Analysis of Surgical Practices: Veterinary Clinical Skills 1 Report

This report provides a comprehensive analysis of a veterinary surgical video, focusing on the practices of the surgical assistant and surgeon. It begins with an overview of the surgical assistant's role in maintaining a sterile environment, facilitating the surgeon's work, and ensuring optimal patient outcomes. The report then details the best practices observed in the video, such as the use of shoe covers, cleaning of the operating table, use of bouffant caps, and the provision of autoclaved surgical packs and sterilized instruments. Conversely, the report also identifies inappropriate practices, including the lack of disposable gloves, surgical gowns, hand scrubbing, and masks worn at the wrong time, along with issues related to animal preparation, sterilization, and post-operative care. Further, the report emphasizes the importance of hand hygiene, the use of personal protective equipment, proper animal preparation, and effective sterilization techniques to prevent contamination and surgical site infections. The reflective summary highlights the key learnings from the assignment, emphasizing the importance of adhering to surgical protocols to prevent adverse reactions and surgical site contamination. The student concludes that the assignment has improved their understanding of surgical procedures and will enhance their capabilities as a veterinary operating assistant.

Running head: VETERINARY CLINICAL SKILLS
Assessment of a surgical video
Name of the Student
Name of the University
Author Note

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Table of Contents
Video analysis..................................................................................................................................2
Best practices...................................................................................................................................4
Reflective summary.........................................................................................................................5
References........................................................................................................................................6

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This assignment will analyse a surgical video and will discuss the good and bad practices
demonstrated by the surgical assistant and the surgeon during the practice.
Video analysis
Surgical assistants are involved in providing assistance in closure of wounds, exposure, and
maintenance of homeostasis, during an operation, which facilitates the surgeons to carry out safe
and effective operation that will ensure optimal outcomes. In addition, a surgical assistant is also
entitled the responsibility of performing pre and post-operative duties. These lead to better care
of the patients. In the aforementioned video, there were some best practices demonstrated by the
surgical assistant. They are as follows:
 The operating theatre is often a messy place and contains several germs. Shoe covers or
waterproof boots are used by surgeons and assistants while entering an operation theatre.
The surgical assistant used a shoe cover as a protective measure that would prevent
contamination with pus and blood. Further, it would help in eliminating dirt particles and
microbes, thereby maintaining a sanitary environment. The shoe cover would also protect
her from body fluids and accidental spills.
 Cleaning serves as one of the most important practices in an operation theatre. The
surgical assistant had removed all unnecessary items from the operation table and had
cleaned all the exposed surfaces with a disinfectant. This would help in killing any
microorganisms that were present on the surface of the table and would prevent
contamination.
 The assistant had used bouffant surgical caps before the operation. Chances of
contamination of the organism would get lowered (McHugh et al., 2014).

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 The assistant gave an autoclaved surgical pack to the surgeon prior the surgery. The pack
contained all sterilized instruments that were placed inside a sealed folded cloth wrap that
had been autoclaved for and steam sterilization. This would further prevent
contamination (Seavey, 2013).
 She used sterilized scissors when asked for by the surgeon. Use of sterilized instruments
was another good practice.
There were some inappropriate practices by the assistant during the surgery. They are as
follows:
 She did not wear disposable gloves. Gloves are one of the most common personal
protective equipments (PPE), and act as barriers in the pathway of microorganism entry.
They are necessary whenever a surgeon or an assistant come in contact with body
secretion or fluids (Garus-Pakowska, Sobala & Szatko, 2013).
 There was no use of aprons or surgical gowns. Surgical gowns function as protective
items and maintain aseptic conditions by inhibiting the transfer of pathogens (Ward et al.,
2014).
 She did not wash or scrub her hands. Infected hands can lead to nosocomial surgical site
infections. However, she did not maintain pre-operative hand hygiene before the surgery
(Harrop et al., 2012).
 She wore masks after the operation had begun. This is inappropriate as masks provide
protection from infection by pathogens.
 There was no evidence of animal preparation and hair clipping. Clipped skin is generally
disinfected with iodine or chlorhexidine to inhibit bacterial contamination.

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 The surgical wrap was not shown to be pre-sterilised and it was touched with bare hands.
This might have led to contamination.
 The post-surgery autoclave temperature was fixed at 184 F, although heavily wrapped
items should be autoclaved at 270 F. This would prevent sterilization of the instruments
(Dancer et al., 2012).
 Although she wore a surgical cap, her head was not completely covered. This would
increase chances of her hair falling on the operation table.
 The animal was brought to the recovery area immediately after the surgery although it
should have been kept under observation for a few hours.
 Warm blankets and heat sources were not provided to the animal. This could lead to post-
surgical hypothermia.
Best practices
Some best practices could have been followed during the surgery to prevent
contamination and surgical site infection. The assistant should have removed her finger rings and
washed her hands with suitable disinfectants. Hand scrubbing is essential before to wearing
gloves to prevent pathogen transfer from the skin to the surgical instruments or the patient
(Widmer, 2013). The hands and arms must have been washed with antimicrobial soap before
proceeding to the operation room. She should have trimmed her fingernails to prevent puncture
of the gloves and further contamination. Long fingernails can tear gloves and lead to infection
(Hayes et al., 2014).
Wearing surgical gown or aprons is another best practice that should have been followed.
Not wearing those lead to a direct exposure of the clothes to the patient drapes, body fluids and

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blood. That increased chances of contamination in both the patient as well as the animal.
Furthermore, preparation of the animal prior to the surgery is one of the most essential steps that
should have been rigorously followed. Animal preparation involves clipping of hair and fur from
the region where the surgery is to be performed. Clippers should have been used parallel to the
skin to clip the hairs in their direction of growth. There was a need to scrub the clipped skin and
rinse it with water that contained a dilute solution of chlorhexidine (Turk, Singh & Weese,
2015). 3 surgical scrub applications should have been used followed by an alcohol cleansing of
the surgical site. Furthermore, the scrub should have been applied in a bull’s eye pattern (towards
periphery).
Reflective summary
From the aforementioned surgical video I learnt that it is extremely essential for surgeons
and the assistants to follow the protocols associated with a surgery in order to prevent any
adverse reactions and surgical site contamination. The VOA assignment provided me with the
opportunity to understand that a surgical team is responsible for preventing contamination in an
operation theatre. They should follow several procedures pre- and post-surgery to ensure that the
organism that has been operated upon is free from any infection.
The assignment gave me a clear understanding of the practices related to hand scrubbing,
disinfection of the operation table, usage of disposable gloves, shoe covers, masks and surgical
caps, which prevent all forms of pathogen entry (Mitchell, Williamson & Molesworth, 2015). I
further learnt that proper sterilization of surgical instruments is essential. The findings will help
me to enrich my surgical capabilities and will improve my performance as a VOA.

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References
Dancer, S. J., Stewart, M., Coulombe, C., Gregori, A., & Virdi, M. (2012). Surgical site
infections linked to contaminated surgical instruments. Journal of Hospital
Infection, 81(4), 231-238. DOI: https://doi.org/10.1016/j.jhin.2012.04.023
Garus-Pakowska, A., Sobala, W., & Szatko, F. (2013). The use of protective gloves by medical
personnel. International journal of occupational medicine and environmental
health, 26(3), 423-429. DOI 10.2478/s13382-013-0095-1.
Harrop, J. S., Styliaras, J. C., Ooi, Y. C., Radcliff, K. E., Vaccaro, A. R., & Wu, C. (2012).
Contributing factors to surgical site infections. Journal of the American Academy of
Orthopaedic Surgeons, 20(2), 94-101. doi: 10.5435/JAAOS-20-02-094.
Hayes, G. M., Reynolds, D., Moens, N. M., Singh, A., Oblak, M., Gibson, T. W., ... & Dewey,
C. (2014). Investigation of incidence and risk factors for surgical glove perforation in
small animal surgery. Veterinary surgery, 43(4), 400-404. DOI: 10.1111/j.1532-
950X.2014.12159.x.
McHugh, S. M., Corrigan, M. A., Hill, A. D. K., & Humphreys, H. (2014). Surgical attire,
practices and their perception in the prevention of surgical site infection. The
Surgeon, 12(1), 47-52. DOI: https://doi.org/10.1016/j.surge.2013.10.006
Mitchell, R. J., Williamson, A., & Molesworth, B. (2015). Use of a human factors classification
framework to identify causal factors for medication and medical device-related adverse
clinical incidents. Safety science, 79, 163-174. DOI:
https://doi.org/10.1016/j.ssci.2015.06.002

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Seavey, R. (2013). High-level disinfection, sterilization, and antisepsis: current issues in
reprocessing medical and surgical instruments. American journal of infection
control, 41(5), S111-S117. DOI: https://doi.org/10.1016/j.ajic.2012.09.030
Turk, R., Singh, A., & Weese, J. S. (2015). Prospective surgical site infection surveillance in
dogs. Veterinary Surgery, 44(1), 2-8. DOI: 10.1111/j.1532-950X.2014.12267.x.
Ward Sr, W. G., Cooper, J. M., Lippert, D., Kablawi, R. O., Neiberg, R. H., & Sherertz, R. J.
(2014). Glove and gown effects on intraoperative bacterial contamination. Annals of
surgery, 259(3), 591-597. doi: 10.1097/SLA.0b013e3182a6f2d9.
Widmer, A. F. (2013). Surgical hand hygiene: scrub or rub?. Journal of Hospital Infection, 83,
S35-S39. DOI: https://doi.org/10.1016/S0195-6701(13)60008-0