Dorsal recumbency

The patient is placed in dorsal or dorsal-oblique recumbency (with the affected limb down) on the surgery table with the injured limb hanging. This exposes the medial part of the humerus and allows the limb to be draped completely.

Preparation of the limb is done outside of the operating room. The entire limb is clipped circumferentially, starting from the thorax on the medial shoulder area to the distal of the carpus. The clipped hair is vacuumed.

The paw to the carpus is isolated with a non-sterile wrap in a way that allows the limb to be hung during the sterile scrub and draping.

A general scrub is done before bringing the patient into the operating room.

In the operating room, the limb is put into a hanging limb position. The limb is prepared for aseptic surgery by performing the final sterile surgical scrub.

Corner drapes are placed around the surgical site and secured with towel clamps. Self-adhesive drapes may also be used.

Note: The draping shown in the photographs in this section was done on a patient placed in lateral recumbency. However, the draping is done in the same way for patients placed in dorsal recumbency.

The surgeon captures the foot with a sterile drape, and a non-sterile assistant releases the distal limb from the hung position. The foot and distal limb are wrapped with a sterile drape.

Note: It is recommended to isolate the foot with an impermeable sterile barrier (eg, plastic bag or surgical glove) to prevent strike-through from fluids used in surgery.

The foot and distal limb can then be over-wrapped with sterile conforming bandage material or an impermeable surgical sleeve, as shown in the photograph.

An extremity or laparotomy drape covering the entire surgery table is recommended on top of the corner drapes. If a surgical sleeve has been applied, a hole can be made to access the surgical site.

An antibacterial adhesive incisional drape can be applied to the entire limb, either directly onto the skin (if no sleeve was used) or on top of the sleeve. The incisional drape should adhere firmly to the exposed skin.

If preferred, a sterile stockinette (rather than a surgical sleeve) can be applied over the entire limb, a hole made and then the edges sutured to the edges of the skin incision.