Buried tension sutures: force-tension comparisons of pulley, double butterfly, mattress, and simple interrupted suture patterns

OBJECTIVES: To compare suture patterns (simple interrupted, modified pulley, horizontal mattress, double butterfly) by use of a novel in vitro model that quantifies force required for closure against tension. STUDY DESIGN: In vitro study. SAMPLE POPULATION: Suture constructs. METHODS: An in vitro suturing frame was constructed with extension springs to provide a standard resistance against movement of 2 panels of loops toward each other. Four different suture patterns were applied to the frame in randomized trials. The frame was affixed to a tensiometer that measured the force required for each suture pattern to close a fixed distance (3.81 cm) at a constant rate (5.08 cm/min) against the tension (0.6 kg/cm) of the extension springs. The closure distance and tension were selected subjectively to mimic tension encountered clinically during wound reconstruction oncologic surgical procedures. RESULTS: The modified pulley suture required the least force to close, followed by the double butterfly, simple interrupted, and horizontal mattress patterns. CONCLUSIONS: The modified pulley suture and double butterfly suture patterns require less force to close a given distance under tension than either simple interrupted or horizontal mattress suture patterns. CLINICAL RELEVANCE: Application of tension relieving suture techniques for fascia, subcutaneous, and buried-knot subdermal suturing should be considered to facilitate direct closure of wounds under tension. Modified pulley and double butterfly suture patterns offer some mechanical advantage by requiring less force to achieve closure compared with other suture patterns that might be used in reconstructive surgery.     

Photodynamic therapy against common bacteria causing wound and skin infections

Photodynamic therapy (PDT) uses the combination of a photosensitising (PS) agent and visible light. Historically, various injectable PS agents have been used with medical grade lasers to treat neoplasia. The objective of this in vitro study was to determine whether PDT using topical aminolevulinic acid (ALA) with a non-coherent light source would kill common wound infecting bacteria, namely, Staphylococcus intermedius, Streptococcus canis, Pseudomonas aeruginosa, and Escherichia coli. Bacterial strains were sensitised to light with ALA before exposing to the non-coherent light source. Colony counts were performed in triplicate and compared to controls. When compared with controls there was a significant decrease in bacterial survival following PDT for all organisms except E. coli. A single treatment required 2-3h of light exposure. These data suggest that PDT may be a possible treatment option for wound infections but repeated treatments or alterations in the PS or its carrier will be needed to decrease treatment times.     

Laparoscopic ovariohysterectomy in nine dogs

Minimally invasive surgery has been found in humans to reduce pain, incidence of infections, and duration of hospitalization. Minimally invasive procedures are also being described in veterinary medicine. Laparoscopic ovariohysterectomy (OHE) was performed on nine, healthy, intact female dogs using a Harmonic scalpel. Creatine kinase values were determined both before and 12 hours following the laparoscopic OHE; the magnitude of the difference between preoperative and postoperative creatine kinase values did not correlate with length of operative time, length of incisions, or amount of hemorrhage. Complications included one dog that had an omental herniation that was primarily repaired and one dog with seroma formation. Median surgical time for all dogs was 60 minutes (range, 35 to 100 minutes).     

Acute cortisol responses of calves to four methods of dehorning by amputation

Objective To measure the plasma cortisol response in calves dehorned by four different methods (scoop, guillotine shears, saw, embryotomy wire) for 9 h after dehorning.
Design A physiological study with controls.
Procedure Horn amputation was carried out on calves restrained manually in a race.
Results The four methods of dehorning provoked similarly increased cortisol responses which lasted for 6 h. During the first hour after dehorning the plasma cortisol concentrations were similar to those following ACTH injection. The overall cortisol response to control handling was about 30% of the responses to dehorning.
Conclusions The similarity of the cortisol responses produced by the four methods of dehorning suggests that the distress experienced by calves following dehorning by amputation is similar regardless of method used.     

Proteomic analysis of rainbow trout (Oncorhynchus mykiss, Walbaum) serum after administration of probiotics in diets

The response of rainbow trout (Oncorhynchus mykiss, Walbaum) towards probiotics present in the feed was investigated by examining the proteome of serum as a measure of the acute phase response (APR). Proteomic analysis by two-dimensional electrophoresis (2D) concurrently with mass spectrometry was used to detect APR related proteins in rainbow trout serum following feeding with probiotics Aeromonas sobria GC2 and Bacillus sp. JB-1. Three candidate proteins increased following use of GC2, and were putatively identified as NADH dehydrogenase, dystrophin and mKIAA0350. Conversely, one of the proteins, which were induced following use of JB-1 was identified as transferrin.     

Microvascular Free Tissue Transfer of the Rectus Abdominis Muscle in Dogs

OBJECTIVE: To assess donor-site morbidity and survival of the rectus abdominis muscle with an overlying skin graft after free tissue transfer to a medial femorotibial defect in dogs. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Phase 1: 6 canine cadavers; phase 2: 7 adult mixed-breed dogs. METHODS: Phase 1: The rectus abdominis muscle was removed from canine cadavers, muscular and vascular dimensions were recorded, and angiography was performed. Phase 2: Muscular transfer was performed through anastomosis of the caudal epigastric artery and vein to the saphenous artery and medial saphenous vein. Transferred tissues were evaluated on postoperative days 3, 6, 10, and 13. Animals were examined daily until euthanasia between postoperative days 31 and 42. Postmortem angiograms were performed and tissues collected for histopathologic evaluation. RESULTS: Phase 1: Appropriate vascular dimensions for microvascular anastomosis were confirmed and surgical technique perfected. Phase 2: Muscular excision produced minimal donor-site morbidity. All muscles survived after microvascular transfer and angiography confirmed vascular patency. All of the skin grafts survived, with one graft undergoing partial necrosis. CONCLUSIONS: The rectus abdominis muscle can be successfully transferred to a medial femorotibial defect and can serve as a bed for acute skin grafting. No significant donor-site morbidity is associated with its removal. CLINICAL RELEVANCE: Microvascular free tissue transfer of the canine rectus abdominis muscle has not been previously described. This technique provides a new alternative for repair of appropriate wounds. Additional studies are needed to define its utility in clinical patients.