A
Absorbable: a classification of suture materials that lose most of their tensile strength within 60 days of being placed in the tissues. Materials that persist for months or years in the body but do NOT have any appreciable strength are still classified as absorbable.
Rapidly absorbable: materials that have significant loss of their tensile strength (amount of lengthwise or pulling force a suture can withstand before it breaks) within 14 days
Slowly absorbable: materials that have significant tensile strength remaining for at least 30 days but lose it by 60 days.
Absorption rate: how quickly a suture is removed from the body, refers to the physical presence of suture not whether there is any strength to the strand that remains. Suture material can have no strength but still be physically present.
Adhesions: bands or sheets of fibrous connective tissue that form as part of the tissue repair process connecting one normal anatomic structure to another when they were previously not connected. Their presence may or may not cause a clinical problem
.
Antiseptics: a substance that inhibits the growth or development of microorganisms but does not necessarily kill them, used to refer to the use of germicidal agents on living tissues.
Appositional: when the wound edges are placed in close proximity similar to how they were positioned before the incision was made.
Asepsis: freedom from exposure to microorganisms; when used in surgery, it refers to the state of surgical sterility acquired by special preparation and covering of the surgical site and sterilization of all instruments.
Aseptic technique: procedures or behaviors designed to prevent contamination of the surgical site by microorganisms.
Autoclave: a machine where high temperature, pressurized steam is produced and circulated killing all living microorganisms and rendering the instrument sterile.
Autoclavable: the ability of an item to withstand the high temperature and pressure used to sterilize it with steam.
B
Backhand grip: a grip used to hold the scissors which allows the scissors to cut more comfortably from left to right.
Backhaus towel clamps: an instrument with ringed handles and sharp curved points designed to attach drapes to the skin of a patient by penetrating both with its sharp points.
Bacteriocidal: an agent that kills bacteria.
Bacteriostatic: an agent that inhibits the growth and multiplication of bacteria.
Bair huggers: device that circulates warm air over the patient to help maintain their body temperature.
Balfour retractors: a self-retaining retractor used to hold the abdominal wall incision open while the surgeon is working in the abdomen.
Bard-Parker handle: a type of handle that holds the scalpel blade and facilitates its use. It comes in several sizes. Common sizes are the #3 handle which holds the #10, #11, #12, #15 blades and the #4 handle which holds the larger blade sizes (#20-25 blades).
Belly of blade: the curved portion of the scalpel blade.
Bite: the motion of passing the needle through (in then out) of the tissue while suturing it.
Box lock: the fulcrum or joint connecting the 2 arms of an instrument.
C
Calculi: abnormal accumulations of minerals in the form of stones within the body of an animal. The singular form of this word is calculus.
Carmalt forceps: shortened or slang term for Rochester-Carmalt forceps.
Cationic bisbiguanide: a group of positively charged chemicals containing phenol. The antiseptic chlorhexidine belongs to this group.
Caudal: directed or situated more toward the tail or posterior end of the body.
Caudal superficial epigastric artery: an artery arising from the external pudendal branch of the deep femoral artery that supplies the skin and mammary glands of the caudoventral abdomen.
Celiotomy: an incision into the abdominal cavity.
Circulating water heating pad: a pad which keeps an animal warm by circulating warm water through it.
Clean surgery: a category within the classification system that groups surgeries according to their level of contamination. A clean surgery is an elective procedure where no acute inflammation is encountered, there is no break is aseptic technique and the gastrointestinal, respiratory or urogenital tracts are not entered. Clean surgeries have a 2.5% rate of postoperative infection.
Clean-contaminated surgery: a category within the classification system that groups surgeries according to their level of contamination. A clean-contaminated surgery is a procedure where there is entry into the gastrointestinal, respiratory or urogenital tracts or there has been a minor break in aseptic technique. Clean-contaminated surgeries are associated with a 4.5% rate of postoperative infection.
Closed gloving technique: a technique for putting on sterile surgical gloves where the hands remain within the sleeves or cuff of the gown. See Lab5.
Contaminated: a surface or structure where microorganisms are present.
Contaminated surgery: a category within the classification system that groups surgeries according to their level of contamination. A contaminated surgery is a procedure involving a fresh traumatic wound less than 4 hours old, a surgery where there is major spillage from the gastrointestinal or urogenital tracts or there has been a major break in aseptic technique. Contaminated surgeries are associated with a 5.8% rate of postoperative infection.
Continuous: a suture pattern consisting of a single strand of suture with knots only at the beginning and the end of the pattern.
Counted brush strokes method: a method of scrubbing where the surgeon counts the number of strokes used to clean each area of the hands and arms in order to ensure all areas are cleaned and exposed to the antiseptic for the desired length of time.
Cruciate patterns: an interrupted appositional pattern where a cross is formed on the surface of the skin before the suture is knotted and cut.
Corpus luteum: a firm purplish glandular mass in the ovary formed by the ovarian follicle after ovulation.
Cranial: directed or situated towards the head (cranium) or the front end of the body.
Cranioventrally: directed or situated toward the front part of the underneath surface of the abdomen or chest.
Crile hemostatic forceps: A surgical clamp used to constrict blood vessels that has interdigitating striations for the entire length of its jaws.
Cutaneous trunci muscle: a large thin muscle just beneath the skin that covers most of the thorax and abdomen of the animal. It is responsible for twitching the skin.
Cystotomy: making an incision through the bladder wall into the lumen.
D
Dead space: a pocket or space created in the tissues by disrupting their fine connective tissue attachments. It has the potential to accumulate fluid (termed a seroma).
Dehisce: incision opens up. This occurs when the sutures tear through the tissues, the suture breaks or knots untie.
Dehiscence: incision opens up due to failure of the surgical closure or wound healing.
Dirty surgeries: a category within the classification system that groups surgeries according to their level of contamination. A dirty surgery is a procedure involving a perforated viscus, acute bacterial inflammation or pus, a traumatic wound more than 4 hours old or having devitalized tissue or foreign bodies present. Dirty surgeries are associated with an 18.1% rate of postoperative infection.
Disinfectant: agents that kill microorganisms (not always all viruses or spores), used to refer to the use of germicidal agents on inanimate objects.
Dominant hand: hand that you naturally write and do most actions with.
Dorsal: directed or situated towards the spine
Duodenocolic ligament (or fold): a mesenteric fold that attaches the mesoduodenum to the mesocolon.
E
Edna clamps: a ringed surgical clamp with curved wide jaws used to attach tubing or instruments to drapes without penetrating the drape. They should not be used on skin because of their strong crushing action.
Encapsulated: surrounded by fibrous tissue.
Everting: turns the wound edges outwards, towards surgeon.
Eyed needle: a needle with a hole in one end through which the suture material can be threaded.
Exteriorize: Bringing an internal structure to the outside of the body. Generally this is a safer technique as it avoids accidental injury to surrounding structures by the instruments, suture or excessive retraction or manipulation.
F
Falciform fat: a ventral fold of peritoneum, typically containing a large amount of fat, that is a remnant of the embryonic ventral mesentery passing from the umbilicus to the diaphragm.
Fingertip grip: a grip used to hold the scalpel where the scalpel handle is held between the thumb and middle finger with the index finger placed along the top surface of the handle or blade.
G
Gastrotomy: a surgical incision through the stomach wall into the lumen.
Granny knot: a knot where the ends of the suture come out on different sides of the loop. It is tied by placing identical throws repeatedly rather than reversing directions with successive throws. The granny knot should NOT be used in surgery because it has a tendency to untie.
H
Half-hitch knot: a knot where one strand forms loops around the other strand which remains straight. It is a square knot where one end has been pulled upwards or harder than the other end. It should not be used to secure suture because it is prone to slipping.
Halstead mosquito hemostatic forceps: a specific small ring-handled surgical clamp with a ratchet locking mechanism used to constrict small blood vessels.
Hand ties: the process of forming a surgical knot using only the hands (no instruments).
Hemostats: a group of ring handled surgical clamps with a ratchet locking mechanism that are used to constrict blood vessels.
Herniation: bnormal protrusion of an organ or tissue through an opening. This is a photo of a diaphragmatic hernia where liver is herniating through a defect in the right diaphragm.
Hydrolysis: destruction of chemical bonds by the addition of water.
Hyperadrenocortism: a disease where there is increased secretion of corticosteroids from the adrenal cortex.
Hypoproteinemia: a state where there is decreased amounts of protein in the blood.
Hypothermia: a low body temperature(below 37.5 degrees Celsius).
I
Imbricate: to tighten up the tissue by overlapping it.
Immediate efficacy: how many skin microorganisms mechanically removed or inactivated by an antiseptic within 60 seconds.
Interdigitation: interlocking of parts by alternating sets of grooves or finger-like processes.
Interrupted: A series of individual sutures that each take only one or two bites on either side of the incision before suture is knotted and cut.
Instrument ties: the process of tying a surgical knot using a needle holder.
Intussusception: prolapse of one segment of the intestine into the lumen of an immediately adjacent section.
Inverting: turns the wound edges inward, away from surgeon.
J
Jaws: the short thick tips of a clamp above the box lock that grasps structures.
K
Kelly hemostatic forceps: a surgical clamp used to constrict blood vessels with interdigitating striations on only the half of the jaw closest to the tips.
L
Laparotomy: incision through the flank or as more commonly used through any part of the abdominal wall.
Lateral: directed or situated farther away from the middle of a structure, towards the side
Ligature: a suture applied around a vessel or tubular structure tightly enough to obliterate the lumen.
Ligate: the process of placing a suture around a vessel or tubular structure tightly enough to obliterate the lumen.
Locking mechanism: an interlocking series of steps or ratchets found on the shanks of surgical clamps that when engaged maintain the instrument tips in a locked position. Label of parts.
Lorna clamps: a specific type of ringed surgical clamp similar to an Edna clamp with curved wide jaws used to attach tubing or instruments to drapes without penetrating the drape. They should not be used on skin because of their strong crushing action.
M
Memory: a suture’s ability to retain bends or kinks instead of remaining straight.
Mesocolon: mesentery that connects the colon to the dorsal body wall.
Mesoduodenum: mesentery connecting the duodenum and right lobe of the pancreas to the dorsal abdominal wall and the root of the mesentery.
Moist contamination or Strike-through: the ability of a drape to provide an effective barrier between sterile and contaminated areas is lost when the drape becomes wet. As a result, a wet drape is considered contaminated. To remain an effective barrier in the presence of fluid, a drape must be pre-treated with a chemical to waterproof it. With these drapes, fluid remains as droplets on the surface rather than wetting the fabric so they remain effective barriers throughout the surgery.
Monofilament suture: material used for suturing that is composed of a single strand or fiber.
N
Needle eye: a hole in one end of the needle through which the suture material can be threaded.
Needle holders: a ring-handed surgical instrument designed to hold the needle while suturing, also referred to as a needle driver.
Needle drivers: a ring-handed surgical instrument designed to hold the needle while suturing, also referred to as a needle hold.
Nosocomial infection: an infection (cellular response and injury secondary to the invasion and multication of microorganisms) that is acquired while a patient is hospitalized or within 30 days of surgery.
Nidus: site where the infection can persist protected from the body’s defense mechanisms and antibiotics.
Nonabsorbable: suture materials that maintain their original tensile strength for at least 60 days. Some nonabsorbable materials lose tensile strength over prolonged periods (eg. silk) while others maintain their original strength and are walled off by fibrous tissue.
O
Open gloving: the process of putting gloves on in a sterile manner while the hands are protruding through the cuffs of the gown.
Ototoxic: having a harmful effect on the eighth cranial nerve (vestibulocochlear) or the organs of hearing or balance.
Ovarian follicle: the egg and its surrounding cells and fluid at various stages of development.
Ovarian pedicle: ovarian vessels and the associated fat and mesentery that attach the ovary to the dorsal aspect of the animal’s abdomen.
P
Palm grip: a strong grip used to hold the scalpel where the scalpel handle is supported in the palm of the hand with the fingers wrapped around the handle. The entire arm is moved when incising tissues so it facilitates cutting through very tough tissues like bovine skin.
Pancreatitis: inflammation of the pancreas, a gland that produces the digestive enzymes and hormones like insulin and glucagon.
Paramedian: just to one side of midline. In the case of the ventral abdomen, a paramedian incision would be just to one side of the linea alba so the individual layers of the abdominal wall (external rectus sheath, rectus muscle and internal sheath/peritoneum) would be visible.
Pedicle: a stem-like or narrow part. In the case of an ovarian pedicle, it is the ovarian vessels and the associated mesentery and fat that attach the ovary to dorsal aspect of the animal.
Pencil grip: when a surgical instrument, usually the scalpel blade, is held like a pencil with the blade supported by the thumb and index finger and the handle resting on the space between the two digits.
Persistent antimicrobial effectiveness: ability to prevent recolonization of skin with microorganisms up to 6 hours after an antiseptic has been applied.
Phagocytosis: engulfing of microorganisms, cells or foreign material by macrophages.
Povidone-iodine: an antiseptic composed of iodine complex with a synthetic polymer called polyvinylpyrrodlidine.
Preputial muscles: a distinct development of the cutaneous trunci muscle in the male dog that runs on either side of ventral abdominal midline to the prepuce. It supports the cranial end of the prepuce and pulls the end of the prepuce back over the tip of the glans penis after erection. It is important to ensure this structure is distinquished from the external rectus sheath and linea alba as it can be mistake for these structures during closure.
Press cutting: process of applying pressure to the tip of a scalpel blade in order to make an incision.
Pubis: a flat thin bone forming the front portion of the floor of the pelvis.
Pyometra: accumulation of pus in the uterus.
Q
R
Rapidly absorbable: a suture material that loses a significant portion of its tensile strength within 14 days of implantation.
Ratchet: the interlocking series of steps found on the shanks of surgical clamps that when engaged maintain the instrument tips in a locked position.
Ratchet locking mechanism: an interlocking series of steps found on the shanks of surgical clamps that when engaged maintain the instrument tips in a locked position.
Residual action: the cumulative antimicrobial effectiveness exhibited by an antiseptic after it has been used for at least 5 days.
Retractor: a surgical instrument which holds tissue out of the surgeon’s way so they can see or work better. This is an example of a Balfour retractor.
Ringed handles: circles on the shanks of some surgical instruments through which the tips of fingers are inserted to support the instrument.
Rochester-Carmalt forceps: a large ring-handled hemostatic clamp whose long tips have longitudinal interlocking grooves.
S
Self-retaining retractors: surgical instruments that hold tissues out of the way without needing to be held.
Septic: an inflammatory process associated with the presence of pathogenic microorganism or their toxins in the blood or tissues.
Seroma: a pocket or accumulation of fluid within the tissues.
Shanks: the arms of a surgical instrument connecting the handles to the box lock.
Skin squames: scale like flakes of the surface layer of the skin.
Slide Cutting: the technique for making an incision where pressure is applied to the scalpel blade as it is drawn across the surface of a tissue.
Slowly absorbable: a suture material where significant tensile strength remains for at least 30 days, but is lost by 60 days.
Spay hook: a surgical instrument with a curved hook at one end designed for grasping and elevating the uterus from the abdominal cavity.
Square Knot: a surgical knot created by reversing the direction of successive throws so that each end passes on the same side of the loop. It is essentially a series of reef knots.
Stay suture: a strand of suture that is passed full thickness through a tissue to allow it to be retracted or manipulated.
Stents: pieces of rubber tubing, foam or buttons that are placed under the surface loop of a suture (eg. vertical or horizontal mattress) when significant tension is present to reduce the potential of the suture pulling through the skin.
Sterile: the complete absence of microorganisms (bacteria, viruses and spores). Refers to inanimate objects that can be subjected to moist or dry heat, gas, chemicals or radiation in order to kill all living organisms on it.
Stratum corneum: surface layer of skin.
Strike-through or moist contamination: the ability of a drape to provide an effective barrier between sterile and contaminated areas is lost when the drape becomes wet. As a result, a wet drape is considered contaminated. To remain an effective barrier in the presence of fluid, a drape must be pre-treated with a chemical to waterproof it. With these drapes, fluid remains as droplets on the surface rather than wetting the fabric so they remain effective barriers throughout the surgery.
Subungual: area under the fingernails.
Superficial cornified layers: the surface layer of the skin.
Surgeon’s knot or throw: a type of surgical knot where during the first throw, one strand of suture is wrapped twice around the tip of the needle holders before grasping the other suture end and pulling it through (ie. strand travels under and over and under and over the other strand before it is tightened). This increases the friction between the two strands so they are less likely to loosen before the second standard throw can be placed. The completed knot required one additional throw more than a square knot because the extra bulk prevents the same amount of tightening. The final knot is larger than a standard knot (extra wrap and throw) so should be used only when necessary.
Surgeon’s throw: the first throw of a surgeon’s knot where the suture is wrapped twice around the tip of the needle holder before grasping the other suture end and pulling it through. It increases the friction between the two strands so that they don’t loosen before the next standard throw can be placed.
Surgically clean: the surface of a living structure where microorganisms have been reduced to the lowest possible number by the surgical preparation procedure. Recolonization occurs from microorganisms surviving within the hair follicles and on the periphery of the prepared area.
swaged-on: a process where the suture material is permanently attached to the end of a surgical needle by placing the suture into the hollow needle end and crimping it.
Swaged needles: needle where suture has been permanently attached to one end of it.
T
Tensile strength: a measure of the amount of force applied lengthwise (ie. pulling) that material can withstand before breaking.
Thrombosis: formation or presence of a clot within a vessel.
Throw: the motion of wrapping the strands of the suture around each other and tightening them.
Timed anatomic scrub: a technique of scrubbing where the total scrub duration is determined by scrubbing each part for a set amount of time.
Tinctures: a solution of a chemical that also contains alcohol.
Tip of blade: the point of the scalpel blade.
Tissue drag: how easy a strand of suture material slides through the tissue when it is being pulled. Materials with significant tissue drag grip or stick to the tissue as they are being pulled through, so more force is needed to pull them through the tissue. They create more tissue trauma than those which slide through easily.
Trailing: applying tension to the strand while suturing a continuous pattern so that it does not loosen between successive bites. This can be done either by an assistant or by placing the suture between the ring and baby fingers of the surgeon’s dominant hand.
Transfixation ligature: a suture placed through the substance of a pedicle or vessel as well as around it in order to anchor it (minimize potential for slippage) as well as constrict the vessel.
Tungsten-carbide tips: a specialized durable metal tip on some needle holders that is more resistant to damage from the needles.
Umbilicus: scar remaining from where the umbilical cord attached to the fetus.
Undermining: separating a tissue (eg. skin) from its underlying tissue attachments so it can be moved or repositioned.
Ungual: referring to the nails.
USP (United States Pharmacopeia): a legally recognized collection of standards for drugs and medical products.
Vacuum-activated positioning bags: a plastic bag containing beads able to maintain the animal in a specific position when all the air has been removed from the inside by a vacuum device.
Ventral: directed or situated toward the underneath surface of the abdomen or chest.
Wide-based tripod grip: the standard way of holding scissors and ringed clamps where the thumb and ring finger are placed in the rings and the index finger is placed towards the fulcrum or box lock.
Wrap: to circle the stand of suture material around the tips of a needle driver.
Xiphoid: the sword-shaped caudal end of the sternum that is composed of cartilage.
U
Umbilicus: scar remaining from where the umbilical cord attached to the fetus.
Undermining: separating a tissue (eg. skin) from its underlying tissue attachments so it can be moved or repositioned.
Ungual: referring to the nails.
USP (United States Pharmacopeia): a legally recognized collection of standards for drugs and medical products.
X
Xiphoid: the sword-shaped caudal end of the sternum that is composed of cartilage.