Yesterday, Jan 12, 2012, I had a chat with a new female
vet graduate from Australia about post-op bleeding in a
neuter of a Labrador Retriever. Closed technique, 2
ligatures used by her but lots of bleeding.
"A transfixing ligature and open technique may be wiser
in big dog neutering to prevent ligature slippage," I
said. The dog was OK after a repeat surgery at this
practice I visited. For new vets, the tying of the
ligature and the number of throws of the knot is
important. I usually knot 5 times firmly using
absorbable sutures. If you knot 3 times, you may find
that the stitch breaks down and then post op return of
the patient.
SPAY TIPS FOR NEW VETS Keep
surgery simple. Using intradermal or subcuticular
stitching impress clients as they don't see the stitches
which are hidden under the skin. However, your stitching
technique has not been perfected yet. It the continuous
intradermal stitches break down or irritate the cat or
dog, there will be intense itching and post-op
infections. Therefore, I usually advise one or two
horizontal mattress sutures to close the skin. In the
past 30 years of spay, I rarely encountered any return
for post-op stitch breakdown or infections. Remember,
your reputation is on the line. Clients will seldom
refer you if your surgical outcome in a spay cause the
client worries and return to be re-operated on due to
post-op stitch breakdown and infections.
I don't use subcuticular or intradermal sutures. If you
want to use this method, you need to use the appropriate
needle size as the ones you use to close the linea alba
may have a much bigger needle which may not be
appropriate for intradermal use.
FIRST IMPRESSIONS OF A VET OR INTERN AT TOA PAYOH VETS
First impressions count for a new vet graduate. "Dr....
wears jeans and his staff wears sneakers," said one
young male vet to me. For older vets, dressing may not
be so important but it is still best to create a good
first impression. For the lady vet, I noted that half of
her left eye is covered by her falling hair, making it
distracting to talk to her. She kept sweeping her hair
to uncover her eye. Best to get a good hairstyle as
clients may only see half of you!
In my surgery, younger vets and interns tend to dress
casually. From 2012, I have stopped staff wearing
sandals, sneaker, jeans and clogs to work. For those who
persists, they will need to work or intern elsewhere.
First impressions still count in a professional
practice. Uniforms are sometimes used to ensure that the
staff dress appropriately and create a good impression
in some vet practices to resolve this tendency of the
young to dress casually. I may implement this dress
code.
TOA
PAYOH VETS
