Visual evidence of progression and eventual resolution of nasofrontal suture exostosis over 27 months in a gelding

A 22-year-old Thoroughbred gelding presented with a noticeable external firm and nonpainful swelling over the location of the frontal sinuses. Further radiographic investigation of the swelling identified soft tissue facial swelling, new bone formation and a radiolucent line between two areas of bone remodelling. The horse was diagnosed with a nasofrontal suture exostosis. This is a relatively rare disease of the head but is one of the more common reasons for facial swelling. It is reported that these horses are not painful and that the swelling and bony reaction will resolve over 12–18 months with no treatment needed. It is well described in the current literature what the initial presentation should look like; however, there is a void when it comes to demonstration of the clinical course of the disease. This report provides veterinarians and owners with a visual reference to a relatively typical course of disease, where swelling can enlarge over time and still resolve within 2 years.     

一种自制缝合线的抗原性的实验研究

将大量肌腱缝合线溶液输入家兔耳静脉内,观察家兔的免疫反应,并分别取肌腱缝合线溶液、天然兔抗原、天然牛抗原皮下多点、腹腔、肌肉注射途径常规免疫家兔,来研究这三种抗原的免疫性强弱。结果发现,肌腱缝合线溶液的免疫反应性很弱。     

Radiographic features of suspected suture‐associated cystic calculi in dogs

This retrospective case series describes the radiographic features of suspected suture‐associated cystic calculi in six dogs with a history of at least one or multiple prior cystotomies. One of the dogs presented twice. Suspected suture‐associated cystic calculi were multifocal, short, predominantly linear mineral opacities localized in the center of the urinary bladder on abdominal radiographs. One patient (n = 1) presented with multifocal round, pin point, and linear radiopaque calculi. The calculi were all calcium oxalate in composition. On gross examination, the calculi had a hollow center. Six cystotomies used monofilament absorbable suture material (polydioxanone [n = 4] or poliglecaprone 25 [n = 1]) in prior cystotomies. Suture material in two of the cases was unknown. Suspected suture‐associated cystic calculi are a rare occurrence in veterinary medicine but should be considered in dogs that have a history of prior cystotomy, hollow core on gross analysis, and radiographic evidence of mineral opaque, predominantly linear, cystic calculi.     

In vitro evaluation of screws and suture anchors in metaphyseal bone of the canine tibia

OBJECTIVE: To compare ease of insertion, load to failure, and mode of failure of cortical and cancellous screws, BoneBiter, IMEX, and TwinFix suture anchors in canine metaphyseal tibial bone. STUDY DESIGN: Experimental biomechanical study. ANIMALS: Canine cadaveric tibias. METHODS: One investigator inserted all anchors and subjectively evaluated ease of placement. Anchor systems were loaded to failure along axis of insertion with audio-video recording to determine failure mode. RESULTS: BoneBiter was the most difficult anchor to insert successfully. Mean+/-SD loads to failure were cancellous screw (711+/-193 N), IMEX 4.7 mm 18 g wire (661+/-163 N), IMEX 4.0 mm 18 g wire (661+/-165 N), cortical screw (635+/-184 N), BoneBiter #5 Kevlar suture (393+/- 109 N), and TwinFix 5.0 mm #2 polyester (267+/-73 N). No significant differences were noted among the cortical screw, cancellous screw, IMEX 4.7 and 4.0 mm, all of which were significantly (P<.001) greater than BoneBiter and TwinFix . Failure modes were pullout of bone, suture-wire breakage, eyelet breakage, or no failure to 1000 N: screws (18,0,0,2), IMEX (18,1,1,0), BoneBiter (2,8,0,0), and TwinFix (0,10,0,0). CONCLUSIONS: Fixation devices were user friendly, with the exception of BoneBiter. Mode of failure is dependent on suture material and anchor design. Cortical and cancellous screws, and IMEX anchors with 18 g wire have significantly greater load to failure compared with BoneBiter and TwinFix suture anchors. CLINICAL RELEVANCE: Based on load to failure, ease of use, design characteristics, and cost, IMEX anchors may have advantages over other comparable soft tissue fixation devices.     

Suture Materials and Suture Selection for Use in Exotic Pet Surgical Procedures

Exotic animals are becoming increasingly popular and more exotic pet owners are seeking veterinary care. This has led to a demand for properly trained veterinarians who are capable of providing quality, up-to-date medical and surgical treatments. Many surgeries are now performed on exotic pets, and selection of the appropriate suture material is an important part of the treatment protocol. An understanding of different available suture materials, healing times of different tissues, and knowledge of different anatomic and physiologic characteristics in different species is important in the selection of the most appropriate suture material. This review will summarize important aspects of suture selection in exotic animals.     

Comparison of the use of a braided multifilament transfixation suture for field castration with other castration techniques

Complications with castrations occur commonly and are usually not life-threatening, with the exception of evisceration or haemorrhage, which are uncommon. Primary closure castration (closing deeper tissue layers and skin) or use of a transfixation ligature alone to prevent evisceration has been recommended. The goal of this study was to investigate the use of a closed technique with multifilament suture for transfixation of the spermatic cord alone in field castrations. The results of this study support our hypothesis that a closed castration technique with a multifilament, transfixing ligature (No. 2 polyglactin 910) did not result in additional post-operative complications when compared with a closed castration technique without ligature placement or a primary closure castration technique in a hospital setting.     

An in vitro biomechanical comparison of the breaking strength and stiffness of polydioxanone (sizes 2, 7) and polyglactin 910 (sizes 3, 6) in the equine linea alba

OBJECTIVE: To determine failure strength, stiffness, and failure mode of 4 suture materials in equine linea alba. STUDY DESIGN: Randomized complete block design. SAMPLE POPULATION: Linea albas collected from 12 adult horses (mean weight, 475 kg; mean age, 10 years). METHODS: The ventral abdominal fascia, including the linea alba, was collected and bisected along the linea alba into right and left halves. Each half was divided into four, 5-cm sections extending from the umbilicus cranially, and randomly assigned to 1 of 4 suture materials: 2 polydioxanone (2 PD), 3 polyglactin 910 (3 PG), 6 polyglactin 910 (6 PG), and 7 polydioxanone (7 PD). A single cycle to failure test was performed on each specimen at a distraction rate of 100 mm/min. Differences in failure strength and stiffness for the materials were evaluated using a mixed linear model with significance set at P<.05. RESULTS: In 94 of 96 test sections, constructs failed by suture failure. There were significant differences in failure strength (P<.0001) and stiffness (P<.001) among the suture/tissue constructs. 7 PD had the highest breaking strength (316.8 N) followed by 6 PG (281.3 N), 3 PG (229.9 N), and 2 PD (193.0 N). Six PG had the largest stiffness (14 N/mm) followed by 3 PG (12.7 N/mm), 7 PD (10.1 N/mm), and 2 PD (7.2 N/mm). Suture breaking strength and stiffness were not affected by linea or fascia thickness, individual horse, half of the linea alba, or abdominal wall position. Eighty-five (90.4%) suture loops failed adjacent the knot. CONCLUSIONS: When tested in single cycle to failure, suture material was more likely to fail than the linea alba. Larger suture materials had higher breaking strengths than smaller suture materials and stiffness was also affected by suture material and size. CLINICAL RELEVANCE: Given its high initial breaking strength and its relatively longer in vivo strength retention, 7 PD seems an appropriate choice of suture material for closure of the equine linea alba when maximal short-term failure strength is desired.     

Suture exostosis with concurrent nasal septum chondrosarcoma in a horse

A 15‐year‐old Hanoverian mare presented with a 10‐day history of facial swelling in the right maxillary and frontal regions, left epiphora and intermittent right epistaxis. Radiographs revealed suture exostosis of both nasofrontal sutures and a deviated and thickened nasal septum. Computed tomography (CT) of the skull revealed exostosis of the nasolacrimal sutures and ducts bilaterally of both nasofrontal sutures and of the right zygomatocomaxillary and lacrimomaxillary sutures. The mid‐to‐caudal aspect of the nasal septum was thickened and had multiple well demarcated hypoattenuated regions within the septum. Histological examination of biopsies taken from the right nasofrontal suture and the nasal septal mass revealed suture exostosis and nasal septum chondrosarcoma. The horse was treated with rest and anti‐inflammatories. The facial swelling and left epiphora were improved at 7 months telephone follow‐up. This report is the first to describe a nasal septum chondrosarcoma in a horse. Additionally, we suggest that the suture exostosis may have developed due to an alteration of the biomechanics of the skull sutures secondary to the septal tumour.     

Entropion correction by fornix-based suture placement: use of the Quickert-Rathbun technique in ten dogs

The objective of this study was to evaluate fornix-based suture placement as a method for entropion correction in the dog. Lower eyelid entropion with resultant trichiasis was corrected in 10 dogs using fornix-based suture placement similar to that employed in the Quickert-Rathbun technique used in man. A double-ended suture was placed originating at the deepest extent of the fornix and exiting the lid 1-2 mm from the eyelid margin. Degree of correction was assessed visually immediately after surgery and at re-examination with a follow-up period of up to 6 months. Fornix-based suture placement led to immediate eversion of the eyelid in each case and thus amelioration of the trichiasis in all dogs. In two cases eyelid eversion initially appeared over-corrected and in two cases exposure of conjunctival tissue was evident initially at the palpebral margin. In all cases, however, such complications were transient with long-term results giving an acceptable apposition between ocular surface and eyelid margin in all adult dogs. In three juvenile dogs on which the technique was used, further surgical treatment was required as the puppies grew. Fornix-based suture placement is a novel approach to entropion correction in the dog which yields acceptable results in the majority of suitable cases without recourse to incisional surgery.     

仪式化立意与表达——中国主流影像文本与负价值的缝合

主流影像文本与正面价值如同一对孪生姐妹,似乎彼此融为一体,不可分割,为此往往形成一种错觉,强调主流影像文本就必须把正面价值放于中心地位,以正面价值的表述作为衡量主流影像文本的重要尺度和砝码。但是,影像文本对价值观念的表述却依照自己的文本逻辑进行,并没有把正价值当成唯一的“标的”。把负价值植入叙事活动,通过叙事缝合,形成故事价值的“负向正”的转换,却是大多数中国主流影像文本所采用的仪式化立意与表达策略。     

Suture exostosis causing obstruction of the nasolacrimal duct in three horses

CASE HISTORY Three horses were presented with facial swelling and epiphora.

CLINICAL FINDINGS: All horses had facial swellings and radiographic findings consistent with exostosis at the lacrimomaxillary suture, and ipsilateral epiphora. Positive contrast dacryocystorhinography demonstrated that the site of obstruction of the nasolacrimal duct was located where the duct traverses the lacrimomaxillary suture.

DIAGNOSIS: Lacrimomaxillary suture exostosis.

CLINICAL RELEVANCE: Lacrimomaxillary suture exostosis should be considered as a differential diagnosis in cases of epiphora in horses. Dacryocystorhinography, preferably retrograde and normograde, may be used as an aid to diagnosis.     

犬前列腺摘除术的2种通路及关键技术探索

为了探索犬前列腺摘除术的不同通路及其关键技术,选择3～5月龄、3～5 kg体重的4只杂交犬,分成1、2组,分别采用翻开耻骨片和经腹底部正中切口牵拉膀胱以暴露前列腺的手术通路,对前列腺进行完整摘除后作尿道断端吻合,术后观察犬的精神、食欲、饮欲、排便、排尿等情况,并于术后第3周进行剖检,观察膀胱及尿道断端的愈合情况。结果显示,采用上述2种手术通路进行前列腺摘除后,试验犬的精神、食欲、饮欲、排便、排尿等一切正常,膀胱有少量出血点,尿道吻合处愈合良好。试验结果表明,采用6-0单丝尼龙线和结节缝合法是吻合尿道断端的可靠方法,而使用盆腔脂肪组织覆盖尿道吻合处能够有效地预防吻合处漏尿且与周围组织黏连,是保证吻合处良好愈合的有利因素。     

A review of swellings of the frontal region of the equine head

Gross swellings of the equine frontal area are most commonly caused by the poorly understood disorder of nasofrontal suture line periostitis that is usually self‐resolving, sinus cysts that are highly amenable to treatment, sinus tumours that in contrast usually respond poorly to treatment and facial trauma that may later lead to nasofrontal suture line periostitis. Other causes of conchofrontal sinus disease such as intrasinus progressive ethmoid haematoma, primary sinusitis and dental sinusitis seldom cause gross swellings of the overlying bones.     

Clinical and ultrasonographic evaluation of three suture techniques for closure of the equine linea alba

Surgical technique plays an important role in preventing ventral midline incisional complications. The aim of this study was to compare the clinical and ultrasonographic outcome of three suture techniques for closure of the linea alba. In this prospective case series (n = 43), horses operated for acute abdominal intestinal disease through a midline incision were randomised in three groups: closure with a conventional continuous technique (Group 1), a small stitches continuous technique (Group 2) and the UX-technique (shoe-lace configuration, Group 3). Age, sex, body weight, type and duration of surgery were recorded and the suture to wound length ratio was calculated. Clinical evaluation of the wound (wound discharge) was performed daily during hospitalisation. At 7 weeks post-operatively the linea alba was evaluated clinically and ultrasonographically. The linea alba width was measured halfway along the length of the incision. One horse in Group 1 had acute incisional dehiscence, but there were no further significant differences between the groups in the short term. Seven weeks post-operatively two horses had complete herniation in Group 1 and one horse had partial herniation in Group 2. In the UX group no herniation occurred. The incidence of herniation was not significantly different between the groups. On ultrasound at 7 weeks the linea alba width was significantly smaller in Group 2 (P = 0.00029) and Group 3 (P = 0.0018) compared with Group 1, even with exclusion of the acute incisional dehiscence and two herniated horses. Limitations were the small group size and relatively low incidence of incisional complications for statistical analysis. It was concluded that the use of small stitches and the UX-technique resulted in a smaller linea alba width compared with the conventional continuous suture technique and might therefore be preferred for closure of the linea alba in equine colic surgery.     

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.     

Difference in incisional complications following exploratory celiotomies using antibacterial‐coated suture material for subcutaneous closure: Prospective randomised study in 100 horses

Reasons for performing study: Incisional complications are a major post operative challenge following ventral midline exploratory celiotomy for abdominal pain in horses. They lead to discomfort, prolonged hospitalisation, longer recovery times and increased cost; therefore, investigation of preventative procedures are warranted. Objectives: To determine the clinical effect of antibacterial (triclosan) coated 2‐0 polyglactin 910 suture material on the likelihood of incisional infections when used for closure of subcutaneous tissue following ventral midline celiotomies in horses. Methods: One hundred horses undergoing exploratory celiotomy assigned at random to one of 2 groups. In the control group coated 2‐0 polyglactin 910 (Vicryl) was used for apposition of the subcutaneous tissue in a simple continuous pattern and, in the study group, antibacterial (triclosan) coated 2‐0 polyglactin 910 suture material (Vicryl Plus) was used. Post operatively an elastic adhesive abdominal bandage was applied, changed and the incision was inspected by a clinician blinded to the study protocol at 24–36 h and 6–9 days post operatively. Outcomes of interest were evidence of incisional pain, incisional oedema, sheath/udder oedema, incisional drainage, hernia formation and dehiscence. Results: Antibacterial‐coated suture material did not decrease the likelihood of incisional complications in 100 horses. Conclusions: A beneficial effect on ventral midline incisions in 100 horses was not evident by using antibacterial‐coated suture material. Potential relevance: Lack of effectiveness of antibacterial‐coated suture material in equine ventral midline closure after exploratory celiotomy and the observed potential adverse effects suggest that further clinical investigations are needed before using such material routinely on horses.