Veterinary Medicine and Clinical Surgery I

1. To know and be able to apply in practice the general principles of surgery, instruments, equipment, and work protocols.
2. Prepare, attend, and monitor the surgical patient during the entire perioperative period.
3. Perform basic surgical procedures such as sutures, bleeding control, bandaging and immobilization, dressings and administration of medication and care.
4. Perform an examination of the ophthalmologic patient, using basic and sophisticated equipment, the selection of diagnostic tests and the application of the most appropriate treatment.
5. Apply the knowledge acquired to carry out the examination of the surgical patient, select the complementary diagnostic tests and interpret the symptoms and lesions in an appropriate manner and propose the appropriate treatment.
6. Develop a clinical mentality, understanding the general steps of the surgical procedure in a coherent and systematic way.

2.1. LECTURES
Topic 1. SURGICAL PATHOLOGY AND SURGERY. Presentation of the subject: contents, organization of practices and the development of the discipline. Concept of surgical pathology and surgery. (1 h)

SECTION l: SURGICAL PATHOLOGY GENERAL (7 h)
Topic 2. MECHANICAL TRAUMATISMS. Basic concepts. Pathogenesis and complications of trauma. CONTUSIONS: Grade, evolution, and treatment.
Topic 3. WOUNDS: Concept and classification.
Topic 4. WOUNDS: General and specific treatment of the different types of wounds.
Topic 5. PHYSICAL AND CHEMICAL TRAUMA INJURIES. Traumas caused by physical and chemical agents. Burns and injuries caused by heat, cold, electricity or caustic products. Concept and classification.
Topic 6. CYCATRIZATION. Local and general factors. Wound repair process and its clinical evolution. Types. COMPLICATIONS. Cicatricial ulcers. Hypertrophic scars. Fistulas. Painful scars. Keloids.
Topic 7. SURGICAL INFECTION. Concept. Classification. Abscess. Phlegmon. Gangrene.
Topic 8. NEOPLASTIC SURGICAL PATHOLOGY. General principles of oncologic surgery. Diagnosis. Biopsy. Treatment.

SECTION ll: GENERAL SURGERY (8 h)
Topic 9. SURGICAL AREA. Facilities, equipment, and personnel. Norms and work protocols. PREPARATION AND MANAGEMENT OF SURGICAL PATIENT. Hospitalization of surgical patients.
Topic 10. PREPARATION OF THE SURGICAL STAFF. Norms and work protocols.
Topic. 11. INSTRUMENTATION AND STERILIZATION. Preparation of instruments, clothing, and disposable material. Sterilization methods.
Topic 12. GENERAL PRINCIPLES OF SURGERY. Definitions and terminology. Dieresis, exeresis and prosthesis techniques and procedures.
Topic 13. SUTURES. Instruments and suture materials. General principles. Patterns of sutures and their practical indications.
Topic 14. SURGICAL HEMOSTASIS. Control of bleeding. Local and general factors. Preventive and curative haemostasis methods and equipment.
Topic 15. DRAINAGE. Clinical indications. Classification. Technique of placement and precautions.
Topic 16. DRESSINGS, CURES AND BANDAGES. Materials used, classification, clinical application, and precautions.
Topic 17. MINIMALLY INVASIVE SURGERY. Equipment. Fibroendoscopy. Laparoscopy. Arthroscopy. MICROSURGERY. Microsurgical material and equipment. Basic techniques.

SECTION III: SURGERY OF THE SKIN, SUBCUTANEOUS TISSUE, AND MAMA (3 h)
Lesson 18. BASIC CUTANEOUS SURGERY. Material and basic principles. Techniques for correction of the excess of skin. Techniques for defects of tissue. Plastias.

Lesson 19. CUTANEOUS SURGERY ADVANCED. Skin flaps and grafts. Hygroma.
Lesson 20. MAMMARY GLAND. Mammary tumors in small animals. Surgery of the nipple: wounds, neoplasias and susceptible congenital malformations of surgical treatment

SECTION IV: OPHTHALMOLOGY (5h)
Topic 21. EYE. DIAGNOSTIC TECHNIQUES IN OPHTHALMOLOGY.
Topic 22. DISEASES AND SURGERY OF THE OCULAR APPENDAGES. Orbit. Eyelids. Conjunctiva. Lacrimal system.
Topic 23. CORNEA AND SCLERA. Corneal ulcers. Keratitis.
Topic 24. DISEASES AND SURGERY OF THE EYE GLOBE. Intraocular pressure alterations. Uvea. Crystalline lens. Posterior segment.

SECTION V: SURGERY OF THE HEAD AND NECK (6 h)
Topic 25. EAR. Otohematoma. Otoplasty. Surgical techniques of application in otitis externa. Myringotomy. Osteotomies of the tympanic bulla.
Topic 26. UPPER RESPIRATORY TRACT. Brachycephalic syndrome. Stenotic ollars. Elongated soft palate. Eversion of laryngeal saccule. Laryngeal surgery. Nasal tumors. Surgical techniques of dehorning.
Topic 27. ORAL CAVITY AND OROPHARYNX. Cleft lip. Cheiloplasties. Cleft palate. Oronasal fistulas. Congenital anomalies, neoplasms and trauma of the tongue. Mucoceles.
Topic 28. DENTISTRY I. Terminology and dental records Congenital anomalies. Caries. Dental fractures. EXODONTICS. Instruments and basic techniques.
Topic 29. DENTISTRY II. ENDODONTICS: Basic material and techniques. ORTHODONTICS. basic instruments and techniques. PERIODONTAL DISEASE. Dental prophylaxis.


2.2. TUTORIAL T1 G1-13 (1 hour)
In this session (first day of class) information is given about the subject: organization, standards, main aspects of biosafety, exam model and evaluation system.

2.3. PRACTICES (20 hours)
Before a student is able to develop the activities of the surgical area, he/she must acquire practical knowledge and skills that will allow him/her to obtain the best performance from his/her stay at the Surgery Department of the Rof Codina University Veterinary Hospital (HVURC). For this reason, the following interactive sessions have been scheduled:

CIRU1 C1: Basic sutures (4 hours). They are carried out on synthetic models until different suture patterns are performed with a certain degree of fluency, familiarization with the properties of the main materials used in veterinary surgery, acquisition of the correct handling of the instruments, as well as being able to choose the suture pattern that best suits the circumstances of the surgical intervention and the patient.

CIRU1 C2: Surgical area. Preparation of surgical staff and instruments (2 h). An explanatory tour through all the rooms that are part of the surgical facilities is performed, detailing the activities and work protocol in each area. Students practice how to prepare and behave correctly in the operating room, including antiseptic washing and drying of the hands, dressing the sterile gown, and putting on sterile gloves. Subsequently, the student prepares and organizes the surgical instruments and material on the table, being able to know the ergonomic way to use them and their functions.

CIRU1 C3: Clinic of Ophthalmology (3 h). It is carried out in the Hospital consultation (consultation and/or operating room) with real cases. The basic general and ophthalmological examination of the patient is performed, differential diagnoses are discussed and reasoned, the corresponding clinical record is filled in and the corresponding surgical and/or medical treatment is prescribed by means of the veterinary prescription. Special attention is given to the use of the different diagnostic equipment available and the application of special diagnostic tests. Students will attend the operating room if there are scheduled surgeries and may participate as assistants in some of them.

CIRU1 C4: Bandages and drains. Placement of surgical drapes (2 h). In this practice we first work with the different materials used for bandages; later, using synthetic models, different types of basic bandages on the extremities are made, especially the Robert-Jones bandage and immobilization by means of splints. Components and functioning of the different types of surgical drains. On a synthetic model, patient positioning, field placement and clamping with field forceps are practiced.

CIRU1 C5: Laparoscopic surgery (2 h). Students recognize and learn to handle the instruments used in laparoscopic surgery using basic equipment. In a console and with different synthetic elements and / or tissues, basic handling such as clamping, dissection and sutures is initiated.

CIRU1 C6: Advanced sutures and electrocautery (5 hours). The skills already acquired in the first practice are perfected and new suture patterns that require greater dexterity and mastery of the handling of the instruments (including those of inversion and overlapping) in anatomical pieces are performed. The placement and fixation of a drainage to the internal tissues and skin by means of suture in a tobacco pouch and in a Roman sandal is practiced. The different components of an electrosurgical scalpel are distinguished and the modes of cutting, coagulation, fulguration, etc. are practiced on anatomical pieces.

CIRU1 C7: Dentistry (2 h). The most used instruments in dentistry are rec ognized and handled correctly. Dental cleaning, extraction of dental pieces and suture of the gum are performed on anatomical pieces.

2.4. BLACKBOARD PRACTICE CIRU1PE1 (1 hour)
In this session a review of the most outstanding aspects of the subject is carried out and the doubts of the students are resolved.

3.1. BASIC BIBLIOGRAPHY
Adams SB. Atlas of equine surgery. 2000
Anderson DE. Field surgery of cattle: Veterinary Clinics of Noth America: Food Animal Practice. 2008
Auer JA. Equine Surgery. 2019
Bojrab MJ. Mechanisms of disease in small animal surgery. 2014
Brühl RD. Errores y complicaciones en cirugía. 2017
Dirksen G. Medicina interna y cirugía del bovino. 2005
Fossum TW. Small animal surgery. 2018
Johnston SA. Veterinary surgery: Small Animal. 2018
Fubini SL. Farm animal surgery. 2016
Fowler D. Manual de tratamiento y reconstrucción de heridas en pequeños animales. 2001
Gelat KN. Fundamentos de oftalmología veterinaria. 2003
Hendrickson A, Baird AN.Turner and McIlwraith’s Techniques in large animal surgery. 2013
Johnston SA, Tobias KM. Veterinary surgery: small animal (vol I y II). 2017
Kirpensteijn J. Reconstructive surgery and wound management of the dog and cat. 2013
Niehaus AJ. Ruminant surgery. Veterinary Clinics of North America: Food Animal Practice. 2016
Rodríguez J. Cirugía sin sangrado. Cirugía en la clínica de pequeños animales. 2014
Rodríguez J. Cirugía en la clínica de pequeños animales. Bases prácticas en el quirófano. 2016
Rodríguez J. Cirugía en la clínica de pequeños animales. Técnicas quirúrgicas. 2017
Rodríguez J. Cirugía en la clínica de pequeños animales. Cuello y cabeza. Volumen I (2018) y II (2019)
Slatter. Fundamentos de oftalmología veterinaria. 2009
Sopena. J. Manejo de heridas y de cirugía de la piel. 2009
Sopena. J. Manual práctico sobre vendajes en animales de compañía. 2018

3.2. COMPLEMENTARY BIBLIOGRAPHY
Aronson LR. Small animal surgical emergencies. 2022
Brockman DJ. BSAVA Manual of canine and feline head, neck and thoracic surgery. 2018
Lhermette P. BSAVA Manual of canine and feline endoscopy and endosurgery. 2008
Reiter AM. BSAVA Manual of canine and feline dentistry and oral surgery. 2018
Stashak TS. Equine wound management. 2008
Tams TR. Small animal endoscopy. 2011
Williams J. BSAVA Manual of canine and feline wound management and reconstruction. 2009

Web pages
European College of Veterinary Surgeons (http://www.ecvs.org)
American College of Veterinary Surgeons (http://www.acvs.org)
Martindale´s Veterinary Center (http://www.martindalecenter.com/Vet.html)
Veterinary Information Network (http://www.vin.com)
AVEPA (http://www.avepa.org)

Journals
American Journal of Veterinary Research
Topics in Companion Animal Medicine
Journal of the American Animal Hospital Association
Journal of Equine Veterinary Science
Journal of Feline Medicine and Surgery
Journal of Small Animal Practice
Journal of Veterinary Emergency and Critical Care
Veterinary Clinics of North America: Equine Practice
Veterinary Clinics of North America: Food Animal Practice
Veterinary Clinics of North America: Small Animal Practice
Veterinary Surgery

Electronic access bibliographic resources available at the USC Library (https://biblioteca-usc.gal). For concrete subjects, the professors will be able to facilitate articles of open access or will recommend the research through PubMed, WOS or Google Scholar.

4.1. GENERAL SKILLS OF THE DEGREE
GVUSC01. Learning and adaptation capacity
GVUSC02. Capacity for analysis and synthesis
GVUSC03. General knowledge of the work area
GVUSC04. Work planning and management
GVUSC05. Ability to apply knowledge in practice
GVUSC06. Ability to work autonomously and as part of a team.
GVUSC09. Ability to communicate in different fields
GVUSC10. Ethical commitment and assumption of responsibilities

4.2. SPECIFIC SKILLS DISCIPLINED (KNOW)
CEDVUSC 07. Knowledge of the alterations of the structure and function of the animal organism.
CEDVUSC 08. Knowledge and diagnosis of the different animal diseases.
CEDVUSC 09. General bases of medical-surgical treatment.

4.3. SPECIFIC SKILLS PROFESSIONALS (KNOW DO, DAY-ONE SKILLS)
D1VUSC 01. Perform history and clinical examination of animals.
D1VUSC 02. Collect and submit specimens with corresponding report.
D1VUSC 04. Diagnose the most common diseases, using diagnostic protocols and complementary diagnostic techniques.
D1VUSC 06. Attend emergencies and perform first aid in Veterinary Medicine
D1VUSC 07. Perform basic medical-surgical treatments in animals.
D1VUSC 08. Prescribe, handle, and administer veterinary drugs correctly D1VUSC 16.
D1VUSC 17. Make technical reports specific to veterinary competencies.

4.4. ACADEMIC SPECIFIC SKILLS (WANT TO DO)
EAVUSC 01. Analyze, synthesize, solve problems, and make decisions in the professional fields of veterinary medicine.
CEAVUSC 02. Maintain ethical behavior in the exercise of their responsibilities to the veterinary profession and society.
CEAVUSC 03. Disseminate information obtained during the professional practice of the veterinarian fluently, orally and in writing, with other colleagues, authorities, and society in general.
CEAVUSC 04. To seek and manage information related to the veterinarian's activity.
CEAVUSC 05. Know and apply the scientific method in professional practice, including evidence-based medicine.
CEAVUSC 06. Know how to seek professional advice and assistance.
CEAVUSC 07. Have basic knowledge of a foreign language, especially in technical aspects related to Veterinary Sciences.
CEAVUSC 08. Be aware of the need to keep knowledge, skills, and attitudes of professional competencies up to date through a process of continuing education.

4.5. TRANSVERSAL COMPETITIONS
CTVUSC 01. Capacity for the reasoning and the argumentation
CTVUSC 01. Capacity for reasoning and argumentation.
CTVUSC 02. Ability to obtain adequate, diverse and updated information by various means, such as bibliographic information and the Internet, and to analyze it critically.
CTVUSC 03. Ability to elaborate and present an organized and comprehensible text.
CTVUSC 04. Ability to make a clear, coherent and concise public presentation.
CTVUSC 05. Ability to handle ICTs
CTVUSC 06. Use of information in foreign language
CTVUSC 07. Ability to solve problems through the integrated application of their knowledge

LLectures are developed with the support of ICT and with the systematic use of the Virtual Campus as a teaching support. Tutorials are held in small groups.

The interactive sessions are held at the Rof Codina University Veterinary Hospital and in the surgery room (pavilion 2, ground level) in the morning and will have manuals and videos to serve as a guide. The groups of practices are totally independent of each other, so students will sign up for each type of practice on the date and time that most interests them.

For autonomous study, the student can use the recommended bibliography and any other material collected during the lectures and practical sessions.

The biosafety regulations can be consulted in the Aula Virtual of the subject, and it is the student's obligation to read and respect them at all times; any doubt in this regard will be resolved by the faculty. Depending on the type of practice, the use of disposable gloves, lab coat, mask, cap, surgical pajamas or clogs is mandatory. In order to develop the work in some practices it is necessary to bring basic dissection material: scalpel, forceps with and without teeth, scissors and needle holders. The PPE and instruments necessary for each practice are clearly indicated in the information of the Virtual Campus.

There is no dispensation of attendance to practices or classes.

Final qualification is composed by the sum of 2 independent parts: 40% continuous evaluation + 60% theoretical exam. To pass the subject it is necessary to pass each of them. There is no dispensation of attendance to practices or classes.

- 40% of the grade corresponds to the continuous evaluation of both expository and interactive sessions. The student's personal work during the classes will be assessed by means of different tests: completion of written exercises -programmed or not-, active participation in the classroom, etc. The student will also be individually assessed in each of the practical sessions (participation, skills acquired, practical application of theoretical knowledge, dedication, effort, etc.) by means of rubrics (the models will be available in the virtual classroom). This part is passed by obtaining 5 points out of 10.
To take the final exam (and pass the subject) it is necessary to attend 100% of the practical sessions.

- 60% of the grade corresponds to the written theoretical exam that evaluates the knowledge acquired in the expository and interactive sessions. The exam will consist of multiple-choice questions (with 4 answers, where at least one is true) and short questions. This part is passed by obtaining 5 points out of 10.

Students who pass one of the parts (continuous assessment and practical or theory) will keep their marks for successive courses.

In case of plagiarism, fraud, or undue use of the technologies during the realisation of the telematic proofs, will be of application the collected in the “Normativa de avaliación do rendemento académico dos estudantes e de revisión de cualificacións”.

TIME FOR STUDY AND PERSONAL WORK : Total 112,5 hours

Total 112,5 hours

52 face-to-face hours:
30 h of lectures
20 h of clinical interactive sessions
2 h of tutoring

60,5 no face-to-face hours:
45 h of individual study
7 h of preparation for the internship
4 h of bibliographic review
2 h of exams
2.5 h of other activities: practical training in the Clinical Skills Laboratory.

- - Attendance, participation and involvement in the expository and interactive sessions.
- Use of the Clinical Skills Lab to acquire more practical skills
- Resolving doubts through individualized tutorials
- Keeping up to date with the subject matter of the expository sessions
- Reviewing theoretical topics before attending the practical sessions
- Reviewing the material provided by the teacher as a study guide.
- Use of recommended bibliographic sources: textbooks, image atlases, web pages, scientific articles.

• Essential knowledge: anatomy, physiology, and pathology (exploration).
• Recommended knowledge: pharmacology, anesthesia, and diagnostic imaging.