Vet Surg 2023 Flashcards
ACVS Phase 2
Biehl et al.
Vet Surgery 2023
“closed glove exchange and contamination”
At the completion of surgery, gloves were removed and hands were swabbed. The inside of the gown cuff was swabbed. Each participant regloved, using a closed gloving technique. The new gloves were removed, and hands were swabbed for culture a second time. Swabs underwent standard bacterial culture.
-Before glove exchange, or baseline, contamination was found on 17/200 dominant hands and 13/200 nondominant hands.
-After performing CGE, contamination was found on 14/200 and 15/200 dominant and non-dominant hands, respectively.
-No difference was detected between the number of CFUs cultured from a surgeon’s hands before CGE and the number of CFUs cultured from a surgeon’s hands post-CGE (one sided sign test, p = .61).
-Twelve (12) different bacterial species were identified, the most common were Staphylococcus spp. (97/154; 63%).
McCormack et al.
Vet Surg 2023
“equine fentanyl concentration in equine plasma and synovial fluid, transdermal”
Each horse had two 100 μg/h fentanyl matrix patches applied on the dorsal aspect of one, randomly assigned, carpometacarpal joint (CMCJ) for 48 h.
-All subjects achieved detectable concentrations of fentanyl in both plasma and synovial fluid. Time to peak synovial and plasma concen- tration was 12 h.
-At 6 h, the synovial concentration in the untreated carpus (0.104ng/mL±0.106) was lower than plasma fentanyl concentrations 0.31 ± 0.27 (p = .036).
-At 12 h, both treated (0.55 ng/mL ± 0.3) and untreated (0.53 ng/mL ± 0.28) synovial fluid fentanyl concentrations were lower than plasma (0.87 ng/mL ± 0.48) concentrations (p < .001 and p = .001, respectively).
-Synovial concentrations of fentanyl did not differ between treated and untreated joints (p > 0.608 for all time points).
Kilcoyne, et al. Vet Surg 2023
“10% DMSO, amikacin concentration, joint”
-To determine the effect of a 10% dimethyl sulfoxide (DMSO) solution on the peak concentration (CMAX) of amikacin in the radiocarpal joint (RCJ) during intravenous regional limb perfusion (IVRLP) compared with 0.9% NaCl.
-The mean ± SD CMAX in the DMSO group was 1361.8 ± 593 μg/mL and in the 0.9% NaCl group it was 860 ± 481.6 μg/mL (p = .058).
-Mean TMAX using the 10% DMSO solution was 23 and 18 min using the 0.9% NaCl perfusate (p = .161).
-No adverse effects were associated with use of the 10% DMSO solution.
Although there were higher mean peak synovial concentrations using the 10% DMSO solution no difference in synovial amikacin CMAX between perfusate type was detected (p = .058).
Bolz et al Vet Surg 2023
“CT, medial femoral tibial, caudal cruciate”
Four Warmblood horses with hindlimb lameness and osseous fragments located in the caudal medial femorotibial joint (mFTJ).
-CT examination confirmed the diagnosis and allowed evaluation of the stifle joint for comorbidities.
-A cranial intercondylar arthroscopic approach facilitated the removal of CdCL insertional avulsion fragments, although not always complete.
-A cranial intercondylar approach was used in three horses, allowing removal of the intra-articular fragment in two horses, and removal of two- thirds of the proximal fragment in the last horse. Acute, profuse, arterial bleed- ing occurred in this horse during surgery with transient postoperative soft tissue swelling.
Bellitto et al.
Vet Surgery 2023
“incisional bursting strength knotless suture”
To evaluate the use of bidirectional knotless barbed suture material for closure of the equine linea alba.
-The incisional bursting pressure was comparable between the two groups (p > .05). Less suture material (p < .01) was required with the barbed suture than the standard suture.
-Closure time was less for the barbed suture than the standard suture (p < .01).
-Suture failure was the main failure mode in both groups (83% cases).
-occurring in close proximity to all the knots for the standard suture group and at various locations along the suture for the barbed suture group (Table 2).
-Suture failure of the barbed suture resulted only in a partial breakage of the incision with most of the residual portion of the suture line remaining unaltered (both edges closed) in all cases; suture failure of the standard suture resulted in a complete breakdown of the suture line in all cases.
-The remaining two cases of the barbed suture group failed laterally from the linea alba (remote failure; 17%)
Vermedal et al
Vet Surg 2023
“bovine calcaneal bursa”
Intrasynovial injection of iodinated contrast and methylene blue into the intertendinous calcaneal bursa (ICB) (n = 16) or gastrocnemius calcaneal bursa (GCB) (n = 2).
-The anatomy of the congenital calcaneal bursae was consistent between CT imaging, endoscopic examination and gross dissection.
-The ICB and GCB were two separate synovial structures with no communication in all limbs.
-The distal and proximal extent of the ICB, defined as the distance from the point of tuber calcanei to the distal/proximal aspect of the ICB, was (median [IQR]) 7.4 (7.4 to 7.8) cm distally and 5.4 (4.7 to 6.0) cm proximally.
Gandini et al. Vet surgery 2023
“jejunocecal anastomosis radiofrequency anastomosis”
The construction time and bursting pressure of RFA (radio frequency) were compared with those of a hand-sewn double layer (Group HS) and stapled anastomoses (Group ST) without oversew of the staple line. Histology was also performed for the TF anastomoses to evaluate the extent of the thermal damage.
-The median (range) construction time (min) for the TF (15.8 [14.4-16.8]) was not significantly different from that for the HS (25.5 [24.2-26.3]) and ST (10.8 [9.7-12.5]) groups (p = .07).
-The construction time for ST was shorter than that for HS group (p < .001).
-The average (standard deviation) bursting pressure (mmHg) for HS (153.1 +/ 17.5) was higher than that for RFA (76 +/ 15) and ST groups (48 +/ 13; p < .001).
-The bursting pressure of the RFA was higher than that of the ST anastomoses (p = .001).
-The thermal damage caused by the device was within the suture oversew in the deeper layers, whereas it extended a few mm beyond the suture line in the serosa.
Boorman et al.
Vet Surg 2023
“Single incisional drilling, hemiepiphysiodesis”
The average age at the time of surgery was 97 days.
-Three horses developed calcinosis circumscripta lesions adjacent to the phy- sis, which were removed successfully.
-No radiographic abnormalities associated with the surgery site were detected on yearling prepurchase radiographs.
-There were no differences in sales and racing performance data between treated horses and maternal controls.
-Postoperative complications were reported in 3 horses (1 female and 2 male). These horses all had a vertical skin incision. These horses developed hard, nonpainful swellings at 1 of the surgery sites around 3 months post- operative. Radiographs revealed the presence of amorphous, cystic and multilobular calcification located lateral to the physis, consistent with calcinosis circumscripta
Wanstrath et al
Vet Surgery 2023
“surgical enlargement, epiploic foramen”
Through a ventral midline celiotomy under general anesthesia, the EF was enlarged by digital separation of the caudal attachments of the caudate lobe of the liver from right dorsal colon, right kidney, gastropancreatic fold, and pancreas. Healthy horses were euthanized under anesthesia, and the enlarged EF was measured at necropsy.
Clinical cases:
-All three horses had a left to right EFE involving distal jejunum, with or without ileum, and manual traction was attempted in all for many minutes but failed.
-Following digital enlargement of the EF in small increments, a minimum size was achieved that allowed correction in all clinical cases.
-No intraoperative hemorrhage or other complications were encountered, and all horses recovered from general anesthesia.
-partial spontaneous closure of the EF at the caudal edge (arrow) at 30 days after surgery but leaving an opening sufficient to accommodate a finger
Lean et al
Vet Surgery 2023
“tie forward, standing”
Standing LTF was performed and evaluated in five experimental horses and five clinical cases diagnosed with iDDSP. Standing LTF was per- formed under endoscopic guidance with horses sedated and the surgical site desensitized with local anesthetic solution.
-Radio-graphic assessment demonstrated that compared to preoperatively, the basihyoid bone and thyrohyoid-thyroid articulation were positioned dorsally (9.6 mm, p = .006 and 20.4 mm, p = .007, respectively) at 2 days postopera- tively.
-During repeat dynamic URT endoscopy at 48 hours postoperatively, 3/5 horses showed resolution of iDDSP and 2/5 marked improvement. One horse experienced brief iDDSP associated with neck flexion which corrected after swallowing. The second achieved a greater speed and total distance prior to iDDSP.
Byrne et al
Vet Surg 2023
“survey laryngoplasty”
-Most participants used 2 prostheses (106/128, 82.8%) and a single loop was the most common method used to anchor the prosthesis in the cricoid (95/128, 74.2%) and arytenoid (125/128, 97.7%) cartilages.
-Use of general anesthesia was common, although 46/128 (35.9%) participants now performed most laryngoplasty surgery with standing sedation.
-The material used as a prosthesis varied among surgeons, although participants typically aimed to achieve grade 2 intraoperative arytenoid abduction. Participants most commonly administered perioperative systemic antimicrobial therapy for 1-3 days (57/128, 44.5%) and 48/128 (37.5%) used local antimicrobial therapy.
Watkins et al
Vet Surg 2023
“cyanoacrylate, knot elongation”
-Total elongation of polyester (6.2–7.8 mm) was greater than multifila- ment UHMWPE (3.4–6.4 mm) and UHMWPE tape (2–3.7 mm) for all conditions.
-Polyester had the lowest knot elongation (1.6 mm) and the addition of cyanoacrylate decreased knot elongation for polyester by 1 mm.
Cherner et al
Vet Surgery 2023
“modified Lembert, small intestines”
-The mod-CL pattern was fastest (8.44 ± 1.30 min, p < .05), and the 2 L pattern was slower (17.07 ± 2.0 min) than the mod-CL and mod-IL (p < .05).
-The anastomotic index exceeded 100 and did not differ between patterns.
-Segments reached higher bursting pressures when anastomosed with mod-IL (145.94 ± 24.18 mm Hg) than mod-CL (p < .05).
-In vivo closure was approximately 8 minutes slower than ex vivo, and with a smaller anastomotic index.
-Anastomoses with a mod-IL pattern appear clinically advantageous, producing a comparable lumen size in less time than 2 L (seromuscular and mucosal)
