Surgery: Comparison of three closure methods and two absorbable suture materials for closure of jejunal enterotomy incisions in healthy dogs

Summary

The macroscopic and histological appearance of jejunal antimesenteric incisions approximated with two different absorbable suture materials (monofilament versus multifilament) and three closure techniques (appositional single layer, crushing single layer, and double layer) were compared in healthy dogs at 14 or 28 days, postoperatively. No significant differences between the two suture materials were observed for most of the macroscopic or histological variables. However, the monofilament suture material caused significantly more fibrous tissue reaction in the muscular layer of the jejunum than did the multifilament suture material. Of the three enterotomy closure techniques used in this study, the appositional single‐layer method proved to be the best. The double‐layer closure method caused a significant decrease in the incisional circumference, the relative circumference, and volume of the jejunum, and a significant increase in jejunal wall thickness. Our findings suggest that canine jejunal enterotomy incisions can be closed using an appositional suture pattern with relatively rapidly absorbable monofilament suture material. The use of double‐layer suture patterns for closure of jejunal enterotomy incisions should be avoided because the size of the intestinal lumen may be reduced.     

Continuous absorbable suture pattern in the closure of ventral midline abdominal incisions in horses

A retrospective study was performed to evaluate the healing of ventral midline abdominal incisions, closed with a simple continuous suture pattern using absorbable suture material, in 139 horses and foals. Dehiscence and incisional hernia developed separately in two horses. The low incidence of dehiscence and incisional hernia, compared with their reported incidence following the use of interrupted suture repair, leads the authors to recommend this alternative method of abdominal incision closure in horses. The security of closure is not sacrificed and the advantages of a rapid closure are desirable.     

Extra-articular absorbable suture stabilization of coxofemoral luxation in dogs

OBJECTIVE: To evaluate the effectiveness of an extra-articular surgical technique using absorbable suture material for the stabilization of traumatic coxofemoral luxation in dogs. STUDY DESIGN: Prospective, clinical study. ANIMALS: Fourteen client-owned dogs with recent and long-standing traumatic coxofemoral luxation (13 craniodorsal and 1 ventral). METHODS: Coxofemoral luxations were surgically reduced and maintained in place with an extra-articular iliofemoral multifilamentous absorbable suture (3 to 6 strands of 2 USP Polyglactin 910). No external support was employed, and all the dogs were encouraged to use the affected limb postoperatively. The average time of clinical and radiographic follow-up was 11.6 +/- 6.3 months (from 2 to 22 months). RESULTS: During the follow-up period, no reluxations occurred and no complications associated with the surgical technique were identified. The dogs started bearing weight from 1 to 10 days after the surgery (mean, 4.3 +/- 2.9 days) and the period of lameness ranged from 7 to 30 days (20 +/- 8.6 days). At the final clinical examination, the dogs did not demonstrate any lameness or pain during passive flexo-extension movements, and there was no significant limitation of the range of motion. CONCLUSION: Extra-articular stabilization with multifilamentous absorbable sutures is a simple, effective method of treatment for acute and chronic coxofemoral luxation. The absorbable material used is strong enough to maintain articular stability during the period of scar tissue formation even in large-breed dogs. CLINICAL RELEVANCE: Absorbable sutures avoid the possible complications related to the use of nonabsorbable material and seem to be sufficient to maintain articular stability during the capsular healing process.     

Comparison of single layer staple closure versus double layer hand-sewn closure for equine pelvic flexure enterotomy

Our objective was to compare thoracoabdominal (TA Premium™ 90) stapled enterotomy closure to traditional hand-sewn closure, using time to perform the technique, luminal diameter, and bursting pressure in ex-vivo specimens. The pelvic flexures of 13 client-owned horses were harvested. Each pelvic flexure had 1 enterotomy performed; 6 were closed via staples, 7 closures were hand-sewn. Luminal diameter at the enterotomy site was assessed via contrast radiography performed pre-and post-enterotomy. Bursting pressure of the closure was assessed by continuous manometry during rapid infusion. Time to perform stapled closure was significantly shorter than hand-sewn closure (P < 0.0001). Percent reduction of luminal diameters was significantly decreased in stapled specimens (P = 0.034). There was no significant difference in bursting strength between closure techniques (P = 0.196). In conclusion, stapled enterotomy closure offers statistically significant reduction in closure time and better maintains pre-enterotomy luminal diameter without reducing biomechanical strength, compared to a double layer hand-sewn closure.     

Comparison of absorbable and nonabsorbable sutures for intradermal skin closure in cats

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.     

In vitro comparison of mechanical and degradation properties of equivalent absorbable suture materials from two different manufacturers

Objective: To compare the mechanical, knotting, and absorption properties of 3 synthetic absorbable suture materials (polyglactin 910, polydioxanone, poliglecaprone 25) from 2 different manufacturers (Huaiyin Medical Instruments Co. Ltd. and Ethicon Inc.). Sample Population: Suture material samples from the same manufacturing lot for each suture type and manufacturer. Methods: Part 1: 10 samples of each suture were incubated in bovine serum and tested for ultimate load and stiffness at days 0, 1, 7, 14, 21, and 28. Part 2: 10 knotted samples were similarly evaluated, without incubation. Results: Huaiyin polydioxanone had a greater (P<.001) ultimate load on days 0, 1, and 7; and a consistently greater stiffness for the duration of the study, compared with the Ethicon polydioxanone. Ethicon poliglecaprone 25 had a greater ultimate load on days 0, 1, 7 (P<.001); on day 21 Huaiyin had a greater ultimate load. Ethicon poliglecaprone had greater stiffness on days 0, 1, 7 (P<.001). Ethicon polyglactin 910 had a greater (P<.001) ultimate load at all times and a greater stiffness (P<.001) at days 0, 1, 7, and 14 compared with Huaiyin polyglactin 910. Huaiyin polydioxanone and polyglactin 910 had greater knot breaking strengths than Ethicon equivalents (P<.001). Conclusion: Differences in mechanical properties exist between nominally identical suture materials from different manufacturers.     

Comparison of three common methods of lung lavage in healthy pigs

Bronchoscopic, endotracheal and transtracheal lung lavage were evaluated in 38 healthy pigs taken from a nucleus herd in a good state of health with respect to their applicability in practice and the traceability of bacteria, cellular parameters and the antimicrobial peptide PR-39 in the respective lavage fluid samples. The total cell count, qualitative morphological cellular characteristics as well as PR-39 could be determined in all lavage fluid samples, while quantitative cell differentiation was not possible in endotracheal lavage samples. The comparison of the three methods resulted in a higher proportion of polymorphonuclear neutrophil granulocytes (PMNs) and higher concentrations of PR-39 in transtracheal samples. For this reason different valuation standards with respect to PMNs and PR-39 concentrations are presupposed for transtracheal lavage samples. The occurrence of pavement epithelial cells as well as the number of contaminating bacterial species per sample was the lowest in transtracheal lavage. Mycoplasma hyopneumoniae polymerase chain reaction appeared to have the highest diagnostic sensitivity in combination with bronchoscopic lavage. In conclusion, bronchoscopic and transtracheal lavage were considered to be more appropriate for bacteriological and cytological diagnostics than endotracheal lavage.     

Comparison of two doses of recombinant human bone morphogenetic protein in absorbable collagen sponges for bone healing in dogs

OBJECTIVE: To determine the effects of 2 doses of recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge (rhBMP-2/ACS) on bone healing in dogs. ANIMALS: 27 adult dogs. PROCEDURES: Dogs underwent a mid-diaphyseal (1-mm) tibial osteotomy (stabilized with external skeletal fixation) and received an ACS containing 0.28 mg (0.2 mg/mL) or 0.56 mg (0.4 mg/mL) of rhBMP-2 or no treatment (control dogs). All dogs were examined daily; bone healing was assessed via radiography and subjective lameness evaluation every 2 weeks. After euthanasia at 8 weeks, tibiae were evaluated biomechanically and histologically. RESULTS: Control dogs required antimicrobial treatment for pin-site-related complications more frequently than did rhBMP-2/ACS-treated dogs. At 4 and 6 weeks, weight bearing was greater in dogs treated with rhBMP-2/ACS (0.2 mg/mL) than in control dogs, albeit not significantly. Compared with control treatment, both doses of rhBMP-2/ACS accelerated osteotomy healing at 4, 6, and 8 weeks, and the 0.2 mg/mL dose enhanced healing at 2 weeks; healing at 6 weeks was greater for the lower-dose treatment than for the higher-dose treatment. Histologically, healing at 8 weeks was significantly improved for both rhBMP-2/ACS treatments, compared with control treatment. Among groups, biomechanical variables did not differ, although less osteotomy-site failures occurred in rhBMP-2/ACS-treated groups. CONCLUSIONS AND CLINICAL RELEVANCE: In dogs that underwent tibial osteotomy, rhBMP-2/ACS (0.2 mg/mL) appeared to accelerate bone healing and reduce lameness (compared with control treatment) and apparently augmented bone healing more than rhBMP-2/ACS (0.4 mg/mL). Compared with control dogs, rhBMP-2/ACS-treated dogs required antimicrobial treatments less frequently.     

Comparison of three radiographic methods for diagnosis of hip dysplasia in eight-month-old dogs.

OBJECTIVE: To compare the accuracy of the extended-hip radiographic (EHR) score, the distraction index (DI), and the dorsolateral subluxation (DLS) score for identifying hip dysplasia in dogs at 8 months of age. DESIGN: Cohort study ANIMALS: 129 Labrador Retrievers, Greyhounds, and Labrador Retriever-Greyhound crossbreds. PROCEDURE: Radiography was performed when dogs were 8 months of age. Dogs were euthanatized at 8 to 36 months of age; hip dysplasia was diagnosed at the time of necropsy on the basis of results of a gross examination of the articular cartilage of the hip joints for signs of osteoarthritis. RESULTS: The EHR score, DI, and DLS score at 8 months of age were all significantly correlated with degree of cartilage degeneration at necropsy. Sensitivity and specificity of using EHR score at 8 months of age to diagnose hip dysplasia (scores > 3 were considered abnormal) were 38 and 96%, respectively; sensitivity and specificity of using DI (values > 0.7 were considered abnormal) were 50 and 89%; and sensitivity and specificity of using DLS score (scores < 55% were considered abnormal) were 83 and 84%. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that specificities of the 3 methods for diagnosing hip dysplasia in dogs at 8 months of age were similar. However, the DLS score had higher sensitivity, indicating that there were fewer false-negative results.     

Comparison of haemodynamic changes during two surgical methods for neutering female dogs

The aim was to investigate if intraoperative registrations of blood pressure and heart rate could be used to estimate surgical trauma. In a prospective clinical trial, registrations in eight dogs neutered by laparoscopic ovariectomy (LOE) were compared with eight dogs subjected to open ovariohysterectomy (OHE). For comparisons phases were used: phase zero = steady state after induction of anaesthesia; phase one = opening of abdomen; phase two = severing of ovarian pedicles; and, phase three = abdominal closure. During LOE, mean systolic blood pressure increased by 7 mm Hg (p = 0.05) and 15 mm Hg (p = 0.01) from phase zero to phase one and two, respectively, and during OHE by 3 mm Hg (ns) and 29 mm Hg (p < 0.0001), respectively. The increase from phase one to phase two differed between groups (p = 0.03). Heart rate did not change. Frequent intraoperative measurements of blood pressure appear a promising method for evaluating surgical trauma.     

Comparison of three different methods to prevent heat loss in healthy dogs undergoing 90 minutes of general anesthesia

ObjectiveTo compare a towel under, a warm water pad under or a forced warm air blanket over dogs as techniques to reduce heat loss during a standardized anesthetic.Study designProspective, randomized, crossover study.AnimalsEight, healthy, mixed breed dogs weighing 16.3–19.6 kg.MethodsDogs were anesthetized four times for 90 minutes. Dogs were placed on a steel table (treatment TA), with a cotton towel (treatment TO) or a circulating warm water pad (treatment WP) between the dog and the table, or with, a towel under the dog and covered with a forced warm air blanket (treatment WAB). Rectal temperature (RT) was recorded at 5 minute intervals. Changes in temperature (ΔRT) were calculated as the RT at a given point subtracted from the RT before anesthesia (baseline) and compared over time.ResultsAfter 90 minutes of anesthesia, the ΔRT was 3.42 °C ± 0.29 for TA, 2.78 °C ± 0.43 for TO, 1.98 °C ± 0.29 for WP, and 0.91 °C ± 0.27 for WAB. Significant differences in ΔRT occurred between TA and WAB at 20 minutes (0.94 °C ± 0.42, p = 0.0206), between TO and WAB at 30 minutes (1.16 °C ± 0.62, p = 0.0063), between WP and WAB at 50 minutes (0.96 °C ± 0.98, p = 0.0249), between TA and WP at 35 minutes (1.19 °C ± 0.54, p = 0.0091), between TO and WP at 70 minutes (1.12 °C ± 0.56, p = 0.0248), and between TA and TO at 75 minutes (0.96 °C ± 0.62, p = 0.0313). These differences in ΔRT between each treatment persisted from the times indicated until the end of the anesthesia.Conclusion and clinical relevanceDuring anesthesia, forced warm air blankets were superior to other methods tested for limiting heat loss. An efficient heat loss technique should be used for anesthesia longer than 20 minutes duration in medium sized dogs.     

An in vitro comparison of two suture intervals using braided absorbable loop suture in the equine linea alba

OBJECTIVE: To compare bursting strength and failure modes of ventral median abdominal incisions closed with loop suture in a simple continuous pattern using two different suture-bite intervals. STUDY DESIGN: In vitro experiment. SAMPLE POPULATION: Equine cadavers (n=14; weighing >318 kg; postmortem interval <2 hours). METHODS: A template was used to make a 25 cm incision with suture interval and bite size of either 1.0 cm x 1.5 cm or 1.5 cm x 1.5 cm. A 200 L polyurethane bladder was inserted within the abdomen and insufflated to create abdominal wall tension. Celiotomies were closed with a #2 braided lactomer 9-1 continuous pattern with a loop suture. Deviation from the linea, closure time (minutes), total suture length (cm), suture length to wound ratio (SL:WL), bursting pressure (mm Hg), and failure modes (fascial or suture) were compared between groups using a Mann-Whitney U test. Significance was set at P<.05. RESULTS: No significant differences were identified between closing time, total suture length used, SL:WL, bursting pressure, or failure mode. Fascial failure was the main failure mode for both techniques; suture failure occurred rarely and knot failure did not occur. CONCLUSION: Based on the overall bursting pressure and failure mode, #2 braided lactomer loop suture placed in a continuous pattern should provide sufficient security for closure of the equine linea alba during recovery and the immediate postoperative period. CLINICAL RELEVANCE: Although there were no significant differences in the 2 patterns evaluated, the 1.5 cm x 1.5 cm pattern may have potential advantages for closure time, less total suture remaining in the wound, and strength.     

Comparison of fibrin glue and suture in the healing of teat incisions in lactating goats

The aims of this study were to investigate whether fibrin glue can be used to close experimentally induced incisions of the teat (mammary papillae) in lactating goats and to compare the healing of the glued with the sutured incisions. Four clinically healthy lactating dairy goats, namely 8 mammary papillae were used. After surgical preparation of the papillae, a 3.5 cm long incision of each papilla was made through skin, muscular layer and mucosa into the papillary sinus. The wounds in the right papillae in all goats were closed with U-shaped uninterrupted 00 chromic catgut sutures. The wounds in the left papillae in all goats were closed, using fibrin glue. One incision was seen to be dehisced and fistulous one day after in fibrin glued teats. The animals were slaughtered 8 days after surgical manipulation. The mammary papillae were removed and examined in the viewpoint on gross and microscopic findings. The healing of wounds was slower and feeble in glued mammary papillary incisions, however faster and stronger in sutured incisions on day 8 after operations. But, available outcomes like less tissue thickness and positive cosmetic results could be obtained byfibrin glue used on mammary papillary incisions, which are very important for teats to be milked by hand and milking machine. Results suggest that it is advisable to use only one or two simple interrupted sutures in teat incisions glued with fibrin to prevent the dehiscence but with a more reliable healing than the sutured incisions.     

2种方法收集3种豆科植物挥发物的成分分析

采用活体植物动态顶空吸附法(DHA)和固相微萃取法(SPME)收集扁蓿豆(Medicago ru-thenica)、黑豆(black soybean)和野大豆(Glycine soja)3种豆科植物气味挥发物,利用气相色谱-质谱联用法(GC-MS)对3种植物挥发物的主要成分进行分析鉴定,探究了不同收集方法对豆科植物挥发...