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Brandly JE, Levine DG, Stefanovski D, Aitken MR. In vitro evaluation of the effect of tris-EDTA and 0.0005% chlorhexidine solution on the strength of two absorbable sutures. Vet Surg 2024; 53:701-709. [PMID: 37743444 DOI: 10.1111/vsu.14029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 08/13/2023] [Accepted: 08/24/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVE To determine the effect of 0.0005% chlorhexidine and tris-EDTA solution on the strength of three commonly used suture types for closure of equine ventral midline celiotomy. STUDY DESIGN Controlled laboratory study. SAMPLE POPULATION Knotted loops (n = 10/group, 150 knot constructs total). METHODS Strands of 2 polyglactin 910, 3 polyglactin 910, and 2 polydioxanone were tied to form knotted loops. All knotted loops were mounted on a tabletop force measurement machine system and loaded at 100 mm/min until the breaking force (N) was determined. The breaking force (N) of knotted loops using dry suture was recorded at study start, then of knotted loops soaked in either 0.0005% chlorhexidine and tris-EDTA for 20 min followed by incubation in equine serum (treatment) or serum alone (control) for 14 and 21 days. Analysis of variance (ANOVA) compared the breaking force between the treatment and control groups at each time point. RESULTS There was no significant difference in the breaking force of 2 USP polyglactin 910 (p = .35, confidence interval [CI] = -0.21-0.59), 3 USP polyglactin 910 (p = .61, CI = -0.41-0.24), or 2 USP polydioxanone (p = .76, CI = -0.63-0.46) soaked in 0.0005% chlorhexidine and tris-EDTA solution followed by equine serum when compared to each respective suture soaked in equine serum only. CONCLUSION/CLINICAL SIGNIFICANCE Since 0.0005% chlorhexidine and tris-EDTA solution did not exhibit a significant effect on the breaking force of the absorbable sutures studied, the solution may be used for incisional lavage in the clinical setting.
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Affiliation(s)
- Jerrianne E Brandly
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - David G Levine
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Darko Stefanovski
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Maia R Aitken
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
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Barnes HK, Munsterman AS, Gillen AM, Caston SS, Tatarniuk DM, Kersh K, Swor T, Hanson RR. Evaluation of the in vitro performance of the double forwarder knot, compared to square and surgeon's knots using large gauge suture. Vet Surg 2024; 53:376-383. [PMID: 38151296 DOI: 10.1111/vsu.14058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 11/02/2023] [Accepted: 11/24/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate the strength and size of the double forwarder (DF) knot in 2 and 3 USP polyglactin 910 when used to form a ligature and to compare the knot holding capacity (KHC), size and weight of the DF knot to surgeon's (SU) and square (SQ) knots with varying numbers of throws. STUDY DESIGN Laboratory study. STUDY POPULATION Knotted suture. METHODS Knots were tied using 2 and 3 USP polyglactin 910 and tested on a universal testing machine under linear tension. Mode of failure and (KHC) were recorded. Knot volume and weight were determined by digital micrometer and balance. KHC, size, and weight between knot type, number of throws, and suture type and size were compared using ANOVA testing, with p < .05 as significant. RESULTS In both suture types, DF knots had a higher KHC than SQ/SU knots (p < .004), with the exception of SU knots with 6-8 throws in 3 USP polyglactin 910 (p > .42). All DF knots failed by suture breakage at the knot, as did all SQ/SU knots with >6 throws. DF knots in 2 and 3 USP polyglactin 910 were larger and heavier than SQ and SU knots when the same number of throws was applied (p < .003). CONCLUSION Self-locking DF knots provided increased strength compared to SU/SQ in large gauge suture but only when fewer than six throws are applied to SU/SQ knots. CLINICAL RELEVANCE The new DF knot could be an alternative for a secure ligature.
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Affiliation(s)
- Harriet K Barnes
- Philip Leverhulme Equine Hopsital, University of Liverpool, Neston, UK
| | - Amelia S Munsterman
- Veterinary Medical Center, Michigan State University, East Lansing, Michigan, USA
| | - Alex M Gillen
- Philip Leverhulme Equine Hopsital, University of Liverpool, Neston, UK
| | | | | | - Kevin Kersh
- Lloyd Large Animal Hospital, Iowa State University, Ames, Iowa, USA
| | - Tamara Swor
- Lloyd Large Animal Hospital, Iowa State University, Ames, Iowa, USA
| | - R Reid Hanson
- JT Vaughan Large Animal Teaching Hospital, Auburn University, Auburn, Alabama, USA
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Kamm JL. Rectal tear repair using barbed suture in the horse. J Am Vet Med Assoc 2024; 262:125-129. [PMID: 37758188 DOI: 10.2460/javma.23.04.0215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/24/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE To describe the repair utilizing integral-anchor barbed suture in equine rectal tears. ANIMALS 3 horses aged 3 to 10 years old with grade 3 to 4 rectal tears. CLINICAL PRESENTATION Grade 3 and 4 rectal tears were referred for surgical repair immediately after iatrogenic tearing or tearing during parturition. Integral-anchor barbed suture (Stratafix Symmetric PDS Plus, size 1, 18" CT-1) was placed using long-handled instruments or hand closure depending on the accessibility and visibility of the tear. Closure of grade 3 tears was performed using a continuous appositional pattern. A horizontal mattress pattern was performed in the grade 4 tear. No other surgical procedures were performed. RESULTS Two grade 3 tears were successfully repaired with no complications and discharged from the hospital. One grade 4 tear was successfully repaired; however, 4 days post-surgery partial dehiscence of the suture site occurred, and the horse was euthanized. CLINICAL RELEVANCE Grade 3 rectal tears were repaired successfully by using an integral-anchor barbed suture. No post-operative complications were reported. Blind hand suturing could be performed in cranial locations when the laceration could not be made visible. For grade 4 rectal tears, additional surgical procedures beyond barbed suture closure are needed.
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Madsen K, Martens A, Haspeslagh M, Meulyzer M, Gustafsson K. The effect of medical grade honey on tensile strength, strain, and Young's modulus of synthetic absorbable suture material used in equine surgery. Equine Vet J 2024; 56:193-201. [PMID: 37326536 DOI: 10.1111/evj.13966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/29/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Medical grade honey (MGH) has been introduced as a protective measure against surgical site infections in equine surgery, but the effect on suture material has not been investigated. OBJECTIVE To evaluate the effect of MGH on the tensile properties of three synthetic absorbable suture materials. STUDY DESIGN In vitro experiments. METHODS Ten strands of Polydioxanone USP 2 (PD2), Polyglactin 910 USP 2 (PG2) and Polyglecaprone USP 2-0 (PC2-0) were incubated 1, 7, 14, 21 and 28 days in MGH, phosphate-buffered saline (PBS), equine plasma (EP) and MGH mixed with equine plasma (HP). Mechanical testing was performed recording maximum load at failure (N), strain at failure and Young's modulus (N/mm2 ). The results were reported from a Welch or regular ANOVA. RESULTS PD2 in MGH had a significantly higher tensile strength compared to PD2 in EP (p < 0.05, mean difference (md) = 16.95 N, CI95% (9.19-24.70 N)) and PBS (p < 0.05, md = 14.48 N CI95% (6.73-22.23 N)) on day 7 and the remaining time points. PG2 incubated in MGH had a significantly higher tensile strength compared to EP (p < 0.05, md = 69.28 N CI95% (64.16-74.40 N)) and PBS (p < 0.05, md = 56.90 N CI95% (51.78-62.02 N)) until day 28. PC2-0 incubated in MGH had a significantly higher tensile strength compared to EP (p < 0.05 md = 12.40 N CI95% (4.59 N-20.20 N)) and PBS (p < 0.05 md = 11.23 CI95% (3.42-19.03 N)) on day 7 and the remaining time points. MAIN LIMITATIONS The sutures were unloaded during incubation and a single cycle to failure test was only performed, which does not reflect the in vivo environment where shear forces are present. CONCLUSIONS MGH did not negatively affect the tensile strength of the suture material and can safely be applied in contact with suture materials commonly used in equine surgery.
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Affiliation(s)
| | - Ann Martens
- Faculty of Veterinary Medicine, Department of Large Animal Surgery, Anaesthesia and Orthopaedic, Ghent University, Merelbeke, Belgium
| | - Maarten Haspeslagh
- Faculty of Veterinary Medicine, Department of Large Animal Surgery, Anaesthesia and Orthopaedic, Ghent University, Merelbeke, Belgium
| | | | - Kajsa Gustafsson
- Department of Veterinary Medicine and Animal Science (DIVAS), University of Milan, Lodi, Italy
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McKay RM, Duffy DJ, Chang YJ, Beamon W, Moore GE. Biomechanical evaluation of three adjunctive methods of orthopedic tension band-wire fixation to augment simulated patella tendon repairs in dogs. Vet Surg 2023; 52:1140-1149. [PMID: 37534913 DOI: 10.1111/vsu.14000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVE To evaluate the effects of three adjunctive methods of tension band wire fixation (TBWF) on the biomechanical properties, gap formation, and failure mode in simulated canine patella tendon rupture (RPT). STUDY DESIGN Randomized, ex vivo. SAMPLE POPULATION Paired hindlimbs from 32 dog cadavers. METHODS Patellar tendons (PTs) and associated bone-muscle-tendon units were harvested. Each PT was transected then sutured using a core locking loop and simple continuous epitendinous pattern. Each hindlimb was randomly assigned to one of three groups (n = 18 hindlimbs/group) using 18 gauge 316 L wire, anchored to the tibial crest distally, to perform transpatellar, suprapatellar, or combined tension band-wire (TBW) augmentation. Ten hindlimbs were utilized as control specimens. Yield, peak, and failure loads, stiffness, loads to 1 and 3 mm gap formation, and failure mode were evaluated. RESULTS Combined transpatellar and suprapatellar TBW augmentation was superior to transpatellar or suprapatellar groups alone. Yield (p = .0008), peak (p = .004), and failure loads (p = .005) were greater for the combined group than for the transpatellar (p = .048) and suprapatellar groups (p = .01) respectively. There was no difference regarding the occurrence of 1 or 3 mm gap formation (1 mm, p = .05; 3 mm, p = .06); however, loads required to cause gap formation were greater in the combined group (p = .036). Mode of failure differed between techniques used for PT augmentation (p < .001). CONCLUSION Combined transpatellar and suprapatellar adjunctive TBW augmentation for simulated PT repairs was biomechanically superior to either transpatellar or suprapatellar TBWF alone. CLINICAL SIGNIFICANCE Combined suprapatellar and transpatellar TBWF may offer a viable surgical option for increased repair-site strength and greater loads to gap formation. Further studies investigating alternative techniques and materials for RPT repair augmentation are warranted.
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Affiliation(s)
- Rachel M McKay
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Daniel J Duffy
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Yi-Jen Chang
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Weston Beamon
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - George E Moore
- Veterinary Administration, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
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Bellitto NA, Oliver FB, Pollock PJ. Comparison of incisional bursting strength of a bidirectional absorbable knotless suture material versus a standard continuous absorbable suture material for closure of the equine linea alba. Vet Surg 2023; 52:1121-1127. [PMID: 37655506 DOI: 10.1111/vsu.14022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/23/2023] [Accepted: 08/13/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE To evaluate the use of bidirectional knotless barbed suture material for closure of the equine linea alba. STUDY DESIGN Laboratory study. ANIMAL OR SAMPLE POPULATION Adult light horse cadavers (n = 24). METHODS A 25 cm incision was made through the linea alba, and a 200 L polyurethane bladder was positioned within the abdomen. The linea alba was closed either using USP2/EP5 bidirectional polydioxanone barbed suture or USP2/EP5 standard polydioxanone suture in a simple continuous pattern. Closure time was recorded for each suture type. The bladder was air-insufflated at 40 L/min, and the pressure at body wall failure recorded. The length of suture used for wound closure and wound failure modes were recorded. Suture length, closure time, bursting pressure, and failure modes were compared using Welch-Aspin t-tests. RESULTS The incisional bursting pressure was comparable between the two groups (p > .05). Less suture material (p < .01) was required with the barbed suture than the standard suture. Closure time was less for the barbed suture than the standard suture (p < .01). Suture failure was the main failure mode in both groups (83% cases). CONCLUSIONS Closure of the equine linea alba using bidirectional barbed suture material reduced the amount of foreign material in the wound and decreased closure time without compromising incisional strength. CLINICAL RELEVANCE Bidirectional barbed suture material could be considered as an alternative to standard suture materials for closure of the equine line alba.
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Affiliation(s)
- Nicholas A Bellitto
- Glasgow Equine Hospital & Practice, School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
| | | | - Patrick J Pollock
- Glasgow Equine Hospital & Practice, School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
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Williams EA, Monnet E. Clinical outcomes of the use of unidirectional barbed sutures in gastrointestinal surgery for dogs and cats: A retrospective study. Vet Surg 2023; 52:1009-1014. [PMID: 37332126 DOI: 10.1111/vsu.13978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/26/2023] [Accepted: 05/29/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE To report the clinical outcomes of gastrointestinal surgery using unidirectional barbed sutures in single-layer appositional closure in dogs and cats. STUDY DESIGN Retrospective and descriptive study. SAMPLE POPULATION Twenty-six client-owned dogs; three client-owned cats. METHODS Medical records of dogs and cats that received gastrointestinal surgery closed with unidirectional barbed sutures were reviewed to collect information on signalment, physical examinations, diagnostics, surgical procedures, and complications. Short- and long-term follow-up information was collected from the medical records, the owners, or the referring veterinarians. RESULTS Six gastrotomies, 21 enterotomies, and nine enterectomies were closed with a simple continuous pattern with unidirectional barbed glycomer 631 sutures. Nine dogs had multiple surgical sites closed with unidirectional barbed sutures. None of the cases in the study developed leakage, dehiscence, or septic peritonitis during the 14-day short-term follow up. Long-term follow up information was collected for 19 patients. The median long-term follow-up time was 1076 days (range: 20-2179 days). Two dogs had intestinal obstruction due to strictures at the surgical site 20 and 27 days after surgery. Both were resolved with an enterectomy of the original surgical site. CONCLUSION Unidirectional barbed suture was not associated with a risk of leakage or dehiscence after gastrointestinal surgery in dogs and cats. However, strictures may develop in the long term. CLINICAL SIGNIFICANCE Unidirectional barbed sutures can be used during gastrointestinal surgery in client-owned dogs and cats. Further investigation of the role of unidirectional barbed sutures leading to abscess, fibrosis, or stricture is necessary.
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Affiliation(s)
- Evan A Williams
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Eric Monnet
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
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Rivenburg RE, Maxwell EA, Bertran J, Souza CHDM, Smith BL. Biomechanical comparison of canine median sternotomy closure using suture tape and orthopedic wire cerclage. Vet Surg 2023; 52:1057-1063. [PMID: 37603027 DOI: 10.1111/vsu.14015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/07/2023] [Accepted: 07/25/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE To compare the mechanical properties of suture tape and orthopedic wire cerclage in an ex vivo canine median sternotomy model. STUDY DESIGN Ex vivo. ANIMALS Twelve large-breed canine cadaveric sternums. METHODS Median sternotomies were performed, leaving the manubrium intact. The specimens were randomly assigned to group W (20-gauge stainless steel orthopedic wire cerclage in a figure-of-eight pattern) or group ST (suture tape in a figure-of-eight pattern). Each specimen was laterally distracted until failure using an electrodynamic materials-testing system. RESULTS No differences were observed for displacement, yield load, maximum load, implant failure between the groups. The orthopedic wire construct was stiffer than the suture tape construct. CONCLUSION Suture tape was biomechanically similar to orthopedic wire cerclage for sternotomy closure in dogs, although wire constructs were stiffer. CLINICAL SIGNIFICANCE Suture tape may represent an alternative to cerclage wire for sternotomy closure in dogs. Additional studies evaluating its clinical use are needed.
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Affiliation(s)
- Rachel E Rivenburg
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
| | - Elizabeth A Maxwell
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
| | - Judith Bertran
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
| | - Carlos H De Mello Souza
- Department of Small Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
| | - Benjamin L Smith
- Arthrex Inc., Department of Orthopedic Research, Naples, Florida, USA
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Pan Y, Mann FA, Wagner-Mann C, Winholtz RA. Addition of two full-thickness simple interrupted sutures to standard incisional gastropexy increases gastropexy biomechanical strength. J Am Vet Med Assoc 2023; 261:1345-1350. [PMID: 37257833 DOI: 10.2460/javma.23.03.0141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/08/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To compare the acute strength (failure load and work to failure) of standard incisional gastropexy (SIG) and modified incisional gastropexy (MIG). ANIMALS 37 pig cadavers. PROCEDURES Stomachs and right abdominal walls were harvested from pigs euthanized for reasons unrelated to this study. The tissues were stored in lactated Ringer's solution overnight in a 5 °C cooler. Matching body wall and stomach tissue pairs were randomized and divided into 2 groups, on which either SIG or MIG was performed the following day. The MIG technique was identical to SIG except 2 additional simple interrupted sutures, 1 cranial and 1 caudal to the continuous suture line, were placed full thickness into the stomach to ensure engagement of the submucosa. After gastropexy, the samples underwent biomechanical testing. Information regarding change in position and load was generated by the MTESTQuattro software. Mode of failure was examined after the procedure was complete. RESULTS The MIG had higher failure load and work to failure compared to SIG. All failures were caused by gastric tissue tearing. CLINICAL RELEVANCE The MIG is biomechanically superior to SIG and may provide more security than SIG during healing. However, clinical study is needed to ascertain if there is a difference in gastropexy failure and complications between these 2 techniques.
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Affiliation(s)
- Yi Pan
- 1Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - F A Mann
- 1Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - Colette Wagner-Mann
- 1Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - R A Winholtz
- 2Department of Mechanical and Aerospace Engineering, College of Engineering, University of Missouri, Columbia, MO
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Mann FA, Pan Y, Middleton JR, Chairez CK, Pyne C. Comparison of incisional gastropexy with and without addition of two full-thickness stomach to body wall sutures. J Am Vet Med Assoc 2023; 261:1351-1356. [PMID: 37257832 DOI: 10.2460/javma.22.11.0492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/15/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To compare complications between a modified incisional gastropexy (MIG) technique and standard incisional gastropexy (SIG). ANIMALS 347 client-owned dogs. PROCEDURES Dogs that had undergone SIG or MIG from March 2005 through April 2019 were identified through a medical record search of the University of Missouri Veterinary Health Center. The MIG technique is identical to SIG except 2 additional simple interrupted sutures are added, 1 cranial and 1 caudal to the continuous suture line, going full thickness into the stomach to ensure engagement of submucosa. Medical record information was used to identify intraoperative, postoperative, and short-term complications, and telephone or email communication to pet owners and/or referring veterinarians was used to identify complications (short-term and long-term) after discontinuance of care at the University of Missouri Veterinary Health Center. Intraoperative, postoperative, short-term, and long-term complications were analyzed in aggregate within 6 matched groupings: (1) gastropexy for gastric dilatation-volvulus, (2) prophylactic gastropexy without other procedures, (3) gastropexy with ovariohysterectomy, (4) gastropexy with castration, (5) gastropexy with splenectomy, and (6) gastropexy with celiotomy other than splenectomy. Overall rates of complications potentially attributed to gastropexy were compared between SIG and MIG using the Fisher exact test. Overall rates of complications not attributed to gastropexy were compared between SIG and MIG using the χ2 test. RESULTS There were no significant differences in overall complication rates between SIG and MIG. CLINICAL RELEVANCE Surgeons who feel that engagement of gastric submucosa is important for gastropexy success may use the MIG technique with minimal fear of complications. However, superiority of one technique over the other cannot be determined on the basis of this study.
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Reid CH, Cooke SJ. Tensile strength and knot security of five suture materials exposed to natural summer conditions of a temperate lake. J Aquat Anim Health 2023; 35:143-153. [PMID: 36934298 DOI: 10.1002/aah.10182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/03/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Wild fish and other aquatic ectotherms are often subjected to procedures during field research that require wound closure using sutures. A variety of absorbable sutures are available for such purposes, yet degradation processes are highly dependent on temperature, and the environments in which wild ectotherms are released are almost always colder than the conditions for which absorbable sutures are typically designed (i.e., ~37°C). We therefore studied the degradation of various suture materials under a set of biologically relevant conditions for temperate freshwater fish. METHODS Using a force gauge, we tested the tensile strengths and knot securities of loops tied with five different absorbable suture materials (PDS-II, dyed coated Vicryl, undyed coated Vicryl, plain gut, and chromic gut) prior to and during submersion in a temperate lake over an 8-week period. RESULT The naturally derived collagen-based suture materials (i.e., plain gut and chromic gut) exhibited major decreases in tensile strength within 2 weeks of submersion but maintained relatively high knot security throughout the study period. The synthetic suture loops had poorer initial knot securities that increased following submersion and showed little to no evidence of degradation after 8 weeks. CONCLUSION Variable rates of absorbable suture degradation, or lack thereof, were observed. We discuss the implications of these trends for fish welfare considerations such as suture retention, wound healing, inflammation, and infection under natural conditions.
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Affiliation(s)
- Connor H Reid
- Fish Ecology and Conservation Physiology Lab, Department of Biology, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - Steven J Cooke
- Fish Ecology and Conservation Physiology Lab, Department of Biology, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
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Monnet E, Hafez A. Influence of conventional versus unidirectional barbed suture on leakage pressures in canine vesicourethral anastomosis: An ex-vivo study. Vet Surg 2023; 52:716-720. [PMID: 36898966 DOI: 10.1111/vsu.13950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 12/23/2022] [Accepted: 02/15/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVE To compare leakage pressures of vesicourethral anastomosis (VUA) performed with conventional and unidirectional barbed sutures in canine cadaveric tissue. STUDY DESIGN Experimental, ex-vivo, randomized study. ANIMALS A total of 24 male canine bladders with the urethra. METHODS Specimens after prostatectomy were randomly divided into a unidirectional barbed suture (UBS) or a conventional suture (C) group. For the UBS group, the VUA was performed with 4-0 unidirectional barbed sutures. For the C group, the VUA was performed with 4-0 monofilament absorbable suture. The VUA was completed with two simple continuous sutures. Surgical time, leakage pressure, site of leakage, and the number of suture bites were recorded. RESULTS The median suturing time was 12.70 minutes (range: 7.50-16.10 min) for the UBS group and 17.30 minutes (range: 14.00-21.30 min) for the C group (p < .0002). The median leakage pressure was 8.60 mmHg (range: 5.00-17.20 mmHg) for the UBS group and 11.70 mmHg (range: 6.00-18.50 mmHg) for the C group (p = .236). The median number of suture bites was 14 (range:11-27) for the UBS group and 19 (range:17-28) for the C group (p = .012). CONCLUSION Unidirectional barbed suture does not statistically affect the acute leakage pressure of VUA in normal cadaveric specimen. It resulted in a shorter surgical time and fewer suture bite placements. CLINICAL SIGNIFICANCE A urinary catheter will still be required when a unidirectional barbed suture is used to complete a VUA in dogs to prevent extravasation of urine in the postoperative period.
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Affiliation(s)
- Eric Monnet
- Department of Clinical Science, Colorado State University, College of Veterinary Medicine and Biomedical Science, Fort Collins, CO, USA
| | - Ahmed Hafez
- Faculty of Veterinary Medicine, Beni-Suef University, Beni Suef, Egypt
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Oberhaus AN, McFadden MS. Prospective, randomized, double blind comparison of suture materials with and without triclosan in dogs undergoing tibial plateau leveling osteotomy. Can Vet J 2023; 64:565-570. [PMID: 37265808 PMCID: PMC10204883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Objectives To determine if triclosan-impregnated suture decreases surgical site infection rates after tibial plateau leveling osteotomy (TPLO) in dogs. Sample population There were 116 dogs with naturally occurring cranial cruciate ligament disease presenting for treatment with TPLO. Procedures Written consent was obtained by all clients in order to be included in this study. Dogs were randomly assigned a suture type immediately before the start of anesthesia. Infection rates were compared between the suture groups, as were the gender, duration of anesthesia, duration of surgery, age of dog, weight, length of incision, and stifle side. Direct examination by a veterinarian was conducted at 24 h, 10 to 14 d, and 8 to 12 wk after surgery. If the dogs did not return for direct examination, owners were contacted by a veterinarian and phone interviews were conducted. Results Overall, 12.9% of the incisions were diagnosed with a surgical site infection (SSI). The SSI rate for dogs that received the triclosan suture was 5.35% (3/56), and the rate for dogs that received the regular suture was 19.64% (11/56), with P = 0.016. The duration of anesthesia, duration of surgery, age, weight, length of incision, and right versus left stifle did not show a significant difference in infection rates. The suture type did have a significant effect, and triclosan-impregnated suture had a decreased infection rate when compared to regular suture. Gender also had a significant effect, with P = 0.032. Conclusion Triclosan-impregnated suture decreased SSI when used for closure in dogs undergoing TPLO. Triclosan-impregnated suture may be considered a material of choice to close surgical wounds at risk of SSI when implants are used.
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Hafez A, Ragab GA, Monnet E. Comparison of leakage pressures of vesicourethral anastomosis performed with intracorporeal suturing in a simulator and conventional suturing ex vivo in canine cadaveric tissue. Vet Surg 2022; 51 Suppl 1:O160-O166. [PMID: 33914356 DOI: 10.1111/vsu.13615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/23/2021] [Accepted: 01/28/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare conventional and intracorporeal vesicourethral anastomosis (VUA) in canine cadaveric tissue. STUDY DESIGN Cadaveric ex vivo study. STUDY POPULATION Twenty-eight canine bladders with urethra. METHODS Specimens after prostatectomy were randomly divided into intracorporeal (I) group or conventional (C) group. For the I group, VUA was performed in a simulator with laparoscopic needle holders and telescope. For the C group, the anastomosis was performed in vitro with standard instruments. The VUA was performed with 4-0 monofilament absorbable suture and was completed with two simple continuous sutures. Surgical time, leakage pressure, site of leakage, and number of suture bites were recorded. RESULTS Fourteen samples were entered in each group. The dorsal side of the anastomosis was initially performed, followed by the ventral side. The median suturing time was 30.8 minutes (range, 19.3-39.2) for the I group and 17.3 minutes (range, 9.2-21.3) for the C group (P < .0001). The median leakage pressure was 10.9 mm Hg (range, 4.1-29.7) for the I group and 10.8 mm Hg (range, 6.2-18.5) for the C group (P = .94). The median number of stitches was 20 (range, 14-26) for the I group and 19 (range, 11-28) for the C group (P = .96). The distribution of the site of leakage was similar between groups (P = .381). CONCLUSION Vesicourethral anastomosis can be performed with leakage pressures similar to intracorporeal and conventional suturing. CLINICAL SIGNIFICANCE This study represents the first step toward laparoscopic radical prostatectomy in dogs.
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Affiliation(s)
- Ahmed Hafez
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Gamal A Ragab
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Eric Monnet
- Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado
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Sarkisian NW, Mulon PY. Comparison between barbed and conventional sutures for longitudinal thelotomy closure in an ex-vivo bovine model. Can Vet J 2022; 63:535-539. [PMID: 35502261 PMCID: PMC9009743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To determine differences in suture time and bursting strength on a longitudinal thelotomy closure using innovative barbed versus conventional smooth suture materials. SAMPLE POPULATION Twenty-four teats from 6 udders of culled beef cows. STUDY DESIGN Experimental ex-vivo surgical study. METHODS Thelotomies (length: 2 cm) were performed on every teat and randomly allocated to closure with either a 3-0 bidirectional barbed suture for both mucosa and connective layers or a conventional 3-layer suture, using 3-0 smooth polydioxanone. For both groups, skin was closed with 2-0 polypropylene monofilament suture. Duration of suturing time for inner layers and bursting strength of the repair were recorded and compared. RESULTS Suturing was faster with barbed versus conventional sutures (527.7 ± 64.5 versus 727.1 ± 60.7 s, respectively; P < 0.0001). However, bursting strength was not significantly different between the 2 types of sutures. CONCLUSION Using the barbed suture significantly reduced the time required to suture the mucosa and conjunctiva layers, with no significant difference between sutures in their bursting strength. CLINICAL SIGNIFICANCE Bidirectional barbed suture material is suitable for closure of thelotomies in cattle.
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Affiliation(s)
- Neshan W Sarkisian
- Department of Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Pierre-Yves Mulon
- Department of Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
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Matz BM, Hlusko KC, Linden DS, Tillson DM, Hofmeister E. Ex vivo comparison of different thoracoabdominal stapler sizes for typhlectomy in canine cadavers. Vet Surg 2022; 51:682-687. [PMID: 35191557 DOI: 10.1111/vsu.13793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 01/10/2022] [Accepted: 02/04/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the influence of staple size on leakage pressure of typhlectomy sites in canine cadavers. STUDY DESIGN Randomized, experimental cadaveric study. ANIMALS Twenty-four fresh canine cadavers. METHODS Ileocecocolic segments were exteriorized following right paracostal laparotomy after euthanasia. Cecal base length and wall thickness were measured. Each cecum was randomly assigned to 1 of 3 groups (TA 30 V3 2.5 mm, TA 60 3.5 mm, and TA 60 4.8 mm). The cecal base was stapled and the cecum was removed. A 10 cm segment including the stapled cecal excision site was tested for initial leak pressure. RESULTS The mean ± standard deviation body weights across the groups were 18.7 ± 6.1 kg, 16.2 ± 7.5 kg, and 14.2 ± 5.5 kg for the TA 30 V3 2.5 mm, TA 60 3.5 mm, and TA 60 4.8 mm groups, respectively (P = .48). There were no differences for mean cecal base length or wall thickness. Mean initial leak pressure (ILP) across groups was 182 ± 111 mmHg (TA 30 V3 2.5 mm), 112 ± 57 mmHg (TA 60 3.5 mm), and 77 ± 60 mmHg (TA 60 4.8 mm) (P = .78). CONCLUSION Each stapler size that was evaluated resulted in a mean ILP in excess of typical intraluminal pressures under normal circumstances. There were no differences among groups. CLINICAL SIGNIFICANCE The results of this cadaveric study support the use of any of the stapler sizes evaluated in similarly sized dogs. A prospective study is needed to be able to correlate stapler size and clinical outcome.
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Affiliation(s)
- Brad M Matz
- Department of Clinical Sciences, Auburn University, Auburn, Alabama, USA
| | - Katelyn C Hlusko
- Department of Clinical Sciences, Auburn University, Auburn, Alabama, USA
| | - Daniel S Linden
- First Coast Veterinary Specialists, Jacksonville, Florida, USA
| | - D Michael Tillson
- Department of Clinical Sciences, Auburn University, Auburn, Alabama, USA
| | - Erik Hofmeister
- Department of Clinical Sciences, Auburn University, Auburn, Alabama, USA
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Pressanto MC, Pascoletti G, Perkins JD, Zanetti EM, Beccati F, Santalucia V, Pepe M. Ex vivo biomechanical evaluation of polyester and polyblend suture techniques to perform equine laryngoplasty. Vet Surg 2022; 51:497-508. [PMID: 35129218 DOI: 10.1111/vsu.13777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 12/27/2021] [Accepted: 01/15/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To validate the use of a polyblend tape suture in equine laryngoplasty (PL). STUDY DESIGN Experimental study. ANIMALS Thirty-two cadaveric larynges. METHODS Each larynx was randomly assigned to 1 of 4 groups: PL with polyblend tape suture (TigerTape), without (TT) or with a cannula (TTC) in the muscular process of the arytenoid cartilage, and PL with polyester suture (Ethibond), without (EB) or with a cannula (EBC). Construct stiffness, total migration, creep, and drift values were measured after 3000 cycles. The specimens were then loaded to failure to assess their residual properties: load at failure, total energy, displacement, and 2 stiffness coefficients. RESULTS After cyclic testing, the total migration and creep were lower in TTC (6.36 ± 1.20 mm; 1.35 ± 0.38 mm/s) than in EB (11.12 ± 4.20 mm; 3.39 ± 2.68 mm/s) and in the TT constructs (11.26 ± 1.49 mm; 3.20 ± 0.54 mm/s); however, no difference was found with EBC (9.19 ± 3.18 mm; 2.14 ± 0.99). A correlation was found between total migration and creep (R = .85). The TTC constructs failed at higher loads (129.51 ± 33.84 N) than EB (93.16 ± 18.21 N) and EBC (81.72 ± 13.26 N) whereas the EB and EBC constructs were less stiff than TT and TTC (P < .001). CONCLUSION Biomechanical properties were generally superior for the TTC constructs tested under cyclical loading. The TT and TTC constructs failed at a higher load than EB and EBC constructs. The cannula in TTC and EBC reduced the failure at the muscular process. CLINICAL SIGNIFICANCE These results provide evidence to support the in vivo evaluation of the polyblend tape suture with or without a cannula in the muscular process for laryngoplasty in horses.
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Affiliation(s)
- Maria Chiara Pressanto
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
- Large Animal Hospital, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
| | | | - Justin D Perkins
- Department of Veterinary Clinical Science, Royal Veterinary College, North Mymms, UK
| | | | - Francesca Beccati
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
- Sport Horse Research Center, Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | | | - Marco Pepe
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
- Sport Horse Research Center, Department of Veterinary Medicine, University of Perugia, Perugia, Italy
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Yong JAA, Smeak DD. Comparison of three purse-string suture techniques for prevention of anal leakage during surgery. Am J Vet Res 2021; 83:270-274. [PMID: 34941565 DOI: 10.2460/ajvr.21.03.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare 3 anal purse-string suture techniques for resistance to leakage and to identify the suture technique requiring the fewest tissue bites to create a consistent leak-proof orifice closure. ANIMALS 18 large-breed canine cadavers. PROCEDURES 3 purse-string suture techniques (3 bites with 0.5 cm between bites [technique A], 5 bites with 0.5 cm between bites [technique B], and 3 bites with 1.0 cm between bites [technique C]) were evaluated. Each technique involved 2-0 monofilament nylon suture that was placed in the cutaneous tissue around the anus and knotted with 6 square throws. Standardized 2.0-cm-diameter circular templates with the designated bite number and spacing indicated were used for suture placement. Leak-pressure testing was performed, and the pressure at which saline was first observed leaking from the anus was recorded. The median and interquartile (25th to 75th percentile) range (IQR) were compared among 3 techniques. RESULTS Median leak pressure for technique A (101 mm Hg; IQR, 35 to 131.3 mm Hg) was significantly greater than that for technique C (19 mm Hg; IQR, 14.3 to 25.3 mm Hg). Median pressure did not differ between techniques A and B (50 mm Hg; IQR, 32.5 to 65 mm Hg) or between techniques B and C. CLINICAL RELEVANCE Placement of an anal purse-string suture prevented leakage at physiologic colonic and rectal pressures, regardless of technique. Placement of 3 bites 0.5 cm apart (technique A) is recommended because it used the fewest number of bites and had the highest resistance to leakage.
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Del Carpio LI, Petit Y, Diotalevi L, Laroche E, Levasseur A, Lussier B. Three-dimensional kinematic evaluation of lateral suture stabilization in an in vitro canine cranial cruciate deficient stifle model. PLoS One 2021; 16:e0261187. [PMID: 34928969 PMCID: PMC8687534 DOI: 10.1371/journal.pone.0261187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 11/24/2021] [Indexed: 11/19/2022] Open
Abstract
The impact of surgical correction of cranial cruciate ligament rupture (CCLR) on 3D kinematics has not been thoroughly evaluated in dogs. The success of current techniques remains limited, as illustrated by suboptimal weightbearing and progression of osteoarthritis. The inability to restore the stifle's 3D kinematics might be a key element in understanding these suboptimal outcomes. The objective of this study was to evaluate the impact of lateral suture stabilization (LSS) on the 3D kinematics of the canine stifle joint. We hypothesized that LSS would not restore 3D kinematics in our model. Ten cadaveric pelvic limbs collected from large dogs (25-40 kg) were tested using a previously validated apparatus that simulates gait. Three experimental conditions were compared: (a) intact stifle; (b) unstable stifle following cranial cruciate ligament transection (CCLt) and (c) CCLt stabilized by LSS. Three-dimensional kinematics were collected through 5 loading cycles simulating the stance phase of gait and curves were analyzed using a Wilcoxon signed-rank test. LSS restored baseline kinematics for the entire stance phase for cranial and lateromedial translation, flexion, and abduction. It restored distraction over 90% of the stance phase. Internal rotation was limited, but not restored. This in vitro study had limitations, as it used a simplified model of stifle motion and weight-bearing. The results of this study report that LSS can restore physiologic 3D kinematics largely comparable to those of healthy stifles. Suboptimal outcome in patients following CCLR stabilization by LSS may therefore result from causes other than immediate postoperative abnormal 3D kinematics.
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Affiliation(s)
- Laura-Isabela Del Carpio
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Yvan Petit
- Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada
- CIUSSS-NÎM Research Center, Sacré-Cœur Hospital of Montreal, Montreal, Quebec, Canada
| | - Lucien Diotalevi
- Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada
- CIUSSS-NÎM Research Center, Sacré-Cœur Hospital of Montreal, Montreal, Quebec, Canada
| | - Elisabeth Laroche
- Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada
- CIUSSS-NÎM Research Center, Sacré-Cœur Hospital of Montreal, Montreal, Quebec, Canada
| | - Annie Levasseur
- Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada
- CIUSSS-NÎM Research Center, Sacré-Cœur Hospital of Montreal, Montreal, Quebec, Canada
| | - Bertrand Lussier
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
- GREPAQ (Research Group in Animal Pharmacology of Quebec), Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
- Osteoarthritis Research Unit, Hospital Research Centre (CRCHUM), Université de Montréal, Montreal, Quebec, Canada
- * E-mail:
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20
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St Blanc AW, Csomos RA. Investigation and validation of a novel Endo GIA stapler for canine lung lobectomies. Can Vet J 2021; 62:1207-1210. [PMID: 34728848 PMCID: PMC8543658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The objectives of this study were to validate the 2.0 mm Endo GIA stapler for lung lobectomies and to compare procedural time and air leakage incidence with suture ligation. Sixteen canine cadavers, 18 to 27 kg, were randomly assigned to undergo lung lobectomy of the right middle lung lobe through intercostal thoracotomy, after which suture ligation or the 2.0 mm Endo GIA stapler was used. Procedural time was recorded. Following the lobectomy, the thoracic cavity was filled with fluid. Positive pressure ventilation was used to hold pressure at 20 cm H2O for 5 minutes. The bronchus was assessed for air leakage as evidenced by visualization of gas bubbles and the ability to maintain positive pressure. Procedural time and air leakage incidence were compared between groups. By these assessments, the 2.0 mm Endo GIA stapler was successful for lung lobectomies in all cadavers. There was no significant difference (t = -0.856, P = 0.407) in body weight by procedure assignment. Procedural time was significantly shorter (P < 0.0001) using the Endo GIA stapler compared to suture ligation. There was no significant correlation (r = 0.044, P = 0.873) between body weight and procedural time. There were no incidents of air leakage in either group. The 2.0 mm Endo GIA stapler may be used as an alternative device for lung lobectomies in canine cadavers. Smaller staples may provide more complete compression of hilar vessels and bronchi, resulting in reduced hemorrhage, air leakage, and thoracic contamination in cases with infection or neoplasia.
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Affiliation(s)
- Alissa W St Blanc
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana 70803, USA
| | - Rebecca A Csomos
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana 70803, USA
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Balsa IM, Giuffrida MA, Mayhew PD. A randomized controlled trial of three-dimensional versus two-dimensional imaging system on duration of surgery and mental workload for laparoscopic gastropexies in dogs. Vet Surg 2021; 50:944-953. [PMID: 33864647 DOI: 10.1111/vsu.13637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 03/01/2021] [Accepted: 04/04/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To evaluate the effect of three-dimensional (3D) laparoscopy compared to two-dimensional (2D) laparoscopy when evaluating duration of surgery for canine intracorporeally sutured gastropexy. STUDY DESIGN Randomized controlled clinical trial. ANIMALS Thirty client-owned dogs. METHODS Dogs were randomized into 2D or 3D groups and underwent a three-port laparoscopic intracorporeally sutured incisional gastropexy with barbed suture. Procedures were performed by a single board-certified surgeon. Duration of surgery was recorded and workload was assessed immediately after surgery using the NASA Task Load Index (TLX). RESULTS Median duration of surgery was 3 min shorter for 3D versus 2D (95%CI -10 to 13; p = .51). Surgical component durations, total and component TLX scores, and intraoperative complications also did not differ between groups. In a subgroup analysis excluding the first eight cases due to presumption of a learning curve with suturing technique, total TLX score (p = .004) and all component scores were lower for 3D as compared to 2D laparoscopy, although duration of surgery did not differ (p = .20). CONCLUSION The use of 3D laparoscopy was not associated with shorter duration of surgery when compared to 2D laparoscopy. CLINICAL SIGNIFICANCE 3D laparoscopy requires further investigation in veterinary medicine to determine its utility in decreasing surgical duration, surgical complications or surgeon mental or physical workload.
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Affiliation(s)
- Ingrid M Balsa
- Department of Surgical and Radiological Sciences, University of California-Davis, School of Veterinary Medicine, Davis, California, USA
| | - Michelle A Giuffrida
- Department of Surgical and Radiological Sciences, University of California-Davis, School of Veterinary Medicine, Davis, California, USA
| | - Philipp D Mayhew
- Department of Surgical and Radiological Sciences, University of California-Davis, School of Veterinary Medicine, Davis, California, USA
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Duffy DJ, Chang YJ, Fisher MB, Chambers AR, Moore GE. Effect of epitendinous suture caliber on the tensile strength of repaired canine flexor tendons. Am J Vet Res 2021; 82:510-515. [PMID: 34032486 DOI: 10.2460/ajvr.82.6.510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the effect of epitendinous suture (ES) caliber on the tensile strength of flexor tendon repairs in cadaveric specimens from dogs. SAMPLE 60 cadaveric superficial digital flexor tendons (SDFTs) from 30 skeletally mature dogs. PROCEDURES Specimens were randomly assigned to 5 suture caliber groups (n = 12 SDFTs/group). After sharp transection, SDFTs were repaired by placement of a simple continuous circumferential ES created with size-0, 2-0, 3-0, 4-0, or 5-0 polypropylene suture. Constructs were preloaded to 2 N and load tested to failure. Loads at yield, peak, and failure and mode of failure were compared among groups by statistical methods. RESULTS Yield, peak, and failure loads for SDFT repair constructs were positively correlated with ES caliber and did not differ between the size-0 and 2-0 groups on pairwise comparisons. Yield load was significantly greater for size-0, 2-0, and 3-0 groups than for the 4-0 and 5-0 groups. Peak and failure loads were significantly greater for the size-0 and 2-0 groups than for the remaining groups. Most size-0 (12/12), 2-0 (12/12), and 3-0 (10/12) group constructs failed because of ES pull-through; several constructs in the 4-0 group (5/12) and most in the 5-0 group (11/12) failed because of ES breakage. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested size-0 and 2-0 sutures should be considered when placing an ES for flexor tendon repairs in dogs. However, in vivo studies are needed determine the effects of increasing ES caliber on clinical outcomes for dogs undergoing these procedures.
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Duffy DJ, Chang YJ, Gaffney L, Fisher MB, Moore GE. Evaluation of a continuous locking novel epitendinous suture pattern with and without a core locking-loop suture on the biomechanical properties of tenorrhaphy constructs in an ex vivo model of canine superficial digital flexor tendon laceration. Am J Vet Res 2021; 82:302-309. [PMID: 33764835 DOI: 10.2460/ajvr.82.4.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the effect of a continuous locking novel epitendinous suture (nES) pattern with and without a core locking-loop (LL) suture on the biomechanical properties of ex vivo canine superficial digital flexor tendon (SDFT) tenorrhaphy constructs. SAMPLE 54 cadaveric forelimb SDFTs from 27 musculoskeletally normal adult dogs. PROCEDURES Tendons were assigned to 3 groups (18 SDFTs/group): sharply transected and repaired with a core LL suture alone (group 1), an nES pattern alone (group 2), or a combination of a core LL suture and nES pattern (group 3). All constructs underwent a single load-to-failure test. Yield, peak, and failure loads; gap formation incidence; and mode of failure were compared among the 3 groups. RESULTS Mean yield, peak, and failure loads differed significantly among the 3 groups and were greatest for group 3 and lowest for group 1. Mean yield, peak, and failure loads for group 3 constructs were greater than those for group 1 constructs by 50%, 47%, and 44%, respectively. None of the group 3 constructs developed 3-mm gaps. The most common mode of failure was suture pulling through the tendon for groups 1 (12/18) and 2 (12/18) and suture breakage for group 3 (13/18). CONCLUSIONS AND CLINICAL RELEVANCE Results suggested augmentation of a core LL suture with an nES pattern significantly increased the strength of and prevented 3-mm gap formation at the tenorrhaphy site in ex vivo canine SDFTs. In vivo studies are necessary to assess the effectiveness and practicality of the nES pattern for SDFT repair in dogs.
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Barbed sutures do not increase wound complications in horses. Vet Rec 2020; 187:72. [PMID: 33638411 DOI: 10.1136/vr.m2967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Thieman Mankin KM, Cohen ND. Randomized, controlled clinical trial to assess the effect of antimicrobial-impregnated suture on the incidence of surgical site infections in dogs and cats. J Am Vet Med Assoc 2021; 257:62-69. [PMID: 32538702 DOI: 10.2460/javma.257.1.62] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the prophylactic efficacy of triclosan-coated (TC) suture in preventing surgical site infections (SSIs) in dogs and cats undergoing surgical procedures. ANIMALS 862 animals (794 dogs and 68 cats). PROCEDURES Incidences of SSI of surgical wounds closed with TC suture and surgical wounds closed with non-TC suture occurring between the time of surgery and 1 month postoperatively were compared. Animals were randomly assigned to TC or non-TC suture groups. When TC suture was assigned, all suture available as TC material was used rather than non-TC suture. Presence of an SSI was determined by an owner questionnaire or direct examination. RESULTS Overall, 50 of 862 (5.8%) animals developed SSIs. Incidence of SSI was 6% (24/428) in the non-TC suture group and 6% (26/434) in the TC suture group. No significant difference was found in the incidence of SSI between groups. No significant difference was detected in the incidence of incisional problems (eg, redness, dehiscence, and seroma formation) between animals in which TC suture was used and those in which non-TC suture was used. On multivariable analysis, other factors were associated with increased SSI rates, including an incision length > 10 cm, surgery performed by the soft tissue surgery department, and anesthesia duration of > 240 minutes. CONCLUSIONS AND CLINICAL RELEVANCE No significant difference in incidence of SSI was detected between animals undergoing surgical procedures performed with non-TC versus TC suture.
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Duffy DJ, Curcillo CJ, Chang YJ, Moore GE. Effect of suture caliber on the tensile strength of tenorrhaphies in cadaveric canine tendons. Am J Vet Res 2020; 81:714-719. [PMID: 33112169 DOI: 10.2460/ajvr.81.9.714] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the effect of suture caliber on the tensile strength of tenorrhaphies performed with a locking-loop technique in cadaveric canine tendons. SAMPLE 60 superficial digital flexor tendons (SDFTs) from 30 cadaveric adult dogs. PROCEDURES Transverse tenotomy was performed, and SDFTs were repaired with a locking-loop technique and polypropylene suture of 5 randomly assigned calibers: size-0, 2-0, 3-0, 4-0, or 5-0 (n = 12 SDFTs/suture caliber). Tendon constructs were tested to failure. Yield, peak, and failure forces and causes of failure were compared between groups. RESULTS Mean ± SD failure force for the constructs was significantly greater with large-caliber suture (size-0: 73.5 ± 3.1 N; size 2-0: 54.4 ± 7.1 N; size 3-0: 28.7 ± 4.9 N; size 4-0: 18.7 ± 3.4 N; and size 5-0: 8.8 ± 2.8 N). The likelihood of construct failure by suture pullout through the tendon substance increased with large-caliber suture (size-0: 12/12), whereas the likelihood of construct failure by suture breakage increased with small-caliber suture (2-0: 10/12; 3-0, 4-0, and 5-0: 12/12 each). CONCLUSIONS AND CLINICAL RELEVANCE Large-caliber suture had greater tensile strength for tenorrhaphies performed with a locking-loop technique in cadaveric canine tendons. Prior to the use of large-caliber suture in patients requiring tenorrhaphy, however, in vivo studies are required to confirm the results obtained here.
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Tremolada G, Hazenfield KM, Smeak DD. In vitro holding security of four friction knots of monofilament or multifilament suture used as a first throw for vascular ligation. Am J Vet Res 2020; 81:821-826. [PMID: 32969726 DOI: 10.2460/ajvr.81.10.821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate holding security of 4 friction knots created with various monofilament and multifilament sutures in a vascular ligation model. SAMPLE 280 friction knot constructs. PROCEDURES 10 friction knots of 4 types (surgeon's throw, Miller knot, Ashley modification of the Miller knot, and strangle knot) created with 2-0 monofilament (polyglyconate, polydioxanone, poliglecaprone-25, and glycomer-631) and braided multifilament (silk, lactomer, and polyglactin-910) sutures were separately tied on a mock pedicle and pressure tested to the point of leakage. Linear regression analysis was performed to compare leakage pressures among suture materials (within friction knot type) and among knot types (within suture material). RESULTS Mean leakage pressure of surgeon's throws was significantly lower than that of all other knots tested, regardless of the suture material used. All the other knots had mean leakage pressures considered supraphysiological. Significant differences in mean leakage pressure were detected between various friction knots tied with the same type of suture and various suture types used to create a given knot. Variability in leakage pressure among knots other than the surgeon's throw was greatest for poliglecaprone-25 and lowest for polydioxanone. CONCLUSIONS AND CLINICAL RELEVANCE Most differences in knot security, although statistically significant, may not have been clinically relevant. However, results of these in vitro tests suggested the surgeon's throw should be avoided as a first throw for pedicle ligation and that poliglecaprone-25 may be more prone to friction knot slippage than the other suture materials evaluated.
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McCagherty J, Yool DA, Paterson GK, Mitchell SR, Woods S, Marques AI, Hall JL, Mosley JR, Nuttall TJ. Investigation of the in vitro antimicrobial activity of triclosan-coated suture material on bacteria commonly isolated from wounds in dogs. Am J Vet Res 2020; 81:84-90. [PMID: 31887087 DOI: 10.2460/ajvr.81.1.84] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate in vitro effects of triclosan coating of suture materials on the growth of clinically relevant bacteria isolated from wounds in dogs. SAMPLE 6 types of suture material and 10 isolates each of methicillin-susceptible Staphylococcus pseudintermedius, methicillin-resistant S pseudintermedius, Escherichia coli, and AmpC β-lactamase and extended-spectrum β-lactamase-producing E coli from clinical wound infections. PROCEDURES Isolates were cultured on Mueller-Hinton agar with 3 types of triclosan-coated suture, uncoated counterparts of the same suture types, and positive and negative controls. Zones of inhibition (ZOIs) were measured after overnight incubation. Sustained antimicrobial activity assays were performed with susceptible isolates. The ZOI measurements and durations of sustained antimicrobial activity were compared among suture types and isolates by statistical methods. Suture surface characteristics and bacterial adherence were evaluated qualitatively with scanning electron microscopy. RESULTS ZOIs were generated only by triclosan-coated materials; triclosan-coated suture had sustained antimicrobial activity (inhibition) for 3 to 29 days against all tested pathogens. The ZOIs around triclosan-coated suture were significantly greater for S pseudintermedius isolates than for E coli isolates. Bacterial adherence to uncoated polyglactin-910 was greatest, followed by triclosan-coated polyglactin-910, and then uncoated monofilament sutures, with least adherence to coated monofilament sutures. CONCLUSIONS AND CLINICAL RELEVANCE Surface characteristics of suture materials may be as important or more important than triclosan coating for microbial inhibition; however, triclosan coating appeared to affect bacterial adherence for multifilament sutures. Triclosan-coated, particularly monofilament, sutures inhibited pathogens commonly isolated from wounds of dogs, including multidrug-resistant bacteria. Further studies are required to assess clinical efficacy of triclosan-coated suture materials in vivo.
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Scott JE, Singh A, Case JB, Mayhew PD, Runge JJ. Determination of optimal location for thoracoscopic-assisted pulmonary surgery for lung lobectomy in cats. Am J Vet Res 2020; 80:1050-1054. [PMID: 31644337 DOI: 10.2460/ajvr.80.11.1050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the optimal intercostal space (ICS) for thoracoscopic-assisted pulmonary surgery for lung lobectomy in cats. SAMPLE 8 cat cadavers. PROCEDURES Cadavers were placed in lateral recumbency. A 5-cm minithoracotomy incision was made in the middle third of ICS 4 through 7 on the left side and 4 through 8 on the right side, and a wound retractor device was placed. A camera port was made in the middle third of ICS 9. Each lung lobe was sequentially exteriorized at each respective ICS. A thoracoabdominal stapler was placed to simulate a lung lobectomy, and distance from the stapler anvil to the hilus was measured. RESULTS For the left cranial lung lobe, there was no significant difference in median distance from the stapler anvil to the pulmonary hilus for ICS 4 through 6. Simulated lobectomy of the left caudal lung lobe performed at ICS 5 and 6 resulted in a significantly shorter distance, compared with lobectomy performed at ICS 4 and 7. Simulated lobectomy of the right cranial and right middle lung lobes performed at ICS 4 and 5 resulted in a significantly shorter distance, compared with lobectomy performed at ICS 7. Simulated lobectomy of the accessory and right caudal lung lobes at ICS 5 and 6 resulted in a significantly shorter distance than for lobectomy performed at ICS 8. CONCLUSIONS AND CLINICAL RELEVANCE An optimal ICS for a minithoracotomy incision was determined for thoracoscopic-assisted lung lobectomy in cats.
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Lozier JW, Niehaus AJ, Hinds CA, Durgam SS, Jones SC, Lakritz J. Investigation of a novel prosthesis technique for extracapsular stabilization of cranial cruciate ligament-deficient stifle joints in adult cattle. Am J Vet Res 2019; 80:779-786. [PMID: 31339759 DOI: 10.2460/ajvr.80.8.779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate a novel prosthesis technique for extracapsular stabilization of cranial cruciate ligament (CCL)-deficient stifle joints in adult cattle. SAMPLE 13 cadaveric bovine stifle joint specimens. PROCEDURES In the first of 3 study phases, the most isometric points on the distal aspect of the femur (distal femur) and proximal aspect of the tibia (proximal tibia) were determined from measurements obtained from lateromedial radiographs of a stifle joint specimen maintained at angles of 135°, 90°, 65°, and 35°. During phase 2, 800-lb-test monofilament nylon leader line was cut into 73-cm-long segments. Each segment was secured in a loop by use of 2, 3, or 4 crimping sleeves such that there were 12 replicates for each construct. Each loop was distracted to failure at a constant rate of 1 mm/s. Mean force at failure and elongation and mode of failure were compared among the 3 constructs. During phase 3, bone tunnels were created in the distal femur and proximal tibia at the isometric points identified during phase 1 in each of 12 CCL-deficient stifle joint specimens. The 3-sleeve construct was applied to each specimen. Specimens were distracted to failure at a constant rate of 1 mm/s. RESULTS Among the 3 constructs evaluated, the 3-sleeve construct was considered optimal in terms of strength and amount of foreign material. In phase 3, all replicates failed because of suture slippage. CONCLUSIONS AND CLINICAL RELEVANCE Use of 800-lb-test monofilament nylon leader line as a prosthesis might be a viable alternative for extracapsular stabilization of CCL-deficient stifle joints in adult cattle. Further in vivo studies are necessary.
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McGlinchey L, Boone LH, Munsterman AS, Coleridge MOD, Rosanowski SM, Farag R, Hanson RR. In vitro evaluation of the knot-holding capacity and security, weight, and volume of forwarder knots tied with size-3 polyglactin 910 suture exposed to air, balanced electrolyte solution, or equine abdominal fat. Am J Vet Res 2019; 80:709-716. [PMID: 31246130 DOI: 10.2460/ajvr.80.7.709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the effect of exposure to a balanced electrolyte solution (BES), or equine abdominal fat on the knot-holding capacity (KHC), relative knot security (RKS), weight, and volume of forwarder knots versus surgeon's knots. SAMPLE 315 knots tied and tested in vitro. PROCEDURES United States Pharmacopeia size-3 polyglactin 910 suture exposed to air (dry [control]), equine abdominal fat (fat-exposed), or BES (BES-exposed) was used to tie forwarder knots with 2, 3, and 4 throws and surgeon's knots with 5, 6, 7, and 8 throws. A universal materials testing machine was used to test the tensile strength of suture and knots to failure, and the KHC, RKS, weight, and volume of knots were determined. RESULTS Forwarder knots had significantly higher KHC and RKS and lower volume, compared with surgeons' knots. Forwarder knots tied with fat-exposed suture had greater weight, but not volume, than did forwarder knots tied with dry or BES-exposed suture with the same number of throws. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that forwarder knots were superior to surgeon's knots when configured as start knots intended for continuous lines of suture. Exposure to media did not negatively affect mechanical or physical properties of forwarder knots and may improve specific biomechanical functions, including KHC and RKS.
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Martin Y, Johnson MD, Travers CJ, Colee J, McConkey MJ, Banks SA. Biomechanical comparison of four prosthetic ligament repair techniques for tarsal medial collateral ligament injury in dogs. Am J Vet Res 2019; 80:469-479. [PMID: 31034275 DOI: 10.2460/ajvr.80.5.469] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare joint stability and ultimate strength among 4 prosthetic ligament constructs for repair of tarsal medial collateral ligament (MCL) injury in dogs. SAMPLE 13 canine cadavers (26 hind limbs). PROCEDURES Each limb was stripped of all soft tissues except those associated with the tarsal joint and assigned to 1 of 4 prosthetic ligament constructs. The AN construct consisted of 3 bone anchors connected with monofilament nylon suture. The AU construct consisted of low-profile suture anchors connected with multifilament ultrahigh-molecular-weight polyethylene (UHMWPE) suture. The TN and TU constructs involved the creation of 3 bone tunnels and use of nylon or UHMWPE suture, respectively. Each limb underwent biomechanical testing before and after MCL transection and before and after cyclic range-of-motion testing following completion of the assigned construct. Tarsal joint stability (extent of laxity) was assessed with the joint in each of 3 positions (75°, 135°, and 165°). After completion of biomechanical testing, each limb was tested to failure to determine the ultimate strength of the construct. RESULTS Relative to intact tarsal joints, joint laxity was significantly increased following completion of all 4 constructs. Construct type was not associated with the magnitude of change in joint laxity. Ultimate strength was greatest for the UHMWPE-suture constructs. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that all 4 constructs effectively stabilized MCL-deficient tarsal joints. Implants used for the TU, TN, and AU constructs had a lower profile than those used for the AN construct, which may be clinically advantageous. In vivo studies are warranted.
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Soula M, Shmalberg JW, Johnson MD. Biomechanical comparison of a modified three-loop pulley technique and a three-level self-locking technique for repair of patellar tendon rupture in dogs. Am J Vet Res 2019; 80:335-341. [PMID: 30919675 DOI: 10.2460/ajvr.80.4.335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare use of a 3-level self-locking suture (3LSLS) technique with use of a previously described modified 3-loop pulley (M3LP) technique to repair rupture of the proximal aspect of patellar tendons in limbs from canine cadavers. SAMPLE Paired hind limbs of 6 adult mixed-breed dogs. PROCEDURES A limb from each pair was randomly assigned to be repaired by the 3LSLS technique or M3LP technique with size-2 ultrahigh-molecular-weight polyethylene and size-0 monofilament polypropylene suture, respectively. Limbs were prepared, and each patellar tendon was transected at a site chosen to simulate rupture at the proximal aspect. Tendons were repaired with the assigned techniques and mechanically tested with a biaxial servohydraulic test system; the clamp was distracted until the repair failed. Force at 1 -mm gap formation, 3-mm gap formation, and repair failure and gap size at failure were measured and compared between methods. Mode of failure was recorded. RESULTS There was no significant difference between methods for the force required to produce a 1 - or 3-mm gap in the repair. The 3LSLS technique required a significantly higher load for complete failure; gap formation immediately before failure was significantly greater for this method than for the M3LP technique. Four of 6 repairs with the M3LP technique and 0 of 6 repairs with the 3LSLS technique failed by suture breakage. CONCLUSIONS AND CLINICAL RELEVANCE The 3LSLS technique with size-2 ultrahigh-molecular-weight polyethylene suture was as effective at resistance to 1 - and 3-mm gap formation as the M3LP with size-0 monofilament polypropylene suture.
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Nutt LK, Wilson ML, Sakals S. Comparison of surgical time and complication rate of subcutaneous and skin closure using barbed suture or traditional knotted suture in dogs. Can Vet J 2017; 58:1281-1286. [PMID: 29203937 PMCID: PMC5680738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This prospective study evaluated the handling, intraoperative and postoperative complication rates of a barbed knotless suture for closure of subcutaneous tissue and skin in 17 client-owned dogs (group A) following a tibial plateau leveling osteotomy procedure. Clinical characteristics, surgical time, and complication rates were compared to a control group of 17 client-owned dogs (group B) with subcutaneous tissue and skin closure using traditional suture material. Signalment was not significantly different between groups and did not have an effect on complication rates. Surgical times were not significantly different for subcutaneous tissue or skin closure between the 2 groups. There were significantly more intraoperative complications in the barbed suture group (A: 4/17; B: 0/17; P = 0.033) but no difference in minor or major postoperative complication rates (minor A: 2/16; B: 1/14; P = 0.626, major A: 2/16; B: 0/14; P = 0.171).
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Affiliation(s)
- Laura K. Nutt
- Address all correspondence to Dr. Laura K. Nutt; e-mail:
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Faria MCF, de Almeida FM, Serrão ML, de Oliveira Almeida NK, Labarthe N. Use of cyanoacrylate in skin closure for ovariohysterectomy in a population control programme. J Feline Med Surg 2017; 7:71-5. [PMID: 15771943 DOI: 10.1016/j.jfms.2004.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2004] [Indexed: 11/18/2022]
Abstract
N-butyl-cyanoacrylate tissue adhesive was evaluated as a skin closure material in a population control programme. Fifty-two female cats underwent ovariohysterectomy: skin closure of 25 of those cats was undertaken with nylon (3–0) and in 27 with the adhesive. Twenty-three cats spent the postoperative period confined in cages and 29 were free within a 50-square-metre fenced area. The parameters used for evaluation were: dehiscence or secretion and presence and extension of erythema at the surgical site. It was observed that the time required for closure of the surgical site with the adhesive was shorter than with nylon, saving approximately 1 min per animal. The adhesive or conventional suture allowed similar healing, and independent of material used for skin closure or the postoperative exercise, there was no statistical difference in wound cicatrization. As the adhesive eliminates the need for suture removal and decreases surgery time, without additional risk to the cat, it may be indicated for surgical population control programmes.
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Avoine X, Lussier B, Brailovski V, Inaekyan K, Beauchamp G. Evaluation of the effect of 4 types of knots on the mechanical properties of 4 types of suture material used in small animal practice. Can J Vet Res 2016; 80:162-170. [PMID: 27127344 PMCID: PMC4836043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 11/23/2015] [Indexed: 06/05/2023]
Abstract
The influence of the type of material used, knot configuration, and use of an additional throw on the tensile force at failure, the elongation, and the mode of failure of different configurations of linear sutures and knotted suture loops was evaluated in this in-vitro mechanical study. We hypothesized that all types of knots would significantly influence the initial force and elongation of suture materials and would influence the force and elongation at which the knotted loops break, but not their mode of failure. A total of 432 samples of 4 types of size 3-0 suture material (polydioxanone, polyglecaprone 25, polyglactin 910, and nylon), representing 9 configurations, were tested in a tensiometer. The configurations were 1 linear suture without a knot and the following loops: square (SQ) knot; surgeon's (SU) knot; granny (GR) knot; and sliding half-hitch (SHH) knot using either 4 and 5 or 3 and 4 throws, depending on the material. For polydioxanone, SQ and SU knots did not decrease the initial force at failure of the suture. Granny (GR) and SHH knots decreased the tensile force at failure and elongation by premature failure of the loop. For polyglecaprone 25, all knots decreased the initial force at failure of the suture, with SHH being weaker than the other knots. For coated polyglactin 910, all knots decreased the initial force at failure of the suture and slippage increased significantly compared with the other 3 sutures. The use of SQ knots with 3 throws did not result in a safe knot. For nylon, knots did not alter the original mechanics of the suture. In conclusion, all knots and types of suture material do not necessarily have the same effect on the initial tensile force at failure of suture materials.
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Affiliation(s)
- Xytilis Avoine
- Address all correspondence to Dr. Xytilis Avoine; telephone: +033 7 83 63 57 93; e-mail:
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Abstract
The diversity implicit in exotic animal surgery requires a tailored approach to optimize successful outcomes. Outlined is information on patient preparation, instrumentation, hemostatic techniques, and magnification as it pertains to the exotic animal. Application of topical antiseptic solutions and judicious removal of pelage and feathers will decrease bacterial load during patient preparation. The use of specific barrier protection ensures proper aseptic technique and enables optimal patient monitoring. Magnification combined with a focal light source enhances visual acuity, allowing for better use of delicate instrumentation and identification of anatomic structures.
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Affiliation(s)
- Kevin T Kroner
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA
| | - Casey Budgeon
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA
| | - Sara A Colopy
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA.
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Abstract
Basic surgical instrumentation for avian soft tissue surgery includes soft tissue retractors, microsurgical instrumentation, surgical loupes, and head-mounted lights. Hemostasis is fundamental during the surgical procedures. The indications, approach, and complications associated with soft tissue surgeries of the integumentary (digit constriction repair, feather cyst excision, cranial wound repair, sternal wound repair, uropygial gland excision), gastrointestinal (ingluviotomy, crop biopsy, crop burn repair, celiotomy, coelomic hernia and pseudohernia repair, proventriculotomy, ventriculotomy, enterotomy, intestinal resection and anastomosis, cloacoplasty, cloacopexy), respiratory (rhinolith removal, sinusotomy, tracheotomy, tracheal resection and anastomosis, tracheostomy, pneumonectomy) and reproductive (ovocentesis, ovariectomy, salpingohysterectomy, cesarean section, orchidectomy, vasectomy, phallectomy) systems are reviewed.
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Affiliation(s)
- David Sanchez-Migallon Guzman
- Avian and Exotic Pet Medicine and Surgery, School of Veterinary Medicine University of California Davis, One Shields Avenue, 2108 Tupper Hall, Davis, CA 95616, USA.
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Rousseau M, Anderson DE, Rozell TG, Hand JM, Faris BR. Comparison of polyglactin-910 and polydioxanone for closure of the linea alba following caudal ventral midline laparotomy in sheep. Can Vet J 2015; 56:959-963. [PMID: 26345301 PMCID: PMC4535513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study compared incisional complications after ventral midline laparotomy using 2 absorbable suture materials for apposition of the linea alba in sheep. The linea alba of 93 yearling sheep was sutured by 3 veterinarians in a simple continuous pattern using either polyglactin 910 (PG910; group PG) or polydioxanone (PDS; group PD). A blinded observer assessed surgical sites at the time of suture removal. Multivariate logistic regression was used to assess the association between incisional complications and variables (suture material used, veterinarian, skin suture removal time). The odds of incisional complications did not vary significantly with the type of suture material used (P = 0.11), veterinarian (P = 0.61) or skin suture removal time (P = 0.36). Most incisional complications were cutaneous suture sinus formation. Either PG910 or PDS may be used for linea alba closure in sheep.
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Benlloch-Gonzalez M, Gomes E, Bouvy B, Poncet C. Long-term prospective evaluation of intestinal anastomosis using stainless steel staples in 14 dogs. Can Vet J 2015; 56:715-722. [PMID: 26130833 PMCID: PMC4466822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This prospective clinical study evaluated the use, complications, and clinical and ultrasonographic follow-ups of end-to-end intestinal anastomoses with skin staples in naturally occurring diseases in canine small and large intestines. Intestinal anastomoses were performed in 14 dogs and pre-, peri-, and postoperative data were recorded. Postoperative clinical and ultrasound evaluations were performed at regular intervals for 1 year. The mean time taken to construct the anastomosis was 5 min. There were no intraoperative complications. Hemorrhage and colonic stricture were the main postoperative complications. Staple loss occurred in 2 cases. Absence of wall layering and focal wall thickening were observed in all cases at each ultrasonographic follow-up. Hyperechoic fat was observed in all but 1 of the cases at month 1. Nine dogs were alive with normal digestive function at the end of the study. The skin stapler technique enabled rapid construction of consistent anastomoses with inexpensive stapling material.
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Atwood C, Maxwell M, Butler R, Wills R. Effects of incision closure method on infection prevalence following tibial plateau leveling osteotomy in dogs. Can Vet J 2015; 56:375-381. [PMID: 25829557 PMCID: PMC4357910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The goal of this study was to retrospectively investigate the effect of incisional closure with either stainless steel skin staples or intradermal poliglecaprone 25 on the prevalence of surgical site infection following tibial plateau leveling osteotomy in dogs. Medical records were reviewed for dogs treated with unilateral tibial plateau leveling osteotomy at Memphis Veterinary Specialists between 2006 and 2013. Procedures (n = 306) from 242 dogs were included in the study. The association of potential risk factors with the occurrence of postoperative infection was assessed using logistic regression. A value of P < 0.05 was considered significant. Weight and administration of postoperative antimicrobials were found to significantly influence surgical site infection prevalence. No significant association was noted between closure method and prevalence of postoperative infection.
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Affiliation(s)
- Chase Atwood
- Address all correspondence to Dr. Chase Atwood; e-mail:
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Anderson SL, Bracamonte JL, Hendrick S. Ex vivo evaluation of 7 polydioxanone for closure of equine ventral midline celiotomies. Can J Vet Res 2014; 78:156-160. [PMID: 24688180 PMCID: PMC3962281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 04/23/2013] [Indexed: 06/03/2023]
Abstract
The objective of this study was to compare the bursting strength (BS) and mode of failure (MF) of ventral midline (VM) celiotomies closed with USP 7 polydioxanone (7PD) in 1 or 2 simple continuous sections. A bursting strength model, consisting of inserting and inflating a 200-L polyurethane bladder through a 25-cm VM celiotomy, was used on 15 fresh equine cadavers. Celiotomies were closed using 7PD in 2 separate sections (4 knots), 2 continuous sections (3 knots), or a single section (2 knots) using a simple continuous pattern. The horses' signalment, body weight, number of total knots, MF, and BS were recorded and analyzed statistically for interactions. No difference was found between the BS of VM celiotomies closure types (P = 0.4). All celiotomy/ suture constructs failed at the abdominal wall. The celiotomy closure types evaluated in this study provided a secure method of closure in VM celiotomies in vivo.
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Affiliation(s)
- Stacy L. Anderson
- Address all correspondence to Dr. Stacy Anderson; telephone: (306) 371-8208; e-mail:
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Puttick JL, Sereda CW. Suture-related urolithiasis following repair of inadvertent prostatectomy in a dog. Can Vet J 2012; 53:787-790. [PMID: 23277648 PMCID: PMC3377465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A 10-month-old male chow chow mixed breed dog was presented for anuria secondary to inadvertent prostatectomy performed during unilateral cryptorchidectomy. Surgical repair was successfully performed; however, this resulted in suture-associated urolith formation 3 months later, requiring a second surgical intervention and urethrostomy.
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Affiliation(s)
- Jennifer L Puttick
- Western Veterinary Specialist Center of Edmonton, 11104, 102 Avenue NW, Edmonton, Alberta T5K 2H4, Canada.
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Hebert S. Use of suture materials in practice. Vet Rec 2012; 170:236. [PMID: 22391910 DOI: 10.1136/vr.e1513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mesa MG, Magie RJ, Copeland ES, Christiansen HE. Surgical wound healing in radio-tagged adult Pacific lamprey Entosphenus tridentatus held on different substrata. J Fish Biol 2011; 79:1068-1075. [PMID: 21967590 DOI: 10.1111/j.1095-8649.2011.03071.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Radio-tagged adult Pacific lamprey Entosphenus tridentatus held in a raceway with Plexiglas-lined walls and bottom healed more slowly and retained sutures longer than fish held in an all-concrete raceway or one with Plexiglas walls and a cobble-lined bottom. On all substrata, healing depended on when sutures were lost, and fish that lost their sutures in <14 days post-surgery healed faster than those that kept sutures longer. Long-term suture retention led to tissue trauma, infection and poor survival.
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Affiliation(s)
- M G Mesa
- U. S. Geological Survey, Western Fisheries Research Centre, Columbia River Research Laboratory, 5501 Cook-Underwood Road, Cook, WA 98605, USA.
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Witte TH, Cheetham J, Rawlinson JJ, Soderholm LV, Ducharme NG. A transducer for measuring force on surgical sutures. Can J Vet Res 2010; 74:299-304. [PMID: 21197230 PMCID: PMC2949343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Accepted: 12/02/2009] [Indexed: 05/30/2023]
Abstract
The objective of this study was to validate, both in vitro and in an ex vivo model, a technique for the measurement of forces exerted on surgical sutures. For this purpose, a stainless steel E-type buckle force transducer was designed and constructed. A strain gauge was mounted on the central beam of the transducer to measure transducer deformation. The transducer was tested and calibrated on a single strand of surgical suture during cyclic loading. Further validation was performed using a previously published cadaveric model of laryngoplasty in the horse. Linear regression of transducer output with actual force during calibration tests resulted in mean R² values of 1.00, 0.99, and 0.99 for rising slope, falling slope, and overall slope, respectively. The R² was not less than 0.96 across an average of 75 cycles per test. The difference between rising slope and falling slope was 4%. Over 45 846 samples, the predicted force from transducer output showed a mean error of 4%. In vitro validation produced an adjusted R² of 0.99 when the force on the suture was regressed against translaryngeal pressure in a mixed-effects model. E-type buckle force transducers showed a highly linear output over a physiological force range when applied to surgical suture in vitro and in an ex vivo model of laryngoplasty. With appropriate calibration and short-term in vivo implantation, these transducers may advance our knowledge of the mechanisms of success and failure of techniques, such as laryngoplasty, that use structural suture implants.
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Affiliation(s)
- Thomas H Witte
- Equine Performance Testing Clinic, Department of Veterinary Clinical Sciences, Cornell University Hospital for Animals, Cornell University College of Veterinary Medicine, Ithaca, New York 14850, USA.
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Papazoglou LG, Tsioli V, Papaioannou N, Georgiadis M, Savvas I, Prassinos N, Kouti V, Bikiaris D, Hadzigiannakis C, Zavros N. Comparison of absorbable and nonabsorbable sutures for intradermal skin closure in cats. Can Vet J 2010; 51:770-772. [PMID: 20885834 PMCID: PMC2885123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Paired skin incisions were made in 6 cats and closed intradermally with the copolymer of glycolide, ɛ-caprolacton, and trimethylene-carbonate, or polypropylene suture. The macroscopic and histologic appearance of the incisions was compared. Polypropylene suture compared favorably to glycolide, ɛ-caprolacton, and trimethylene-carbonate suture for closure of skin incisions in cats.
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Proudman CJ, Edwards GB, Barnes J. Differential survival in horses requiring end-to-end jejunojejunal anastomosis compared to those requiring side-to-side jejunocaecal anastomosis. Equine Vet J 2010; 39:181-5. [PMID: 17378448 DOI: 10.2746/042516407x171354] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY Horses requiring different methods of intestinal anastomosis during equine colic surgery may have differences in mortality and morbidity. HYPOTHESES Horses requiring side-to-side jejunocaecal anastomosis have a higher mortality and morbidity rate than those requiring end-to-end jejunojejunal anastomosis. Morbidity and mortality of handsewn vs. stapled side-to-side jejunocaecal anastomoses are not significantly different. METHODS A prospective, nonrandomised, observational study was conducted. Clinical and surgical details were recorded during hospitalisation and survival data acquired by periodic telephone questionnaire. Differences in mortality and morbidity rate were evaluated by survival analysis. RESULTS A total of 184 horses underwent end-to-end jejunojejunal anastomosis and 178 underwent side-to-side jejunocaecal anastomosis. Horses with a jejunocaecal anastomosis had a significantly higher mortality rate. The incidence of post operative colic in horses requiring side-to-side jejunocaecal anastomoses was greater than those requiring end-to-end jejunojejunal anastomoses. Within the group undergoing side-to-side jejunocaecal anastomosis there was no evidence of differential survival between horses with handsewn vs. stapled anastomoses. CONCLUSIONS Mortality rate is higher in horses that have required side-to-side jejunocaecal anastomosis than in those that needed end-to-end jejunojejunal anastomosis; and post operative colic is more common after side-to-side jejunocaecal anastomosis. No difference in mortality was found between horses with handsewn and stapled side-to-side jejunocaecal anastomoses. POTENTIAL RELEVANCE Surgeons should be aware of the increased mortality and morbidity in horses requiring side-to-side jejunocaecal anastomosis. Our finding of no difference in mortality between handsewn and stapled side-to-side jejunocaecal anastomoses justifies surgeons exercising personal preference in their selection of anastomosis method.
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Affiliation(s)
- C J Proudman
- Equine Division, Faculty of Veterinary Science, University of Liverpool, 'Leahurst', Neston, Cheshire CH64 7TE, UK
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Anderson ET, Davis AS, Law JM, Lewbart GA, Christian LS, Harms CA. Gross and histologic evaluation of 5 suture materials in the skin and subcutaneous tissue of the California sea hare (Aplysia californica). J Am Assoc Lab Anim Sci 2010; 49:64-68. [PMID: 20122319 PMCID: PMC2824970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Revised: 07/07/2009] [Accepted: 08/12/2009] [Indexed: 05/28/2023]
Abstract
Invertebrates are increasing in their importance to both the public and private aquarium trade and play a vital role in biomedical research. Surgical techniques have become an important approach to obtaining data and maintaining good health in both of these areas. However, studies examining tissue reaction to suture material in invertebrates are lacking. The current study evaluated the gross and histologic reaction of Aplysia californica to 5 commonly used suture materials, including polydioxanone, black braided silk, polyglactin 910, monofilament nylon, and monofilament poliglecaprone. Histologic samples were graded on the amount of edema (score, 1 to 4), inflammation (1 to 4), and granuloma formation (1 to 4) present, and a final overall histology score (1 to 6) was assigned to each sample. Compared with untreated control tissue, all suture materials caused significantly increased tissue reaction, but the overall histology score did not differ among the suture materials. Silk was the only suture that did not have a significantly increased granuloma score when compared with the control. Although none of the suture materials evaluated seemed clearly superior for use in Aplysia, we recommend silk because of its less robust granuloma induction, which is favorable in a clinical and research setting.
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Affiliation(s)
- Eric T Anderson
- Departments of Clinical Sciences North Carolina State University, Raleigh, North Carolina
- Center for Marine Sciences and Technology, North Carolina State University, Morehead City, North Carolina
| | - A Sally Davis
- Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
- Comparative Molecular Pathology Unit, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - J McHugh Law
- Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Gregory A Lewbart
- Departments of Clinical Sciences North Carolina State University, Raleigh, North Carolina
| | - Larry S Christian
- Departments of Clinical Sciences North Carolina State University, Raleigh, North Carolina
| | - Craig A Harms
- Departments of Clinical Sciences North Carolina State University, Raleigh, North Carolina
- Center for Marine Sciences and Technology, North Carolina State University, Morehead City, North Carolina
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Kelmer G, Schumacher J. Repair of abdominal wall hernias in horses using primary closure and subcutaneous implantation of mesh. Vet Rec 2008; 163:677-679. [PMID: 19060315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Abdominal incisional hernias in over 40 horses were repaired by exposing the hernial sac and ring and closing the ring with absorbable, interrupted, inverted, cruciate sutures after inverting the hernial sac into the peritoneal cavity. A mesh was sutured, under tension, over the closed ring. Placing the mesh subcutaneously, rather than in the retroperitoneal space, simplified the dissection and minimised the likelihood of penetrating the peritoneal cavity, a problem common to techniques of hernia repair in which the mesh is implanted into the retroperitoneal space. Implanting the mesh subcutaneously created a strong repair, the typical result of which was a cosmetically acceptable, uniformly flat appearance to the ventral aspect of the abdomen. There were few complications and there was only one failure, due to the tissue surrounding the mesh becoming infected.
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Affiliation(s)
- G Kelmer
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, 2407 River Drive, Knoxville, TN 37996, USA
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