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VEM5432 Advanced Small Animal Surgery SEMESTER: FALL 2019 CREDIT HOURS: 3 CREDIT HOUR GRADING SYSTEM: A-E GRADING PHASE: 3 Course Coordinator Name: Daniel D

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VEM5432 Advanced Small Animal Surgery SEMESTER: FALL 2019 CREDIT HOURS: 3 CREDIT HOUR GRADING SYSTEM: A-E GRADING PHASE: 3 Course Coordinator Name: Daniel D 7/26/2019 2:52 PM 1 VEM5432 Advanced Small Animal Surgery SEMESTER: FALL 2019 CREDIT HOURS: 3 CREDIT HOUR GRADING SYSTEM: A-E GRADING PHASE: 3 Course Coordinator Name: Daniel D. Lewis, DVM, DACVS Office: SAH-365 Phone: 352-294-4426 Email: [email protected] Office Hours: By appointment only. Course Description Problem-oriented topics and lectures in small animal surgery. Soft tissue surgery topics including skin, oral cavity, nasal/mandible, esophagus, head/neck, intestine, thoracic cavity, urinary tract, liver/spleen; handling chest and abdominal trauma, reconstruction, and neoplasms. Orthopedic topics include basic and advanced principles and techniques of fracture management as well as reconstructive techniques of musculoskeletal abnormalities affecting small animals. This course is designed to give the student a sound clinical understanding of a canine and feline soft tissue and orthopedic surgery. The course is targeted at students following the small animal tract, but many of the principles taught in this course can and do apply to other species. The course will emphasize a practical approach to commonly encountered clinical problems. Student Learning Outcomes After successful completion of this course, students will be able to: 1. Introduction to Cutaneous & Reconstructive Surgery • Know the anatomy and functions of the skin. • Understand the blood supply to the skin in dogs and cats. • Know wound classification and significance. • Understand tension, tension lines, how to use them in the dog and cat. • Understand the principles of reconstructive cutaneous surgery; tissue handling, needle selection, suture material, and suture patterns. • Know different local” wound closure techniques. UF | COLLEGE OF VETERINARY MEDICINE 7/26/2019 2:52 PM 2 2. Cutaneous Surgery: Advanced Techniques • Understand classification of skin flaps. • Understand the principles of axial pattern flaps. • Understand the pathophysiology and principles of free skin grafting. • Know appropriate skin closure techniques for wounds with extensive tissue loss and/or limited local tissue for closure (i.e. distal extremities). • Know different local” wound closure techniques. 3. Fracture Mechanics, Classification & Healing • List the basic forces which cause fractures and what fracture patterns typically is associated with each force. • Draw a basic stress/strain or load/deformation curve and label the major components and points of the curve. • Rate bone’s resistance to failure in tension, compression, and shear forces. • Classify and describe a fracture based on its radiographic appearance. • Grade open fractures. • Classify growth plate fractures according to the Salter-Harris classification scheme, and discuss the significance of this classification scheme with regard to premature growth plate closure and prognosis. • Name the zone of the growth plate that Salter-Harris fractures typically traverse, and why this zone is biomechanically weak. • List the clinical and radiographic criteria that allow one to diagnosis a fracture. • Describe in detail the clinical, radiographic, and histologic events of 1o and 2 o fracture healing. 4. Lecture 5 Decision Making in Fracture Management • Understand the principles assessing fractures. 5. Management of Difficult Wounds • Have the ability to correctly classify a wound. • Be able to choose the appropriate wound management for the different wound classifications. • Have a thorough understanding of the wound healing process. • Understand the principles of basic wound management in each stage of healing. • Be able to recognize common causes of delayed or chronic wound healing. • Be familiar with the variety of wound care dressings and adjuncts and indications for using each, including: Wet-to-dry Hydrophilic dressings Sugar and honey Vacuum-assisted wound closure − Maggot therapy − Low-level laser therapy − Silver − − − • Know different local” wound closure techniques − UF | COLLEGE OF VETERINARY MEDICINE 7/26/2019 2:52 PM 3 6. Fractures of the Pelvis & Sacrum • Understand the pelvic anatomy and diagnose fractures/luxations from radiographs. • Understand and be able to apply the criteria which determine if a given pelvic fracture or fracture configuration can be managed non-surgically. • Be familiar with a lateral approach to the ilium and a greater trochanteric osteotomy approach to the acetabulum. • Understand surgical fracture fixation options for sacroiliac fracture/luxations, ilial shaft, acetabular and ischial fractures. • Be aware of soft tissue and neurovascular injuries and complications relevant to pelvic fractures. 7. Lecture 7/8 Ear Surgery • No objectives given. 9. Surgery of the Head & Neck • Know the indications for and procedure for esophagostomy. • Be familiar with surgical anatomy for esophagostomy, thyroidectomy, and mandibular/ sublingual sialoadenectomy. • Be familiar with the diseases that indicate thyroidectomy. • Understand the principles of pre and postoperative care of thyroidectomy patients. • Understand the role of parathyroid hormone in calcium regulation. • Know the clinical signs, treatment options, and prognosis for dogs with primary hyperparathyroidism. • Know the types of salivary mucoceles and how their treatments differ. • Be familiar with diagnosis, and perioperative care of dogs with salivary mucoceles. 10. Cleft Palate & Oronasal Fistulas • To understand the etiology, incidence, clinical signs, indications, techniques, postoperative care and complications associated with correction of cleft palate and oral nasal fistulas. 11. Fractures of the Femur • Diagnose and classify femur fractures from radiographs. • Be familiar with the craniolateral approach to the hip and lateral approach to the shaft of the femur. • Understand fracture fixation options for femoral physeal fractures, femoral neck fractures, and femoral diaphyseal fractures. • Formulate an appropriate surgical plan for a given femoral fracture and associated fracture assessment score. • Be aware of complications relevant to femoral fractures. • Describe how one would assess femoral and sciatic nerve function. • Understand why Schroeder-Thomas splints should not be used for femoral fractures. UF | COLLEGE OF VETERINARY MEDICINE 7/26/2019 2:52 PM 4 12. Distal Hindlimb Fractures: Tibia & Fibula • Diagnose and classify tibial and fibular fractures from radiographs. • Describe the medial approach to the diaphysis of the tibia. • Suggest appropriate fracture fixation options for physeal diaphyseal tibial fractures. • formulate an appropriate surgical plan for a given tibial fracture and associated fracture assessment score. • Describe potential complications relevant to tibial fractures and their repair. 13. Surgical Diseases of the Esophagus • Familiarize yourself with the anatomy and normal and abnormal swallowing mechanisms of the esophagus. • Be able to differentiate between the different neuromuscular and mechanical obstructions of the esophagus in terms of radiographic signs, clinical signs and surgical remedies. • Know which diagnostic tests are to diagnose the different disease conditions discussed in the lecture. • Know the different approaches to the esophagus. • Know principles of esophageal suturing and complications associated with esophagotomy and resection and anastomosis. • Know the radiographic diagnosis for PRAA and how it is treated surgically. 14. Surgery of the Stomach and Pylorus • Describe the normal anatomy of the stomach. • Interpret the basic techniques involved with gastric and pyloric surgery. • Discuss the diagnosis and management of gastric foreign bodies. • Describe the diagnosis and management of pyloric outflow obstruction. 15. Forelimb Fractures: Scapula & Humerus • Diagnose and classify scapular fractures from radiographs. • Be familiar with an approach to the craniolateral region of the shoulder joint and muscular attachments to the scapula. • Understand fracture fixation options for scapular body and neck fractures. • Formulate an appropriate surgical plan for a given scapular fracture and associated fracture assessment score. • Know indications for surgical repair of scapular fractures and why some can be managed conservatively. 16. Forelimb Fractures: Radius, Ulna & Carpus • Diagnose and classify radius and ulna fractures from radiographs. • Be familiar with the medial and lateral approach to the shaft of the radius. • Understand fracture fixation options for radius/ulnar fractures. • Formulate an appropriate surgical plan for a given radius/ulnar fracture and associated fracture assessment score. • Know considerations relevant to distal radial fractures in small breeds. • Know the definition of Monteggia fractures. UF | COLLEGE OF VETERINARY MEDICINE 7/26/2019 2:52 PM 5 17. Fractures of the Maxilla & Mandible • List the preoperative considerations that are important for an animal with a mandibular or maxillary fracture. • State which is the tension surface of the mandible and what forms of fixation utilize the mechanical properties inherent to this surface. • State what is the most important consideration in repairing fractures of the maxilla and mandible. • Discuss why it is advisable to intubate animals with complex intraoral fractures through a pharyngotomy or via a tracheotomy. • Describe how to perform a pharyngotomy for intubation. • Describe how tape muzzles are utilized for fractures of the maxilla and mandible. • Describe how to stabilize mandibular symphyseal fracture-separations. • Describe how an acrylic external fixator would be constructed to stabilize a complex mandibular
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