgment means rational analysis for a good decision, whether to operate or not and when to operate, form a part of a surgical judgment.
A surgeon who recognises his short comings, learns from failures of his own and of others, develops a better judgment.
A surgeon has to be bold. He must have the eyes of an eagle, fingers of ladies and the heart of a lion. He must know the difference between a planned and emergency surgery.
It is always preferable to do surgery in an operation theatre, where professional and manual help is adequately available. Open field surgery is a common practice in most developing countries.
A surgeon must be familiar with the surgical anatomy of the part and the surgical procedure. In case of doubt, referring the book will give guidance and confidence.
He must ensure that all equipments, drugs and other items have been arranged properly.
A better approach is to mentally visualize the operation to be done and to make a check list of all items required.
A surgeon must keep records of each and every aspect of a case, which will be useful for the future planning and expansion of the clinic.
The case sheets should be such that there can be stored for future reference and use.
Description of the patient identification marks, owners name and address, history of the case clinical findings type of surgical and postoperative treatment and the outcome should be recorded.
Records can be analysed to work out incidence of various diseases in an area and also to judge the efficacy of the treatment measures adopted. Records will help to identity the technical areas of difficulty.
After surgery, Post operative care should be followed.