Presurgical hand antisepsis: concepts and current habits of veterinary surgeons

Objective: To assess current habits for surgical hand preparation among veterinary surgical specialists and to compare data with current guidelines for hand asepsis techniques. Study design: Survey of veterinary surgical specialists. Sample Population: Diplomates of the American (ACVS) and European Colleges of Veterinary Surgeons (ECVS). Methods: An internet‐based survey of hand preparation methods before surgical procedures was conducted of 1300 listed ACVS and ECVS Diplomates. Results: A 42.6% response rate was obtained. Approximately, 80% of respondents use disinfecting soaps as a primary method for hand antisepsis. Of those, 81% use chlorhexidine‐based scrubs and 7% use a neutral soap followed by a hydroalcoholic solution. Conclusions: Contrary to current recommendations of the World Health Organization and scientific evidence supporting use of hydro‐alcoholic rubs for presurgical hand preparation, veterinary surgical specialists still use surgical scrub solutions containing disinfecting soaps.     

The American College of Veterinary Surgeons The First Twenty-Five Years

The American College of Veterinary Surgeons (ACVS), founded in 1965 and recognized by the AVMA in 1970, maintains high standards for surgical training programs and administers rigorous certifying examinations. It provides educational outreach to the veterinary medical profession by presenting scientific programs at ACVS annual meetings, sponsoring the Veterinary Surgical Forum in the USA and Europe, and publishing a refereed journal, Veterinary Surgery. The ACVS offers research grants and other awards to surgical residents, and encourages its members to pursue original investigations and contribute to the veterinary literature. In its silver anniversary year, it is appropriate to recall the aspirations and accomplishments of this forward-looking specialty organization.     

Remembrances of Jacques Jenny, DrMedVet 1917–1971

Editor's note : The holding of the 19th Annual Meeting of the American College of Veterinary Surgeons in Philadelphia in conjunction with the Centennial Celebration of the School of Veterinary Medicine of the University of Pennsylvania provides an opportunity for reflection. Dr. Jacques Jenny, Professor of Orthopedic Surgery at the School, was Chairman of the Organizing Committee that gave rise to the American College of Veterinary Surgeons on December 16,1965, and was elected as first President of the College. The solid foundation and high ideals that the Organizing Committee established are in large part responsible for the success of the College. Dr. Jenny died on November 20, 1971. Those of us fortunate to have known him personally realize the immense gap that his premature death left. For those that did not know him, I hope that this article permits some appreciation of the contributions of Dr. Jenny the comparative orthopedic surgeon, as well as of the very special human qualities of Jacques Jenny the man. The first author, Dr. Mark Allam, was Professor of Surgery and Dean of the School of Veterinary Medicine during most of Dr. Jenny's career at the University of Pennsylvania, and was the first Chairman of the Board of Regents of the American College of Veterinary Surgeons. The second author, Dr. David Nunamaker, is the first holder of the Jacques Jenny Professorship in Veterinary Orthopedics at the University of Pennsylvania.     

Estimate of the annual economic impact of treatment of cranial cruciate ligament injury in dogs in the United States

OBJECTIVE: To estimate the economic impact to veterinary clients for the medical and surgical treatment of rupture of the cranial cruciate ligament (RCCL) in dogs for the year 2003. DESIGN: Economic impact survey. SAMPLE POPULATION: 501 diplomates of the American College of Veterinary Surgeons (ACVS) indicating that their area of surgical emphasis was small animal orthopedic surgery or small animal general and orthopedic surgery and 4,000 veterinarians indicating to the AVMA that their professional area was small animal practice exclusive or mixed animal practice (at least 80% small animal). PROCEDURE: Veterinarians were surveyed concerning the cost for medical and surgical treatment of RCCL for 2003. The economic impact was calculated by multiplying the number of RCCL surgeries performed by the mean cost of surgery. This was added to the number of RCCL cases managed medically multiplied by the mean cost of medical management. This estimate for survey responders was extrapolated to the total number of veterinarians in the study population for the ACVS or AVMA. RESULTS: Estimates for the total cost of surgery were $171,730,134.72 and $1,020,167,907 for veterinarians in the ACVS and AVMA populations, respectively. The cost of medical management was $2,885,687.86 and $126,558,155.16 for veterinarians in the ACVS and AVMA populations, respectively. After combining the ACVS and AVMA populations, we estimated that owners spent $1.32 billion for the treatment of RCCL in the United States in 2003. CONCLUSIONS AND CLINICAL RELEVANCE: RCCL is a prevalent, costly injury. Results may motivate veterinary and consumer agencies to prioritize funding for a better understanding of the injury.     

Retention of surgery specialists in academia: a critical agenda

Recruitment and retention of specialists to academia appears to be a growing problem in university teaching hospitals. Members of the American College of Veterinary Surgeons (ACVS) believe that the movement of surgery specialists to practice may have an impact on the training of veterinary students and surgery residents. To address these concerns, 1,071 ACVS diplomates and 60 department heads and hospital directors from all veterinary schools in North America were surveyed to determine whether a problem exists, the extent of the problem, and potential reasons for migration of specialists to practice. Responses were obtained from 620 ACVS diplomates (58 per cent) and 38 department heads and hospital directors (63%) from 28 different universities. The responses confirmed a net movement of surgery specialists from academia to practice. Eighty seven percent of department heads and hospital directors believed there was a shortage of small animal surgery specialists in academia; this information was supported by the fact that 47% responded that they had open positions and 68% had difficulty filling positions in the last five years. The demand was slightly less for large animal surgery specialists, and 42 per cent of respondents indicated that they had open positions. Financial considerations were the most common reason for surgery specialists to move from academia to private practice. Seventy-six percent of responding ACVS diplomates in private practice had a total compensation package valued at greater than $125,000 per year, whereas 77.8% of diplomates in academia had total compensation valued at $125,000 or less. Most universities offer starting salaries (not including benefits) for recently certified surgery specialists ranging from $70,000 to $90,000. Reasons for moving from academia to practice besides financial considerations included undesirable location of university hospitals; lack of interest in research; and a belief that university administration was not supportive of surgery specialists. Many academic surgery specialists were frustrated by the requirement for productivity in research, teaching, and service for promotion in tenure-track positions.     

The European College of Veterinary Pathologists (ECVP): the professional body for European veterinary pathologists

The European College of Veterinary Pathologists (ECVP) was established in 1995 with the aim of advancing veterinary pathology and promoting high standards within the specialty in Europe. The ECVP is one of 21 European colleges recognized by the European Board of Veterinary Specialisation (EBVS), which represents a quality-assurance system for European veterinary specialists. Until the ECVP was founded, there was no unified European system recognizing the specialty of pathology, and many European countries followed their own qualification systems, which varied in form and standard. The ECVP provides an annual certifying examination, the passing of which is required to gain membership (diplomate status) in the college. This qualification is now accepted on equal terms by the well-established American College of Veterinary Pathologists (ACVP). In line with EBVS requirements, the ECVP has also established a standard continuing professional development (CPD) and re-registration system for its membership. Furthermore, it has promoted and unified European post-graduate training in veterinary pathology by setting up requirements for residency training programs and making registration and monitoring of these programs by the ECVP a prerequisite for approval of an institution as a training facility. The concurrent establishment, together with the European Society of Veterinary Pathology, of an annual summer school that trains residents for the certifying examination has further fostered European post-graduate training. Within 10 years, the ECVP has succeeded in establishing common standards and a unified approach to veterinary pathology throughout Europe. This article describes the evolution and organization of the ECVP.     

Survey of prokinetic use in horses with gastrointestinal injury

OBJECTIVE: To report prokinetic strategies used to manage horses after gastrointestinal surgery. DESIGN: Electronic questionnaire. SAMPLE POPULATION: Diplomates of the American College of Veterinary Surgeons (ACVS) who perform equine intestinal surgery. PROCEDURE: A survey (21 questions) designed to determine use of prokinetic agents was sent electronically to 112 ACVS Diplomates known to perform equine intestinal surgery. Several clinical scenarios were also described to determine which, if any, prokinetic agent respondents would select. RESULTS: Responses were obtained from 58 (52%) surgeons from 44 clinics. Selection of prokinetic agent for specific gastrointestinal conditions was relatively uniform whereas there was considerable variation in dose administered. For postoperative ileus (POI) associated with most intestinal lesions, 2% lidocaine was most commonly selected. Other prokinetics in decreasing frequency of use were erythromycin lactobionate, metoclopramide, and cisapride. Prokinetic agents were more commonly administered after small intestine strangulating obstructions and less commonly for large intestinal lesions. No novel agents were identified by respondents. CONCLUSIONS: Prokinetic drugs are commonly used for the management and/or attenuation of POI in horses, but dosages and routes of administration are variable. CLINICAL RELEVANCE: Although prokinetics are commonly used for management of POI in horses there is clearly a need for more controlled studies to define efficacious dosing and a need to develop new prokinetic drugs.     

The creation of an international audit and database of equine colic surgery: survey of attitudes of surgeons

REASONS FOR PERFORMING STUDY: Currently, there is a lack of available evidence-based data concerning the optimum treatments for horses affected by different types of colic and this precludes the application of clinical audit in this area. In order to accumulate such data, a large-scale, multicentre database of the outcomes of colic surgery is proposed. The attitudes of surgeons is an important consideration in determining the feasibility of developing this database. OBJECTIVES: To assess attitudes and opinions of equine surgeons concerning clinical audit and to assess the perceived advantages and problems of setting up a large-scale international audit/database of colic surgery. METHODS: Interviews were conducted with 30 equine surgeons (large animal/equine surgeons who are diplomates of either the American College of Veterinary Surgeons or the European College of Veterinary Surgeons). Questionnaires were sent by e-mail to 98 equine surgeons. RESULTS: Face to face interviews were conducted (n = 30) and 43/98 completed questionnaires received (44%). The results of the 2 techniques were very similar. There was generally a high level of interest in the development of a large scale database of colic surgery, but perceived problems included time to collect and submit data, and confidentiality issues. A minority of surgeons reported that they were undertaking any form of specific monitoring of the results of colic surgery within their hospitals. CONCLUSIONS: There is a good level of interest among equine surgeons to develop a large scale database of colic surgery and most would be willing to contribute data from their own hospitals provided that data collection is quick and easy, and that confidentiality is maintained.     

Reminiscing

IN 1971 the late, beloved Jacques Jenny proposed an annual address to be known as the Mark W. Allam Lecture. This was to honor Dr. Allam, the Father of the American College of Veterinary Surgeons, for his countless achievements in our profession of Veterinary Medicine.     

The Certifying Examination of the American College of Veterinary Surgeons

The admission requirements and the examining process for applicants for admission to the American College of Veterinary Surgeons are described. Sample questions from the 1976 written examination are included along with the areas of veterinary surgery covered by the examination.     

International Equine Ophthalmology Consortium (IEOC) Symposium

This first IEOC symposium met its goals of gathering a group of leading equine ophthalmology clinicians and researchers to identify the challenges of the field. To facilitate collaboration, notes from round‐table discussions, including the ideas and plans that were discussed are being complied and will be distributed to the attendees. Development of an IEOC membership organisation and website was discussed and supported by the group in an effort further to advance the science of equine ophthalmology. To present results from the collaborations made at this first IEOC meeting, an IEOC mini‐symposium will be held at the American College of Veterinary Ophthalmologists Annual Meeting in Chicago Illinois, on 6th November 2009. The second annual IEOC symposium will be held in Vienna, Austria on 4th and 5th June 2010.     

Tenth Annual ACVS 2000 Symposium

The Tenth Annual ACVS Veterinary Surgical Symposium will be held on September 21–24, 2000, at the Hyatt Regency Crystal City, in Arlington, Virginia. Small animal and equine surgical seminars will be presented and include orthopedic and soft-tissue diseases and techniques. Special sessions will be held on critical care, anesthesia, and dentistry. Laboratories will include arthroscopy, laser surgery, ultrasound, emergency procedures, and dentistry surgery. The symposium will offer a large exhibit hall with equipment, services, pharmaceuticals, and diagnostic tests.
To receive meeting information, e-mail acvs@aol.com ; call 301-913-9550; fax 301-913-2034; visit http://www.acvs.org ; or write ACVS, 4401 East West Highway, Suite 205, Bethesda, MD 20814–4523.     

Small Animal Literature Index

T his literature index is compiled by Miss C. R. Crook of the Library of the Royal College of Veterinary Surgeons (32 Belgrave Square, London, S.W.1. Telephone: BELgravia 6568). The relevant journals are available for loan to Members of the Royal College of Veterinary Surgeons.     

Passage from India: the first European Veterinary Immunology Workshop

The European Veterinary Immunology Group (EVIG) was founded under the auspices of the European Federation of Immunologic Societies (EFIS) in 2001, and held its first meeting in autumn 2003 in Berlin. Here, we summarize the short history of this group, report on the workshop in Berlin and outline some future perspectives up to the next meeting scheduled for 2006 in Paris.     

Anthelmintic resistance of gastrointestinal parasites in small ruminants

Consensus Statements of the American College of Veterinary Internal Medicine (ACVIM) provide veterinarians with guidelines regarding the pathophysiology, diagnosis, or treatment of animal diseases. The foundation of the Consensus Statement is evidence-based medicine, but if such evidence is conflicting or lacking, the panel provides interpretive recommendations on the basis of their collective expertise. The Consensus Statement is intended to be a guide for veterinarians, but it is not a statement of standard of care or a substitute for clinical judgment. Topics of statements and panel members to draft the statements are selected by the Board of Regents with input from the general membership. A draft prepared and input from Diplomates is solicited at the Forum and via the ACVIM Web site and incorporated in a final version. This Consensus Statement was approved by the Board of Regents of the ACVIM before publication.     

Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats

Consensus Statements of the American College of Veterinary Internal Medicine (ACVIM) provide veterinarians with guidelines regarding the pathophysiology, diagnosis, or treatment of animal diseases. The foundation of the Consensus Statement is evidence-based medicine, but if such evidence is conflicting or lacking, the panel provides interpretive recommendations on the basis of their collective expertise. The Consensus Statement is intended to be a guide for veterinarians, but it is not a statement of standard of care or a substitute for clinical judgment. Topics of statements and panel members to draft the statements are selected by the Board of Regents with input from the general membership. A draft prepared and input from Diplomates is solicited at the ACVIM Forum and via the ACVIM Web site and incorporated in a final version. This Consensus Statement was approved by the Board of Regents of the ACVIM before publication.     

BENIGN DUODENAL ULCERATION AND PERFORATION IN A DOG

A Case History presented at the 1978 annual meeting of the American College of Veterinary Radiology. The case history was prepared by Dr. Normun Ackerman and presented by Dr. Charles Root. *     

UNILATERAL TENSION PNEUMOTHORAX IN A DOG

A Case History presented at the I978 annual meeting of the American College of Veterinary Radiology. The case history was prepared by Dr. Norman Ackerman and presented by Dr. Thomas Millman.*