Department of Comparative Medicine Aseptic Surgery Technique Guidelines

Aseptic surgery technique includes the following elementsto prevent cross contamination during surgery:

  • Use and maintenance of sterile instruments.
  • Appropriate surgical preparation of the animal.
  • Appropriate location for conducting the surgery.
  • Use of sterile gloves and other appropriate surgeon surgical attire.

Sterile instrumentsare required for ALL survival surgeries.

Specific sterilization methods should be selected on the basis of the physical characteristics of the materials to be sterilized. Instruments and other materials may be sterilized by:

  • Autoclave (steam) - Use of laboratory autoclaving units is allowed, however DCM must be informed in order to validate that autoclaves are properly sterilizing. Contact DCM at 4-2452 for further information.
  • Gas (ethylene oxide) - Contact DCM at 4-2443 for further information.
  • Dry heat(glass bead sterilizer)-This method is recommended for instrument sterilization between serial survivalrodent, bird, reptile, amphibian, or fish surgeries. Existing units may be available for use; contact DCM at 4-2443 for further information.
  • While glass bead sterilizers (GBSs) can be used between serial surgeries on the above listed animals, instruments must initially be autoclaved or gas sterilized. A new sterile pack must be used every day, unless there is a break in sterility (in this case, a new pack is required immediately).In order to achieve instrument decontamination using the GBS, the following steps must be followed:
  • Turn unit on 30 minutes prior to use
  • Handle and place instruments on sterile field aseptically for each use
  • Use sterile saline, 70% ethanol, or isopropyl alcohol to wipe instruments prior to GBS decontamination
  • Maximum of 2 instruments in GBS at a time, with 1 instrument for 15s and 2 instruments for 30s
  • Allow instruments to cool prior to next surgery
  • Number of surgeries per pack determined during AUP approval by skill and training of person performing the surgeries
  • Chemical(various)-The required contact time varies with the agent used. Some chemicals used are hazardous (carcinogenic) to humans.Instruments disinfected by liquids must be handled aseptically, rinsed in sterile water/ saline, and dried with a sterile towel before surgical use.For additional information and guidance, contact DCM at 4-2443.
  • Contact time of >10 hours is needed for destruction of spores; therefore, immersion in a liquid sterilant is not recommended.
  • Alcohol is NOT considered an acceptable immersion sterilant.

Survival Surgical Procedures in Non-rodent Mammals

1. Sterile instruments-see above

2. Preparation of Incision Site

  1. Hair/fur must be removed from the surgical site by plucking,clipping, or depilatory agents, as appropriate. This must be performed in a location separate from the surgical room.
  2. Three consecutive preps of povidone-iodine (or other appropriate skin disinfectant such as chlorhexidine) scrub must be performed,with each scrub followed by an alcohol rinse. The center of the clipped area is scrubbed first, and then the scrubbing is continued in concentric circles to the outer edges of the clipped area.Following the last alcohol rinse, the surgery site is sprayed with a povidone-iodine solution.
  3. Following preparation of the surgical site, the area isaseptically drapedto help prevent contamination of the site.

3. Location for surgery

Major surgical procedureson non-rodentmammals must be conducted in a dedicated surgical facility. Contact DCM for schedulingat 4-2443.

A major survival surgery is defined as one that “penetrates and exposes a body cavity, produces substantial impairment of physical or physiologic functions, or involves extensive tissue dissection or transection.”

4. Surgical attire

Survival surgery on non-rodent mammals requiresappropriate hand scrubbing techniques for surgeon preparation, the use of sterile gloves, scrubs, facemasks, and head coverings. For major survival surgical procedures, the surgeon must also wear a sterile surgical gown.

SurvivalSurgical Procedures in Rodents

1. Sterile instruments-see above

2. Preparation of Incision Site

  1. Hair/fur must be removed from the surgical site by plucking,clipping, or depilatory agents, as appropriate. This must be performed in a location separate from the surgical area.
  2. Three consecutive preps of povidone-iodine (or other skin disinfectant such as chlorhexidine) scrub should be performed,with each scrub followed by an alcohol rinse. The center of the clipped area is scrubbed first, and then the scrubbing is continued in concentric circles to the outer edges of the clipped area. Asterile cotton swab can be used for small rodents. Following the last alcohol rinse, a final application of povidone-iodine solutioncan be made.

It is critical that rodents are not soaked with prep solutions, which can lead to hypothermia.

  1. Following preparation of the surgical site, the area should be aseptically draped to help prevent contamination of the site.

3. Location for Surgery

Rodent survival surgeries should be performed in a dedicated facility or space and must be conducted using aseptic technique. Rodent surgery may be conducted in a portion of a laboratory or procedure room that provides separation from other activities and is a dedicated surgical space for the surgical procedure. Consideration should be given to the species, the nature of the procedure, and the potential for physical impairment or post-operative complications such as infection. The surface on which surgery is conducted must be sanitizable.

4. Surgical attire

Rodent survival surgery must be performed using sterile gloves, a clean lab coat or gown, and a facemask. A head covering is recommended to reduce the risk of stray hair falling into the operative field.

Survival Surgical Procedures in Birds,Reptiles,Amphibiansand Fish

Birds

1. Sterile instruments-see above

2. Preparation of Incision Site

For birds, feathers must be removed from the surgical area. This is accomplished by plucking feathers from the immediate operative site, then gently separating the feathers along the feather tracts and carefully securing them in place with adhesive tape strips. Povidone-iodine (or other skin disinfectant)solutionmust be used; do notuse soapy scrubs or alcohol, as these will strip protective oils from the skin. Following preparation of the surgical site, the area should be draped to help prevent contamination of the site.

3. Location for surgery

Bird survival surgeries should be performed in a dedicated facility or spaceand must be conducted using aseptic technique. The surface on which surgery is conducted must be sanitizable.

4.Surgical attire

Bird survival surgery should be performed using sterile gloves, a clean lab coat or gown, and a facemask. A head covering is recommended to reduce the risk of stray hair falling into the operative field.

Reptiles

1. Sterile instruments-see above

2. Preparation of Incision Site

Three consecutive preps of povidone-iodine (or other skin disinfectant) scrub should be performed, with each scrub followed by an alcohol rinse. The center of the surgical area is scrubbed first, then the scrubbing is continued in concentric circles to the outer edges. A sterile cotton swab can be used for small reptiles.Following preparation of the surgical site, the area should be draped to help prevent contamination of the site. Please consult with DCM (4-2420) on surgical approaches and closure techniques in reptiles.

3. Location for Surgery

Reptile survival surgeries should be performed in a dedicated facility or spaceand must be conductedusing aseptic technique. The surface on which surgery is conducted must be sanitizable.

4. Surgical attire

Reptile survival surgery must be performed using sterile gloves, a clean lab coat or gown, and a facemask. A head covering is recommended to reduce the risk of stray hair falling into the operative field.

Amphibians and Fish

1. Sterile instruments-see above

2. Preparation of Incision Site

The mucus layer covering the skin should be disturbed as little as possible. Amphibians and fish should be prepped one time with either a dilutepovidone-iodine or a 0.75% chlorhexidine(diluted from 2% chlorhexidine)solution. In amphibians, benzalkonium chloride (2 mg/ml) may also be used as a skin disinfectant. The incision site should be gently sponged of mucus or other debris prior to applying the disinfectant. A sterile saline rinse follows the disinfectant step. The skin should be kept moist during surgery. This can be accomplished with moistened gauze sponges and/or a plastic drape. The skin is highly permeable and water loss will be significant if the skin dries out, which can lead to postoperative complications.

3. Location for surgery

Amphibian/fish survival surgeries should be performed in a dedicated facility or spacemust be conducted using aseptic technique. The surface on which surgery is conducted must be sanitizable.

4. Surgical attire

Amphibian/fish survival surgery should be performed using sterile gloves, a clean lab coat or gown, and a facemask. A head covering is recommended to reduce the risk of stray hair falling into the operative field.

Non-Survival Surgical Procedures (animal does not wake up from the surgery)

1. Instruments

It is not necessary to use sterile instruments in non-survival surgical procedures,

however,the instruments used should be clean and free of any gross debris.

2. Preparation of Incision Site

Incision site should be clipped and clean enough to provide adequate visualization for

the procedure to be performed.

3. Location for Surgery

The procedure should be performed in a sanitizable area.

4. Surgical attire

The surgeon should wear clean scrubs or a lab coat, and gloves.

Revision Date:March 12, 2014 and December 19, 2016

AV Approval:Dorcas O’Rourke, DVM – December 19, 2016

IACUC Approval Date:December 19, 2016