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Surgery Policy and Guidelines

Policy

Definitions

Guidelines

Record-Keeping Requirements

Training

Veterinary Outreach


Policy

Successful surgical outcomes in research animals of all species (including mice and rats) require the same techniques and procedures as in any veterinary practice.  Proper aseptic techniques must be employed to prevent surgical-related infections, and appropriate anesthetics and analgesics must be used to prevent or mitigate pain, distress and discomfort.  Researchers performing surgical procedures in all animals must adhere to the following:

  • All survival surgeries (major and minor) must be performed using aseptic techniques
  • Non-survival surgical procedures do not require aseptic techniques or dedicated facilities, but should be performed in a clean, clutter-free area.
  • Major survival surgical procedures on non-rodents must be performed only in dedicated surgical facilities.
  • A single animal may not undergo more than one major survival surgery unless the multiple procedures are required to meet the objective of a single animal research activity, justified for scientific reasons and approved by the IACUC.  (See Multiple Survival Surgery policy).
  • All surgeries must be performed by qualified, trained personnel using techniques that avoid or minimize pain (e.g., adequate anesthesia and analgesia).
  • Research personnel must maintain adequate intra-operative (e.g., during the surgery) and post-operative monitoring records. IACUC members and veterinary staff may request copies of all such records for review without prior notice.

Definitions

  • Aseptic Technique -  practices and procedures used to reduce microbial contamination to the lowest possible level. This includes the use of sterile gloves, sterile instruments (via autoclaving, ethylene oxide, cold sterilants, hot-bead sterilizer, etc.), animal prep (hair removal if necessary, then cleaning and disinfecting the skin with alcohol, followed by a chlorhexidine or povidone iodine-based disinfectant) and the use of a sterile surgical drape when possible.
  • Dedicated Surgical Facility – A dedicated surgery suite always includes separate areas for animal preparation, surgeon preparation, and surgery.  These areas are set up to be cleaned and maintained in an aseptic condition (e.g., all room surfaces are non-porous and easily sanitized).
  • Terminal (non-survival) Surgery – A procedure in which the animal is euthanized prior to recovery from anesthesia.
  • Survival Surgery – An operative procedure after which the animal recovers from anesthesia.
  • Major surgical procedure – Any operation that penetrates and exposes a body cavity OR any procedure that produces permanent impairment of physical or physiological functions.  Minor laparoscopic procedures, craniotomies and other relatively minor surgical procedures that may penetrate a body cavity will be reviewed by the IACUC on a case-by-case basis.
  • Minor surgical procedure - Any operation other than those considered major surgical procedures.

Other Guidelines

  • Eyes should be lubricated with a sterile ophthalmic ointment to prevent corneal drying.
  • Supplemental heat should be provided during surgery and recovery as animals lose their ability to regulate body temperature while under general anesthesia.
  • Sterile gloves must be used for all survival surgery.
  • All instruments must be sterile at the start of surgeries.  A hot bead sterilizer may be used between different animals.  Use of alcohol as the primary means of sterilization is NOT adequate.
  • Skin sutures or staples must be removed 10-14 days after surgery, once the incision has healed. 
    • Sutures may need to be removed earlier if inflammation or other adverse effects are present.
    • If the animal(s) will be euthanized within 28 days of the surgery, the sutures do not need to be removed.

Record-Keeping Requirements

Intra-Operative Records must include the following information: 

  • Animal identification-- species and animal identification.
  • Body weight at the start of the procedure (this can be an estimate for mice, e.g. 25 or 30 gm).  This may be required for precise calculation of dosages (anesthetics, analgesics, antibiotics, etc.)
  • Name of the surgeon.
  • Description of surgical procedure.
  • Details of all medications given to the animal, including dosage, route, and time of administration
  • Notes concerning any complications encountered.
  • Euthanasia method (terminal surgeries only)
  • Researchers are encouraged to use or modify one of the following template forms:
Post-Operative Monitoring Records must include the following: 
  • Details of all care and monitoring provided to the animal such as wound cleaning, bandage changes, flushing of indwelling catheters, body temperature, heart rate, etc., as described in the approved IACUC protocol.
  • Any complications encountered-- e.g., delayed recovery from anesthesia, bleeding from incision site, etc.
  • Dose, route, and time of all medications or compounds administered to the animal.
  • If postoperative records are maintained in the vivarium, contact information for all research staff responsible for daily assessment and care must be provided on the record.
  • All postoperative record entries must include time, date, and initials of personnel performing the procedure.
  • Researchers are encouraged to use or modify one of the templates listed below:

Personnel Training

Regardless of an individual's qualifications or educational background, all personnel performing surgery must have thorough knowledge and understanding of the approved IACUC protocol procedures and must be trained by someone who possesses a knowledge of surgery policies, proper surgical technique, and familiarity with the relevant surgical procedure and with the anatomy of the species. ULAR veterinarians are charged by the IACUC to confirm that the training is adequate.  It is the Principal Investigator's and/or Lab Manager's responsibility to maintain training records for all members of the research team.

At a minimum, training of surgical personnel must include

  • A thorough knowledge of aseptic technique.
  • Administration and assessment of anesthesia
  • Appropriate tissue handling (tissue trauma contributes to postoperative infections).
  • Appropriate use of instruments
  • Effective methods of hemostasis.
  • Correct use of sutures and/or skin staples
  • Postsurgical care and monitoring, including the ability to recognize and alleviate pain and distress.

Completion of the Aseptic Surgery module of the CITI training is required for all personnel that will be performing surgical procedures.


Veterinary Outreach/Post Approval Monitoring

Campus veterinary staff will perform Quality Assurance Reviews in all laboratories performing survival surgeries to ensure adherence to the tenets of the Guide for the Care and Use of Laboratory Animals.  These review sessions will be pre-arranged so that ULAR veterinary staff can meet with key lab personnel and discuss procedures involving survival surgery, including proper aseptic technique, administration of anesthesia and analgesics and appropriate documentation.  If additional training is needed it will be provided.  A standard checklist will be utilized to facilitate the review.


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