Table 2

Procedures and medications initiated to prevent infection above and beyond standard large-animal survival surgery standards

Preoperative measuresAll surfaces of the operating room including the walls and ceiling were sanitized with Quatricide PV-15 (Pharmacal) prior to each surgery
Swine received a Hibiclens (chlorhexidine gluconate) bath over the entire body the day before and the day of surgery
All hair clipping was performed before entering the OR
Feet were wrapped with Vetrap before entering the OR
Xeroform Petrolatum gauze inserted in the ears
Head, ears, and neck were washed with 2% chlorhexidine wipes before entering the operating room
Staff replaced all personal protective equipment before entering OR
Additional scrub and drape measuresEars were wrapped with sterile Vetrap  
Tegaderm was placed over the top of the snout, over the eyes, and around the ears creating a perimeter around the surgical site on the head
A dedicated scrub pack was used separate from the instrument pack with the surgeon rescrubbing/regowning after scrub
Three-step scrub instead of two-step scrub: incision sites prepped with 70% ethanol then with betadine using gauze held with a dedicated scrub hemostat, then with a ChloraPrep wand
Three layers of drapes instead of two: sterile Steri-Drapes were placed around the incision sites then site was covered by Ioban then with a large split-sheet sterile drape placed over the entire surgical area
Prophylactic antibioticsVancomycin (10–20 mg/kg, i.v.) infused over 30 min prior to the first incision
Cephalexin (10–20 mg/kg, orally) three times/d for 7 d
OtherUsing dedicated instruments for the neck site (not used at the head site) and a new pair of surgical gloves to handle the EEG transmitter
All instruments were heat/pressure sterilized as possible. Chemical sterilization with ethylene oxide was not used
The EEG transmitter was prevented from touching the skin of the pig by adding new drapes and packing sterile gauze around the incision site
Surgical sites were heavily irrigated with sterile saline prior to closing
Postsurgically, the skin of the pig was oiled regularly to prevent irritation and scratching
Placards placed on the swine pen indicated areas approved for scratching by caretakers avoiding incision sites
  • OR, Operating room.