TPLO Closure Protocol

Purpose

TPLO surgery ends at skin closure. Closure is the final point under direct surgical control and the moment recovery begins.

This protocol standardizes how that transition is managed without replacing surgical technique, antibiotic strategy, or aseptic practice.

Phase 1 — Intraoperative Closure

Objective

Address residual bacterial burden at the time of closure using a standardized final lavage step.

Clinical Rationale

Closure strategies are evaluated at the point of closure — the final point under surgical control — using activity-based methods applied across orthopedic and implant-associated procedures.

Standard saline irrigation remains foundational but may not address residual bacterial burden immediately prior to closure.

Protocol Steps

1. Apply the final intraoperative lavage as the final adjunct prior to closure
2. Allow appropriate dwell time
3. Perform copious saline irrigation immediately prior to layered closure
4. Proceed with routine layered closure

This step integrates into existing TPLO workflows without altering technique, instrumentation, or operative timing.

Phase 2 — Postoperative Recovery

Objective

Standardize owner communication and recovery execution following TPLO surgery.

Clinical Rationale

Closure marks the transition from surgical control to owner-mediated healing. Recovery execution is treated as a continuation of the closure protocol.

Protocol Steps

• Provide structured TPLO recovery guidance to the client
• Reinforce restrictions, milestones, and follow-up expectations
• Maintain continuity from surgery through home recovery

When This Applies

• All TPLO procedures
• Begins immediately prior to skin closure
• Continues through recovery handoff

Operating Room (Closure)

1. Complete TPLO procedure
   All fixation and implant placement finalized per surgeon direction.
2. Apply final intraoperative closure lavage
   Apply the adjunctive lavage as directed by the surgeon.
3. Allow appropriate dwell time
   Maintain the operative field per protocol before proceeding.
4. Perform saline irrigation and proceed with closure
   Perform saline irrigation immediately prior to routine layered closure.

Recovery Execution

5. Begin TPLO recovery guidance process
   Ensure the client receives procedure-specific recovery instructions.
6. Reinforce key restrictions and milestones
   Review activity limits, monitoring, and follow-up timing.
7. Confirm recovery guidance has been initiated prior to discharge