不同缝合材料与方法在犬小肠肠管吻合术中的应用效果观察

为了探索不同缝合材料与方法在犬小肠肠管吻合术中的应用效果,选择8只5-7月龄、7～8kg体重的家犬进行小肠肠管切除及吻合术,术后观察其精神状态与消化机能恢复情况,并于术后2个月剖检、切片,观察施术肠管的外部形态与肠壁组织学变化。结果显示:双层缝合比单层缝合的肠管易发生粘连,且肠腔内部比较狭窄;双层缝合的黏膜不如单层缝合对合好,且出现空隙和炎性渗出物的情况比单层缝合严重;肠线质地比丝线硬,缝合过程中容易拉断黏膜。结果表明,在犬小肠肠管吻合术中,单层缝合较传统的双层缝合效果好,其中以选择带针非吸收性外科缝线行间断伦勃特缝合效果最好。     

犬小肠端端吻合术的改进及临床与组织学观察

在犬小肠两断端肠腔内,置入一条状支撑物以固定肠管进行单层缝合吻合肠管的方法。通过实验手术,对肠管端端吻合术的单层、双层两种缝合方法进行临床、病理解剖学、X线摄片、组织学观察与比较。结果证明,单层缝合法吻合小肠是安全的、可行的,值得推广使用。     

细小肠管吻合术缝合方法的改进

随着犬、猫等伴侣动物饲养量的日益增加,肠道阻塞、肠套叠等疾病时有发生,这些疾病一旦导致肠管坏死,必须进行肠管切除及肠管吻合术.对于小型动物而言,由于肠管口径细小(有的管径不足1 cm),肠管吻合的传统缝合方法(两次缝合)极易造成肠壁肌纤维对合不良,肌层增厚等引起肠腔狭窄.近年来,作者尝试采用肠管断端的后壁连续缝合及前壁库兴氏缝合的一次性缝合,结合局部肠系膜覆盖的方法,成功地进行了近15例犬的细小肠管的端端吻合手术,均取得了良好的手术效果.     

单层缝合在犬腹腔手术中的应用

近年来 ,单层缝合方法在伴侣动物临床中得到更广泛的应用 ,尤其是肠管手术和母犬剖腹产手术中 ,库兴氏缝合的单层实施 ,完全可以满足手术的需要并达到预期的目的。1　肠管吻合　 2～ 3月龄的幼犬因肠套叠 ,很容易引起直肠脱、不食和呕吐症状 ,伴随有少量带血的稀便出现。由于肠套叠多发生在回盲段和盲结肠段 ,被确诊时多已发生肠套叠两天以上 ,肠管常有一定程度的坏死 ,因此作者在手术中切除坏死段肠管后 ,采用库兴氏缝合和肠管吻合处用网膜覆盖的方法 ,取得了良好的手术效果 ,使细肠管吻合变得容易而且省时间。手术截除坏死肠段后 ,用肠钳…     

家畜肠管吻合手术的改进

家畜肠管吻合手术主要适用于嵌闭式阴囊疝、脐疝、肠阻塞、肠套叠、肠扭转以及阉割后夹肠等引起的局部肠管坏死等病症。按常规方法,将坏死肠管部分切除后,将健康肠管对齐缝合,这样因肠腔空虚,肠壁靠拢,缝合困难,吻合效果欠佳。手术后容易造成肠内容物外漏或肠管狭窄,甚至导致     

“火腿肠支撑”肠管吻合术的应用

近几年,笔者在动物临床上治疗仔猪因脐疝、犬肠套叠、肠扭转等引起的局部肠管坏死病症,将坏死肠管部分切除后,把健康肠管对齐缝合,这样因肠管空虚,肠壁靠拢不易,缝合困难,吻合效果欠佳,手术后容易造成肠内容物外漏,或肠管狭窄,甚至导致手术失败。笔者对常规的吻合方法进行了多次改进试验,最终选用     

不同缝合材料与方法在犬膀胱切开术中的应用效果

为了探索不同缝合材料与方法在犬膀胱切开术中的应用效果,选择8只5～7月龄、7～8kg体重的家犬进行实验性膀胱切开术。术后观察动物精神、食欲和泌尿状态,并分别于术后1个月、2．5个月解剖观察施术膀胱的外部形态及其切口处组织学变化。结果显示：多数实验犬术后膀胱的形态、位置可恢复正常,且表面光滑湿润;膀胱内壁切口处光滑,仅见淡淡瘢痕,部分实验犬膀胱壁有不吸收丝线或吸收不完全肠线残留。结果表明：膀胱切口缝合材料应当采用可吸收缝线;第一层缝合宜采用全层穿透缝合或仅缝黏膜层,第二层即浆膜肌层缝合宜用丝线行间断内翻缝合或用肠线行Cushing氏缝合。     

皮内缝合在犬外科手术中的应用

为探讨皮内缝合技术在犬外科手术中应用的效果,自2008年3月-2009年5月,在成都市谐和动物医院进行外科手术的76例病犬,使用可吸收外科线进行了皮内缝合。结果使用该法缝合的伤口愈合良好,该法与传统的结节缝合相比,切口愈合更快,伤口美观,术后不用拆线,值得推广使用。     

侧侧吻合治疗一例犬肠套叠

犬肠套叠为小动物临床上较为常见的一种消化道疾病,笔者收治一例较为严重的犬肠套叠病例,在进行肠管切除、侧侧吻合缝合、整复固定后,愈后良好,现将心得体会报道如下。1病史及临床症状患犬为6月龄罗威纳犬,体重13 kg,1周前出现呕吐与腹泻症状,食欲废绝,精神沉郁,在某动物医     

家畜肠管吻合手术的改进

家畜肠管吻合手术主要适用于嵌闭式阴囊疝、脐疝、肠阻塞、肠套叠、肠扭转以及阉割后夹肠等引起的局部肠管坏死等病症。按常规方法，将坏死肠管部分切除后，将健康肠管对齐缝合，这样因肠腔空虚，肠壁靠拢，缝合困难，吻合效果欠佳。手术后容易造成肠内容物外漏或肠管狭窄，甚至导致手术失败。     

Analysis of suture anchor eyelet position on suture failure load

Objective: To compare mechanical performance of 2 orientations of the 5 mm Corkscrew^® suture anchor with #5 Fiberwire^®. Study Design: In vitro biomechanical study. Sample Population: Suture anchor–suture constructs (n=40). Methods: Acute and cyclic tensile loads were applied to suture threaded through eyelets of 40 anchors perpendicular to the long axis of the anchor. Eyelets were positioned so that the suture pull was in line with (anchor rotation angle of 0° [ARA 0]) or 90° (ARA 90) to the eyelet plane. Load at failure, stiffness, and cycles to failure were determined. Results: All constructs failed by suture breakage at the eyelet. Mean load at failure was significantly higher in the ARA 90 group (634±93 N) compared with the ARA 0 group (495±52 N; P=.0015). No significant difference was found between groups for mean number of cycles to failure (270±177 versus 178±109; P=.2166) and stiffness (50±4 versus 48±5 N/mm; P=.3141). Conclusions: The Corkscrew^® 5 mm suture anchor with Fiberwire^® suture fails via suture breakage at the eyelet under higher acute loads if the suture is loaded at an angle of 90° compared with 0° with respect to the plane of the eyelet.     

Biomechanical analysis of suture anchors and suture materials in the canine femur

Objective— Biomechanical analysis of acute load to failure (ALF) of 3 veterinary and 1 human suture anchor and cyclic load to failure with two suture material/suture anchor constructs in canine femoral condyles.
Study Design— Biomechanical in vitro study.
Sample Population— Cadaveric femora from 20–30 kg dogs.
Methods— Three veterinary and 1 human suture anchor were placed in the cranial and caudal aspects of the femoral condyle and subjected to 0° ALF. Anchors were loaded with 5 USP Fiberwire or 27 kg test nylon leader line (NLL) and subjected to 90° cyclic testing for 10,000 cycles followed by ALF at 90°.
Results— No significant difference in ALF for any anchor type was detected in the cranial aspect of the femoral condyle; however all veterinary anchors had higher ALF in the caudal aspect of the femoral condyle. In cyclic testing, the constructs in descending order (most cycles to least) were: (1) FlexiTwist/NLL, (2) Securos/Fiberwire, Securos/NLL, (3) IMEX/Fiberwire, IMEX/NLL, and (4) FlexiTwist/Fiberwire, Fastin/Fiberwire. Fiberwire was significantly stronger than NLL in post-cycling ALF testing.
Conclusions— Veterinary anchors had higher ALF in the caudal versus cranial aspect of the femoral condyle. Except for the FlexiTwist in which NLL performed better, Fiberwire and NLL both had similar cyclic performance with each veterinary anchor type. The veterinary anchors exceeded the human anchor in ALF and cycles to failure.
Clinical Relevance— The tested veterinary suture anchors with Fiberwire or NLL may be used in the femoral condyle, preferably in the caudal aspect, and should withstand estimated loading conditions in appropriately confined postoperative canine patients.     

Biomechanical evaluation of suture pullout from canine arytenoid cartilages: effects of hole diameter, suture configuration, suture size, and distraction rate

OBJECTIVE: To evaluate the mechanical properties of canine arytenoid cartilage-suture constructs. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Eighty canine cadaveric larynges. METHODS: Arytenoid cartilage-suture constructs were loaded to failure on a materials testing machine. The effect of hole size, suture configuration, suture size, and rate of distraction on load at failure, displacement at failure, energy to failure, and construct stiffness were evaluated. Polypropylene sutures were used exclusively. Specific variables evaluated were: (1) hole size-SH needle, 22, 20, and 18 ga hypodermic needles; (2) suture configurations-single dorsal and ventral articular sutures, double sutures, horizontal mattress, locking loop, and single non-articular sutures; (3) suture size-1, 0, 2-0, and 3-0; and (4) distraction rate-0.83 and 36.66 mm/s. RESULTS: Hole size had no effect on any biomechanical variable. Double suture and horizontal mattress configurations had the highest median load and energy at failure. Single dorsal suture configurations that did not include the arcuate crest had the lowest median load at failure. Larger suture sizes tended to result in stiffer constructs. Cartilage-suture constructs behaved in a viscoelastic manner where load at failure, energy at failure, and stiffness increased when distraction rate was increased, whereas displacement at failure did not. Most constructs failed by suture pullout regardless of distraction rate, although 50% of horizontal mattress configurations failed by avulsion of the muscular process. CONCLUSION: Suture and hole sizes appear to have few effects on the biomechanical performance of arytenoid-suture constructs. Double-suture and horizontal mattress suture patterns had the best overall mechanical properties for arytenoid lateralization. Single-suture techniques, which do not incorporate the arcuate crest, were biomechanically inferior. CLINICAL RELEVANCE: Cumbersome large-diameter sutures offer no advantage over smaller sutures when performing arytenoid lateralization. The cross-sectional geometry of the muscular process should be taken into account when placing sutures in the arytenoid cartilages. Single-suture techniques that do not incorporate the arcuate crest should be avoided.     

Comparison of suture materials and suture patterns for inverting intestinal anastomosis of the jejunum in the horse

In 7 horses, 4 anastomoses were done in the small intestine in each, using the combinations of synthetic absorbable monofilament and multifilament suture materials with continuous- and interrupted-suture patterns in the serosubmucosal layer of a 2-layer inverting-suture technique. Horses were evaluated 30 days after the operation for adhesion formation, lumen diameter, evidence of chronic obstruction, and suture tract inflammation at the anastomosis. Postoperative obstruction occurred in 5 of the 7 horses, and 6 horses survived. One horse was euthanatized on postoperative day 6 after 48 hours of ileus and obstruction; necropsy revealed a partial intussusception involving the anastomosis done with continuous multifilament-suture material. Two other horses that became obstructed between postoperative days 3 and 5 had protracted ileus and gastric reflux up to 48 hours' duration, but survived. Horses that had obstruction after the 6th postoperative day recovered within 4 hours of onset. The continuous inverting-suture pattern in the serosubmucosal layer resulted in significantly (P less than 0.05) fewer adhesions than did the interrupted pattern, and suture material had no effect on adhesion formation. There was no significant difference in the percentage of reduction of lumen diameter between the variations of the 2-layer technique, and there was no evidence of chronic obstruction related to any of the anastomoses. Suture tract inflammation was moderate in the anastomoses, using continuous-multifilament suture, with neutrophils being the predominant cell type. The anastomoses with continuous-monofilament suture had mild inflammation with focal accumulations of neutrophils. Minimal inflammation was associated with both types of suture in the interrupted pattern.