Institutional Animal Care & Use Committee, Yale University

Definitions:

	Survival Surgery: Survival surgery is defined as a surgical intervention in which it is anticipated that the animal will recover from anesthesia, regardless of the survival time. Survival surgery is further defined as either major or minor.
	Major Survival Surgery: The PHS Guide for the Care and Use of Laboratory Animals defines major survival surgery as "penetrates and exposes a body cavity or produces substantial impairment of physical or physiologic functions (such as laparotomy, thoracotomy, craniotomy, joint replacement, and limb amputation).
	Minor Survival Surgery: The PHS Guide for the Care and Use of Laboratory Animals defines minor survival surgery as "does not expose a body cavity and causes little or no physical impairment (such as wound suturing, ...)."

General Considerations:

Animals must be monitored at least once daily (until sutures/staples are removed) and based on that assessment the need for additional monitoring throughout the day can be made.

Once sutures/staples are removed, animals should be monitored 2-3 times during the first week following removal to ensure complications, if any, are detected.

Administration of analgesia must be in accordance with the corresponding approved Yale University IACUC protocol.

Postoperative Records
Post operative records must be kept in the animal room for three days following major surgery, and for 24 hours following minor procedures. Records must be maintained by the principal investigator for three years following the completion of the study. Records must include the following information:

General Information:
-	Yale University IACUC protocol number
-	animal ID number(s)
-	investigator name
-	responsible person�s name, phone(day & after hours)
-	procedure date
-	procedure performed
-	preop, intraop, or postop complications
-	anesthetic administered
-	total fluids administered during procedure and postoperatively
Daily Information(refer to Intermediate Postoperative Care):
-	name of person assessing the animal
-	responsible person's name, phone(day & after hours)
-	date and time of treatment.
-	medication and fluid administered (include drug dosage, route and time of administration)
-	condition of the animal (attitude, appearance, appetite, urine/fecal output)
-	appearance of incision
-	analgesia administered (dosage(mg/kg), route of administration)
-	fluid administration, if needed

Postoperative Care

Immediate Postoperative Care (until sternal recumbency is maintained, sternal recumbency is achieved when the animal is alert and mobile):

-	Animals must be monitored from the completion of surgery until recovered from anesthesia sufficiently to maintain itself in sternal recumbency.
-	Animals should be kept warm and dry to prevent hypothermia until they are fully recovered. Animals can be wrapped in a small piece of cloth or gauze and placed under a heat source(e.g., hot water circulating pad, hot water bottles) to speed recovery. If an electric heating pad is used, it should be at the lowest setting and placed under the animal�s cage. Animals should never be placed directly on the heating pad to prevent thermal injury or chewing on the cord.
-	Animals must not be placed directly on bedding to prevent aspiration of the bedding. A cage lined with a clean drape or towel is recommended. Animals can be returned to a cage with bedding once they are fully awake and ambulatory.

Intermediate Postoperative Care (following sternal recumbency and free of complications)

Animals may be reluctant to reach up to drink after surgery, so moistening normal food and placing it on the cage bottom will ensure access to food and water.

Animals should be monitored for the following:

-	Fluid intake - In some cases, decreased fluid intake will result in inadequate food consumption. Fluid intake may need to be monitored and supplemented with moistened chow, or fluid administration (SQ, IP). Also record positive findings (e.g., the animal seems well hydrated - coat looks good, skin turgor adequate, seen drinking).
-	Appetite - Record if the animal is eating and if given moistened chow. Inappetence must be reported to VCS.
-	Condition of the animal: changes in attitude - record and report depression, decreased appetite (see above), reluctance to move, or restlessness to VCS. Record when normal attitude returns.
-	appearance - ruffled hair coat, dilated pupils, pale skin or mucous membranes, abnormal posture, shivering, and/or guarding should be recorded as abnormal and reported to VCS. Also record when the animal appears "normal" (e.g., alert, active, bright).
-	urine and fecal output -record presence of urine and fecal output. Abnormalities must be reported to VCS.
-	Incision - Monitor incision and report increased swelling, discharge, seroma, and/or dehiscence to VCS. Record how the incision is being cleaned. Also record when there are no complications and the incision is healing properly.
-	Analgesia - Record the type of analgesic (dose (mg/kg), route of administration) and the frequency and duration of administration. This must follow what is stated in the approved Yale University IACUC protocol.

Surgical clips/sutures are normally removed within 7-10 days. Record the date clips/sutures are removed.

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