Biomedical Engineering Reference
In-Depth Information
Evaluation of Presurgical Fitness
Nonhuman primates should be acquired from legitimate
vendors who employ veterinarians knowledgeable and
experienced in primate medicine. Since there is no clear
definition of a research na¨ve animal, extreme caution is
advised when buying nonhuman primates previously used in
procedures. Specific questions regarding previous surgeries,
even those consideredminor, should be asked to establish the
surgical history of the nonhuman primate. Clinically unap-
parent differences between animals used merely as blood
donors versus those subjected to surgeries, experimental
bacterial inoculation, or pharmacokinetic studies may
become quite dramatic in the face of multiple survival
surgeries. It is required by the United States Department of
Agriculture (USDA) that a complete medical history be
available to the veterinarian who, along with the researcher,
makes an accurate risk assessment (
United States Depart-
ment of Agriculture, 2006
). Research na¨ve nonhuman
primates imported to the USA may have nonexistent or
incomplete medical histories. Finding an ideal surgical
candidate will be facilitated by knowing the origin, quaran-
tine results, results of veterinary physical examination,
medical history, clinical pathology results, nutritional status
and phase of physical growth, and potential behavioral
challenges (e.g. con-specific aggression, propensity for
stereotypic behavioral patterns or self-mutilation). Animals
housed for extended periods of time before initial or repeated
surgeries should be re-evaluated by physical examination
and selected clinical pathology assays prior to surgery. The
favored age range for surgical use of rhesusmonkeys is 6
The IACUC and the Attending Veterinarian (AV),
taking responsibility for determining that the research
personnel are qualified and properly trained (
National
Resource Council, 2011b
). An experienced veterinarian
should be involved in presurgical planning and training
as deemed necessary by the IACUC and AV.
l
Anesthesia and postoperative care managed by highly
trained veterinarians and certified veterinary technicians
with nonhuman primate clinical expertise.
l
Surgical Facilities
Invasive surgical nonhuman primate research should be
conducted in properly equipped facilities. Aseptic surgery
requires a dedicated facility that is maintained and operated
in a manner that ensures cleanliness and minimizes
unnecessary traffic. For most surgical programs, functional
components of aseptic surgery include surgical support,
animal preparation, surgeon's scrub, operating room, and
postoperative recovery. These areas should have minimal
traffic flow and separation of the related nonsurgical and
surgical activities. This can be best achieved by physical
barriers but also by distance between areas or by the timing
of appropriate cleaning and disinfection between activities
(
National Resource Council, 2011c
). Failure to meet these
guidelines could impact animal welfare, confound research
data, and jeopardize the facility's regulatory standing.
Cost
Nonhuman primates are an expensive investment. Research
na¨ve 5
10
years, as their dentition has fully erupted (
Bourne, 1975
),
skeletal growth is completed, and the animals are still
motivated to learn tasks required by the researcher.
e
10 years old rhesus monkeys with negative herpes
B and common macaque retrovirus serology ranged in
prices from $5000 to $6000 in 2009
e
2010. Added shipping
e
expenses ($800
$7000), per diems, training, experimental
procedures, and veterinary care accumulating over months
to years of laboratory effort make the total investment
substantial.
e
Surgical Judgment
Surgical judgment cannot be learned by reading a surgery
textbook, nor is it necessarily attained by years of experi-
ence, unless the surgeons are willing to take advice from
others and turn mistakes into lessons learned and make
constant adjustments to their techniques (
Turner and
McIlwraith, 1982a
). A conscientious surgeon should
consider the following before each experimental surgery:
GENERAL PRINCIPLES OF EXPERIMENTAL
SURGERY
“Primum, non nocere” (“Above all, do no harm”) is still as
relevant today as it was in the 5th century
BC
when it was
coined by Hippocrates. The goal of this chapter is consistent
with the mission of the American College of Veterinary
Surgeons (ACVS) which is to “
l
Is a surgery the only or the best option to facilitate the
research?
l
What skills are necessary to perform the desired
surgery?
advance the art and science
of surgery and promote excellence in animal health care
through research, education and service to the public”
(
American College of Veterinary Surgeons, 1965
). Experi-
mental and therapeutic surgeries share many general princi-
ples, including the basic premise of repair, creating minimal
trauma, and the return to the healthy, pre-surgical status quo.
.
Is the necessary support system, such as anesthesia,
instruments, supplies, and qualified staff available?
l
Sound principles of surgery include the knowledge of
anatomy and physiology, clear plan of action, gentle
and aseptic tissue handling, effective hemostasis, use of
