Chapter 75-82 Flashcards
Lopez VS 20
SQ tacking in cats
● 297 cats, 3 treatment groups
o 1. S.c (simple continuous) with tacking (known as quilting), 2. S.c, 3. No SQ closure
o Seroma was less common in s.c with tacking closure group (13%) compared to both s.c (26%) and no closure of SQ (27%)
o There was greater comfort in cats with both s.c closure groups at 1 day PO c.f to no closure group
● Recommendation to close cat subcutis with s.c with tacking for decreased seroma and pain
Travis VS 18
SQ quilting pattern in dogs
● 2 groups: quilting group (SQ apposition with tacking) vs nonquilting group (no tacking)
● incisional seroma was lower in quilting group (OR 0.3) compared to nonquilting group
● pain was lower in quilting group
● incidence of SSI not different between studies
Rodriguez VS 18
Biomechanics
● post-umbilical region was weakest (compared to preumbilical or umbilical), achieved lowest load to failure
● load to failure was greater in ma compared to females
● no difference seen between full-thickness and fascia-only closure
● tissue failure with suture loosening occurred mainly in 5 x 5 mm suture bite group (compared to 2x2 mm)
Mastrocco VS 21
NPWT and debridement
● 3 surgical debridements were required in 2 dogs; 4 surgical debridements were required in 1 dog
● primary closure achieved at 4, 5, and 6 days of NPWT
Cunningham VS 20
lateral extent of SQ bed
● 8 cadavers, 4 different size circle defects (2, 4, 6, 8cm); wound bed covered with barium sulphate ->CT
● Extension >2cm from the incision; 2(0/8), 4(1/8), 6(5/8), 8(6/8)
● Extension >3cm form the incision; 2(0/8), 4(0/8), 6(2/8), 8(5/8)
● In larger defects the lateral extent of the SQ wound bed extends past the previously recommended revision margin of 2-3cm, need to consider this for recuts and radiation planning
Salvaggio VS 20
Phovia
● Phovia is a novel fluorescence biomodulation product containing two parts;
o 1=blue LED lamp, 2=Carbopol-based hydrogel (topical photo converter)
● Phovia improved re-epithelization, decreased dermal inflammation and improved matrix formation compared to control portions (saline) of the same wound
● No adverse reaction to treatment
● Did not influence macroscopic appearance, but improved microscopic features (above)
Angelou JSAP 20
Elbow hygroma
● 4/12 hygromas treated with a drain recurred
● no recurrence was seen in any case treated with primary resection of hygroma
Bates VS 23
Perpendicular or diagonal configurations and low-viscosity fluid maximized fluid dispersion and retrieval.
* Wound instillation therapy involves delivering lavage fluid or medications to a closed wound space. This is feasible using a wound-infusion catheter and active suction drain.
Jack JSAP 19
Healing of lower eyelid defects
● 3 dogs, 2 dehisced tumor excisions (high grade MCT, melanoma) one laceration
● All healed well without reconstruction, so not all lower eyelid injuries/tumor resections require reconstruction (which is the current notion) and can still have good ophthalmologic outcomes (ie no KKS)
Latimer VS 18
HBOT on wounds
● No effects at all. No difference between any of the assessed variables ; contraction, epithelization, subjective wound scores, histopath scores
● Safe (no adverse effects), no evidence to support its use to manage uncomplicated wounds
Nolff VCOT 18
NPWT on wounds
● 26 dogs, prospective, randomized clinical study; patients were matched
● Total time to closure was significantly shorter in NPWT (14.2 days) compared with Silver (28.6 days)
● Wound planimetry (measurements) on days 3, 6 and 9 showed significant greater reduction in total wound area for NPWT at all-time points
● Wounds in NPWT group showed less progression of local infection than did wounds in Silver group
● Negative; need for GA at each foam dressing change due to ingrowth of granulation tissue into foam
Heald VS 20
Electroceutical tx
● utilized direct current dressings to disinfect tissues in chronic wounds in 1 cat and 1 dog
Repellin VS 21
Manuka honey and essential oil hydrogel
● Epithelialization was 10% higher in honey essential oil hydrogel group than control
● wound contraction and histologic score did not differ between groups
● no difference in infection rate among groups (15% infection rate, Staph most common)
Rajeev JAVMA 22
Deep neck infx
- CT was useful to plan for surgery, and surgical treatment resulted in resolution of clinical signs in all dogs with long-term follow-up available.
- Empirical antimicrobial treatment, such as amoxicillin–clavulanic acid or ampicillin- sulbactam, should be considered.
Tinsely JAVMA 23
ATT with cat bite wounds
- In the multivariable model, age, weight, surgical treatment, ATT and MGCS scores were associated with nonsurvival.
o For every 1 year of age, odds of nonsurvival increased by 7% (P = .003) and for every 1 kg of body weight, odds of nonsurvival decreased by 14% (P = .005).
o Odds of dying increased with lower MGCS and higher ATT scores (MGCS: 104% [95% CI, 116% to 267%; P < .001]; ATT: 351% [95% CI, 321% to 632%; P < .001).
o Odds of dying decreased by 84% (P < .001) in cats that underwent surgery versus those that did not. - This multicenter study indicated association of higher ATT and lower MGCS with worse outcome. Older age in- creased the odds of nonsurvival, while each kilogram increase in bodyweight decreased odds of nonsurvival.
Philip JVECC 22
foxtail FB
- The prevalence of foxtail associated disease was 0.25% in dogs and 0.07% in cats over this time period.
o Most animals were young to middle-aged and presented in the summer months. - The most common location in dogs was the aural canal, cutaneous/subcutaneous space, and nasal canal. In cats, ocular fox- tails were most common (30/37).
o Ultrasound supervised by a boarded radiologist was utilized in 114 cases, mainly for subcutaneous, sublumbar, and intracavitary foxtail locations, with successful location of a foxtail in 72.8% of cases scanned.
o Computed tomography was performed in 78 dogs with sus- pected intracavitary foxtail migration, and in all cases, structural changes related to the presence of the foxtail were found. - Anerobic bacteria were most commonly isolated when a culture was submitted, with Actinomyces spp. rarely isolated.
o The most common of the 120 anaerobic isolates were Bacteroides/Prevotella spp. (n = 38), Fusobacterium spp. (n = 32), and Peptostreptococcus anaerobius (n = 30). - The short-term outcome for foxtail-associated lesions is good, and most cases can be managed on an outpatient basis. A minority of cases develop life-threatening disease and may require a multidisciplinary approach of multimodal imaging, endoscopy, or surgery.
Hennessy VRU 22
hyaxial mm abscess
- Hypaxial muscle abscess is an important differential in dogs presenting for abdominal or back pain, lameness, and nonspecific signs like fever, lethargy, and hyporexia. It can occur concurrently with intrathoracic disease such as pyothorax secondary to migrating vegetal foreign material.
- Clinical signs included lethargy, fever, increased respiratory effort, and abdominal or back pain.
- Radiography and/or ultra- sonography were employed during preliminary work up at clinician discretion and respectively revealed changes consistent with osteomyelitis in the cranial lumbar ver- tebrae and heterogenous, hypoechoic areas in the hypaxial musculature consistent with abscesses.
- Computed tomography findings included enlargement of hypaxial mus- cles with well-defined fluid attenuating noncontrast enhancing areas with a contrast- enhancing rim consistent with abscesses, periosteal reaction and lysis of vertebrae, and retroperitoneal effusion.
- Computed tomography provided expedient, thorough visualization of the relevant hypaxial lesions for diagnostic and surgical planning purposes and also characterized intrathoracic components of this disease.
De Lorenzi JSAP 18
self inflating tissue expanders
● Oxtex self-inflating tissue expanders in cases with distal cutaneous limb defects
○ Hydrogel core and external silicone coating. 3 phases of device expansion;
■ 1. Delay phase 3-4d(no expansion), 2. Control phase of linear expansion, 3. Plateau phase (takes 3-4 weeks to reach)
● Uses “biological creep” = generation of new tissue following a chronic stretching force
● Mean 5 expanders per dog, devices removed after a mean of 24 days
● Primary closure achieved in 8/11 cases
○ All closed when used proximal to elbow/stifle
○ 75% of wounds closed distal to elbow/stifle but proximal to carpus/tarsus
○ 33% closed distal to carpus/tarsus (worst location to do this in) (so don’t use in this location….)
● Major tissue necrosis or vascular compromise occurred in 4/11 cases (kind of a lot!)
Miyazaki VS 18
skin stretchers for sing bilateral mastectomy
● Case report, Velcro pads placed, then elastic cables; tightened every 6-8 hrs 2-4 days pre-op
● Both closed without major tension
Massari VS 20
lip to nose flap in cats
● SCC excised with 4-5mm margin of normal tissue, tumors were 2-4mm in size
o Invasive SCC in all cases (6 lateral, one dorsal); Complete excision in all cases
● No major complications, all cats had successful flap healing and cosmetic outcomes (per owners)
o 6/7 cats developed self-limiting muzzle oedema
o 3/7 cats had partial thickness necrosis of the flap, spontaneously healed
o No long term complications of chronic rhinitis, sneezing, nasal stenosis
Chiti VS 18
lip to nose in dogs
One dog with a dorsal nasal planum defect & one cadaver dog
● Modification to the lip-to lid flap for lower eyelid defects, utilizes the subdermal plexus
o Allows direct mucosal apposition to obtain a good functional and cosmetic outcome
● Successful in the one live patient, good cosmetic outcome
Jones JAVMA 19
Sudermal plexus flaps
● Types: advancement (34%), axillary fold (22%), inguinal fold (22%), rotation (17%), transposition (3%), and distant direct (2%)
● Complications noted in 51% of procedures (37% minor, 14% major)
○ Advancement and transposition flaps had the lowest complication rates.
○ Higher complication rate for reconstructing wounds (acute or chronic) compared to tumor excision
○ Most common complication in both dogs and cats was dehiscence of the distal wound edge=30%
○ Mean time to onset of complications was 1 week
● Outcome considered excellent in 48%, good in 36%, fair in 14%, poor in 2%
○ Combined rate of good to excellent outcomes was 84% (so do a SPSF over a more advanced recon sx such as axial pattern flap or free skin graft)
Doyle VCOT 19
superior and inferior labial aa
● Angiograms demonstrated that superior and inferior labial arteries were located within the musculomucosal layer of the labia
● At junction of the rostral and caudal half of upper lip, extensive choke anastamoses joined the angiosome of the infraorbital artery
● Inferior labial artery perfused the caudal half of the lower labium and had extensive choke anastomoses with the rostral and middle mental arteries
● superior labial artery and angularis oris artery supply the caudal half of the superior labia, and the infraorbital artery supplies the rostral half of the superior labia
Berns JFMS 20
single pedicle flap for cat stenotic nares
● 5 brachycephalic cats with ventral nasal obstruction due to stenotic nares
● skin resected followed by single pedicle advancement flap
● good outcome seen in all 5 cases
Bonventura JAVMA 21
skin grafts on distal aspect of limbs; single vs bilateral procedures
● graft outcome deemed successful if viability >75% achieved
● 90% single session procedures were successful
● 82% staged procedures were successful
● graft survival, graft outcome, and complication rate did not differ between groups
● time to complete healing was longer after staged procedures (50 days) vs single-session procedure (30 days)
El Taliawi VS 20
substitiue for PSIS
● allogenic fascia lata is biocompatible and can be considered as an alternative to porcine small intestinal submucosa for augmentation in dogs
