Introduction To Surgical Skills

Faculty and Staff Information

Course Director:

Tara Paterson, DVM, MSc, Associate Professor Email:

Office: Cassia building, 2nd floor


Visiting Professors:

  • Tara Walcott, DVM
  • Katie Morris, DVM

VSL Technical Staff: 

Office Hours for remote students: Mondays 12:30-1:20 AST (via Zoom)
Office Hours for on-island students: By appointment only

Course Location

SAMS514 labs will take place in the Junior Surgery & Anesthesia Lab (JSAL, ground floor of RJ Sis hall). Lectures will take place KB Taylor blue. All course material will be available on Sakai. Sakai Lessons will be used for weekly organization of tasks with direct links to resources as needed.

Required Resources
  • Veterinary Surgery: Small Animal (2nd ed)(Johnston & Tobias, 2018)

Other than the required & recommended textbooks, all other course resource material will be available on Sakai and include:

  • SAMS514 Suture Pattern Guide
  • Lecture pdfs & recordings
  • Demonstration videos

For remote students: a laptop or other electronic device will be required to enable access to lectures & videos as well as participate in live, interactive sessions on Zoom (functional camera and microphone required).

Recommended Resources
  • Veterinary Surgical Preparation and Protocol (Pasquini, 2011)
  • Fundamentals of Small Animal Surgery (Mann, Constantinescu & Yoon, 2011)
  1. Students who need accommodations should contact Student Accessibility and Accommodations Services (SAAS), located in the Welcome Center, inside the International Students Office. 
  2. Information can be found at
Other Requirements

All students will require the following supplies for learning the surgical skills taught in this course:

  • Suture pad model
  • Intestinal suture model (max 6” in length)
  • Needle holder (Crile-Wood or Mayo-Hager)
  • Thumb forceps (Brown-Adson or Adson)
  • Doyen suture scissors
  • Suture material (silk or synthetic monofilament/multifilament recommended, size 2-0 or 3-0)
  • OPTIONAL: 3 X Halsted hemostatic forceps (or similar)
Course Rationale

This course is an introductory surgery course and is designed to lay the foundation for advanced 3rd year courses in surgery including both Small Animal Surgery (SAMS518) & Large Animal Surgery (LAMS516) as well as clinical surgical courses including Junior Surgery and Anesthesia lab (SAMS527) and SA Clinical Services(SAMS528).

Course Learning Outcomes

Upon successful completion of this course, the student will be able to:

  • CLO1: Demonstrate proficiency in a variety of basic surgical skills including knot tying, suture patterns, ligation, finger trap, instrument handling.
  • CLO2: Describe the various classifications of suture material and differentiate between types of suture material. Apply knowledge of suture material and surgical needles to the selection of an appropriate suture material + needle combination for a given surgical procedure.
  • CLO3: Describe in detail the appropriate procedures for surgical preparation of both the surgeon & patient.
  • CLO4: Explain the importance of asepsis and describe the various aspects of aseptic technique used to minimize the risk of surgical infection.
  • CLO5: Describe the stages of wound healing & principles of wound management and apply these to the management of wounds.
  • CLO6: Discuss principles of bandaging and apply this knowledge in the selection and application of commonly used bandages & slings.
  • CLO7: Identify surgical instrumentation and describe the application of each.
Lesson Learning Outcomes

Lecture/Surgical Skills Learning Outcomes

LECTURE: Surgical Preparation

Explain the difference between sterilization, disinfection & antisepsis

List the common forms of sterilization used in veterinary medicine and their applications/limitations: steam, ethylene oxide, ionizing radiation, gas plasma, paracetic acid, cold chemical sterilization

Discuss cold sterilization and list the appropriate chemical agents used for this method of sterilization

Explain the difference between antiseptic & disinfectant

Cite the spectrum of activity for the following antiseptics: povidone iodine, chlorhexidine, hydrogen peroxide, alcohol-based combination antiseptic preparations

Define asepsis

Describe the various procedures used in aseptic technique performed by the surgical team

Describe the ways to decrease a surgical patient risk for SSI

Cite Halsted’s surgical principles

Describe the steps taken by the surgical team when preparing a patient for surgery

Describe the procedures for surgical site preparation

Describe the proper technique for quarter drape application

List the surgical apparel worn by the surgical team and describe their function

Describe the following processes involved with pre-surgical preparation of the surgeon: aseptic hand scrub, application of surgical gown, open & closed gloving techniques


LECTURE: Suture material & surgical needles

Describe the properties of each of the following types of suture material: Surgical gut, polyglactin 910 (Vicryl – plain, Rapide, Plus), polydiaxanone (PDS), polyglecaprone 25 (Monocryl), silk, nylon, polyester, polypropylene, stainless steel, barbed suture

Classify the suture materials above based on the following characteristics: absorbable versus non-absorbable, strand type (mono- versus multifilament), origin of fibers

Discuss the inherent characteristics of suture material: size, flexibility, memory, surface friction, knot security, tensile strength & tissue reactivity

Describe the systems of suture material sizing

Discuss the purpose of suture material coatings and cite the benefits of triclosan

Explain the difference in the process of absorption between natural and synthetic suture materials

Discuss the factors to consider when selecting a suture material for a given procedure

List the potential complications of suturing

Discuss the biomaterial alternatives to suture & list their applications: tissue adhesive, surgical staples & hemoclips

Identify the parts of a surgical needle

Discuss the factors to be considered when selecting a surgical needle

List the various types of surgical needle point and pair these with the appropriate tissue



Describe the different types of wounds

Describe the phases of wound healing and cite the predominant cell type(s) (where applicable) involved in each phase; explain the impact of each phase on a healing wound

Discuss the degrees of contamination and how it relates to the relative risk of surgical infection; give examples of each

Explain the degrees of contamination as it relates to traumatic wounds

Describe methods used for initial management of a traumatic wound: wound cleansing, lavage/irrigation and wound debridement

Cite the applications of various topical medications commonly used in wound management [including spectrum of activity (where applicable) and effect on wound healing]

List the types of wound healing and their associated types of surgical closure (where applicable)

Discuss important aspects of managing degloving wounds

List the benefits of honey/sugar in wound healing

List the functions of drains and indications for their use

Compare the Penrose & Jackson-Pratt drains

Discuss the key principles of drain placement


LECTURE: Principles of bandaging

List the functions of bandages

Cite the three layers of a bandage and their function(s)

Differentiate between adherent & non-adherent dressings and discuss the applications for each type of dressing

Discuss the basic principles of bandage application

Describe how to apply the following types of bandages and list their function(s): Robert Jones, modified Robert Jones (+/- reinforcement), Spica splint, cast

Describe how to apply the following types of orthopedic slings and list their function(s): Velpeau, Ehmer

List the potential complications of a bandage


LECTURE: Surgical instrumentation & techniques

Identify, name & describe the function of the basic surgical instruments

Demonstrate the proper handling of these instruments

List the parts of a ringed instrument

Describe the different methods of making incisions and their applications

Explain the difference between blunt and sharp dissection



SURGICAL SKILLS: Knots & hand ties

Perform a square knot & surgeons knot using the 2-hand tie technique

Perform a square knot & surgeons knot using the 1-hand tie technique


SURGICAL SKILLS: Skin suture patterns - Interrupted patterns

Perform a square knot & surgeons knot using an instrument tie

Demonstrate proficiency in the following interrupted suture patterns & state when each would be appropriately used:

simple interrupted, cruciate, vertical mattress, interrupted horizontal mattress, Surgeon’s stitch


SURGICAL SKILLS: Skin suture patterns – Continuous patterns

Demonstrate proficiency in performing the intradermal skin pattern using either a buried knot or the Aberdeen knot as the final knot

Demonstrate proficiency in the following continuous suture patterns & state when each would be appropriately used:

Simple continuous, Ford interlocking, Continuous horizontal mattress


SURGICAL SKILLS: Ligatures & 3-clamp technique

Demonstrate proficiency in the following ligatures:

Circumferential, transfixing, modified Miller’s knot, strangle knot

Demonstrate proficiency in the 3-clamp technique for pedicle ligation


SURGICAL SKILLS: Hollow organ suture patterns

Demonstrate proficiency in the following hollow organ suture patterns: appositional (simple interrupted & simple continuous), Lembert (interrupted & continuous), Cushing & Connell

Demonstrate proficiency in performing a Finger trap

Alignment of Course Learning Outcomes with Program Learning Outcomes





Demonstrate proficiency in a variety of basic surgical skills including knot tying, suture patterns, ligation, finger trap, instrument handling




Describe the various classifications of suture material and differentiate between types of suture material. Apply knowledge of suture material and surgical needles to the selection of an appropriate suture material + needle combination for a given surgical procedure.




Describe in detail the appropriate procedures for surgical preparation of both the surgeon & patient



Explain the importance of asepsis and describe the various aspects of aseptic technique used to minimize the risk of surgical infection



Describe the stages of wound healing & principles of wound management and apply these to the management of wounds

PLOs: 2, 3, 5, 6,

23, 24, 25


Discuss the principles of bandaging and apply this knowledge in the selection and application of commonly used bandages & slings

PLO23, PLO24, PLO25



Identify surgical instrumentation and describe the application of each




Course Schedule



Grading and Assessment Policy

SVM Grading scale:

















Student assessment will be based on homework, surgical skills assessments, and one final written examination.

Professionalism & attendance:

Students are expected to attend all class activities. While attendance in lecture is not mandatory, attendance in laboratory sessions is mandatory – for both on-island AND remote learning students. Attendance will be checked weekly. Please refer to Section XVII for further details on the course attendance policy. Professionalism will be assessed based on attendance, communication & interaction with course faculty & peers. See Appendix 5.

Surgical skills assessments:

Students will be required to demonstrate proficiency in all surgical skills taught during the course (see Appendix 2 for full list of skills). Two surgical skills assessments will be administered during the term. Any skill that is scored <70% is deemed to be unsatisfactory. To ensure adequate proficiency, the student will be asked to meet with a course instructor to repeat the demonstration of the surgical skill(s) in question. There will be NO adjustment to the original grade assigned.

Final written examination:

The final written examination is comprehensive and will cover all topics and surgical concepts discussed in the course.

Bonus Exam question assignment:

Each student will have the opportunity to submit one multiple-choice style examination question during the term based on an assigned topic. A bonus of 1% will be applied to the final course grade for students who complete the assignment satisfactorily. This assignment is optional.

Summary of course grade:

Professionalism & attendance


Surgical skills assessments

60% (30% each)

Final written examination




Bonus assignment


The course has been designed as a mastery course. The importance of clinical skills in this course must be emphasized and recognized. Any student who fails to demonstrate adequate clinical proficiency and/or fails to remediate any skill(s) that was/were deemed unsatisfactory in a skills assessment will result in failure of the course (F Grade).

With regards to ExamSoft examinations, a grade reduction of 5-10% will be applied to that exam if students do not observe the parameters during exams monitored online.

Recommended Study Strategies

Surgical skills: Routine & frequent practice of the surgical skills taught in this course is essential for skill acquisition and long-term skill retention. This strategy will also minimize the last-minute panic before surgical skills assessments and will help the student to identify those skills they may be struggling with. These difficulties can then be addressed during the regularly scheduled lab hours (or during weekly Zoom Office hours for remote students).

Any student requiring additional assistance should email the course director ( to arrange a mutually convenient time to meet. Please note: when seeking additional assistance for practical skills, please ensure that you have practiced before the meeting and have identified the problems you are having. Do not schedule such meetings and expect all skills to be re-taught to you.

Didactic material: The student is encouraged to utilize the Lesson Learning Outcomes (Appendix 2) to guide their preparations for the final written examination.

Instructor's Expectations of the Student
  1. The student is expected to attend lectures in real-time wherever possible.
  2. The student is expected to prepare for each laboratory session by reviewing all pertinent instructional videos prior to each laboratory session. If no videos are available, the student should review the step-by-step instructions in the SAMS514 Suture Pattern guide.
  3. The student is expected to practice the surgical skills on a regular basis outside of laboratory hours.
  4. The student is expected to arrive to their scheduled laboratory session on time and remain in lab for the full 90 minutes.
  5. The student is asked to assist in the clean-up of the laboratory facility at the end of their lab session. This includes:

Clean-up: At the end of each laboratory session, please ensure that the workstation is clean. Please dispose of all materials as described below. The second group of the afternoon is asked to please clean table tops with the disinfectants provided in the Surgical suite and wipe dry. If the overhead surgical lights were used, please ensure that they are turned off.

Waste disposal: Please ensure that materials used during each lab session are disposed of appropriately. Surgical needles and scalpel blades must be disposed in the appropriate red sharps containers located at each end of the Surgical suite. Non-biohazard material (paper, suture material without needle, suture packaging) should be disposed of in the grey waste bin. Exam or surgical gloves should also be disposed of in the appropriate waste bins.

  1. Upon completion of this course, it would be appreciated if the student would take the time to complete the course evaluations since your thoughts, comments and constructive criticisms are extremely important and valuable to us as we continue to develop and improve this course.
Professionalism Statement

Professional behavior in the classroom and laboratory is expected at all times. The use of cellphones, social media or other entertainment media is strictly prohibited during lectures, laboratories or other live interactions. Further, the student is expected to approach all assessments and assignments in a professional and honest manner.

Attendance/Participation Policy

Students are expected to be available during the standard 8-5am AST school day, to virtually attend, engage with online content, and participate in all classes and clinical rotations for which they have registered. Employment is not an excusable absence. Although attendance, engagement, and participation may not be recorded at every academic activity, attendance, engagement, and participation is graded for mandatory sessions. Students’ lack of attendance, engagement, and participation may adversely affect their academic status as specified in the grading policy.

If failure to attend, engage, or participate in individual classes, examinations, and online activities, or from the University itself is anticipated, or occurs spontaneously due to illness or other extenuating circumstances, proper notification procedures must be followed.

SAMS514 lecture attendance policy: Attendance to lectures is expected. There is often discussion in lecture pertaining to the laboratory session for that week. Therefore, if the student fails to attend lecture, it is expected that they will review the entire lecture via Panopto prior to the follow day’s laboratory session in order to be fully prepared for the lab. Should the online recording of the lecture fail, it is the student’s responsibility to obtain information from the missed lecture from a colleague.

SAMS514 laboratory session attendance policy: Attendance to labs is mandatory and will be recorded during each laboratory session. As per the 2016-2017 Student Manual, laboratory sessions are considered required educational activities (along with quizzes & exams). The Student Manual (ref page 101-102) clearly states that students are allowed only two medical excuses and one non-medical excuse per year. This pertains to all required educational activities. Students are expected to complete the appropriate online procedures for these absences. For further details and procedures, please refer to the Student Manual.

Students failing to attend a laboratory session without completing the appropriate procedures will be contacted by the Course Director and a reduction in professionalism points will ensue. In necessary, the SVM Assistant Dean of Students will be notified and the appropriate actions taken.

If the absence is due to illness, the appropriate procedures should be followed to submit an online medical excuse AND the Course Director should be contacted prior to the lab.

If the absence is not illness-related, the Course Director should first be notified. Absences may be excused in some circumstances. However, these will be dealt with on a case-by-case basis.

Policy Regarding Missing Examinations and/or Failure of Submission of Assignments

Students who fail to attend an examination (Sakai quiz/test or Examsoft) or submit an assignment by the deadline without a valid reason (see student manual: SGUSVM POLICY ON AN EXCUSED ABSENCE (EA) FOR STUDENTS) will receive a score of “0” points for the examination.

Students who have technical issues during the examination MUST inform the Course Director (s) ( and IT ( OR OR call 1-631-665-8500 ext. 4444 (US, NU, International) OR 1-473-439- 2000 ext. 4444 (Grenada), AND Dean of Students ( during the open period for the examination. Failure to do so immediately will result in the student receiving the highest score recorded at the time, but NOT being eligible to take a completion examination.

Scheduling of examinations (regular, re-sit, completion, comprehensive, or exemption) is at the discretion of the University.

ExamSoft Policy

All students are responsible for knowing and complying with the University’s Code of Conduct and the guidelines. Students must read and then sign the Honor Code statement at the start of examinations to indicate that they will comply with the University Code of Conduct.

Prior to Exam Day

  1. Each student is required to have a laptop for the purpose of taking computer-based examinations (e-Exams) at SGU. Students must ensure that their laptops meet the current minimum system requirements prior to exam day:
  2. Examinees must use their MY SGU Member Center username and password to access the Custom Home Page ( created by ExamSoft for the University.
  3. Examinees are responsible for downloading and registering the latest version of Examplify on their laptop prior to exam day. Once Examplify has been successfully downloaded, examinees are strongly encouraged to familiarize themselves with the software by downloading and taking practice exams.
  4. Examinees are responsible for setting their laptop up for ExamMonitor prior to the exam (see links below).
  5. Examinees will be notified via MyCourses, of all exam related information. Email notifications will also be sent from ExamSoft Support to examinees, notifying them of examinations available for downloading.
  6. Examinees experiencing difficulties with their laptop are encouraged to visit the IT department for assistance prior to exam day. Examinees needing a laptop must visit the Office of Institutional Advancement (OIA) to request an exam loaner.
  7. Examinees should visit the following information to familiarize themselves with the online proctored exam format and set up their baseline photo.
    1. A Examsoft/ExamID quick guide for students (Please note that the current Examplify version is 2.3.8)
    2. The Examsoft student perspective video 30mins
    3. The Examsoft/ExamID FAQ
    4. Examsoft information page
    5. The general Reminders/Guidelines
Copyright Policy

The materials (such as slides, handouts and audio/video recordings) provided to students who are taking courses at St. George’s University (SGU) are the intellectual property of the Faculty and/or Administration of SGU. Students are free to use these materials solely for the purpose of group or individual study. Reproduction in whole or in part is prohibited.