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Made available in DSpace on 2022-04-28T19:41:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Objective: To evaluate outcomes associated with the use of an angularis oris axial pattern flap (AOAPF) for rostral facial reconstruction in cats. Animals: Nine adult client-owned cats. Study Design: Short case series. Methods: Ten AOAPF were performed in nine cats after resection of a tumor. Wounds were located at the nose, infraorbital, supraorbital, frontal, eye, and ear canal region. Orbital exenteration (n = 3), pinnectomy (n = 2), nasal planum resection, total ear canal ablation (n = 2), and partial eyelid reconstruction (n = 3) were performed. Results: Short-term postoperative complications included flap edema (n = 10), suture dehiscence (n = 3), and distal tip necrosis (n = 3). All wounds resulting from minor complications healed by second intention in 5–15 days. Long-term complications included epiphora (n = 2), frequent grooming around the eyes (n = 2), and enucleation due to corneal ulcer secondary to impaired postoperative eyelid function (n = 1). Tumor recurrence occurred in 3 cases. Conclusion: The AOAPF was a versatile and reliable option for rostral facial reconstruction in cats with acceptable long-term outcomes. School of Veterinary Medicine and Animal Science São Paulo State University Department of Clinical Studies Ontario Veterinary College University of Guelph School of Veterinary Medicine and Animal Science São Paulo State University

Objective To describe the treatment of persistent right aortic arch (PRAA) in dogs with combined ligamentum arteriosum (LA) transection and esophageal diverticulum resection. Animals Three client owned dogs. Study design Short case series. Methods Medical records were reviewed for clinical signs, diagnostic procedures, surgical treatment, post-operative therapies including medications and feeding regime, outcomes, and follow-up imaging. Results Esophageal resection was performed using a thoracoabdominal (TA) stapler with suture overlay. All dogs recovered well from surgery and did not experience any peri- or post-operative complications. The last follow-up was performed between 64 and 1004 days post-operatively. In all cases, regurgitation resolved and did not recur in any dogs. No dogs required medical therapy or dietary modifications. In two cases, follow-up imaging was performed that revealed marked improvement of esophageal dilation. Conclusion Resection of esophageal diverticulum secondary to PRAA utilizing a TA stapler with suture overlay was technically feasible and did not seem associated with early or late complications.

OBJECTIVE: To compare the duration of closure and biomechanical properties of staphylectomies closed with absorbable bidirectional barbed suture or smooth monofilament suture in a simple continuous or interrupted pattern STUDY DESIGN: Ex vivo study SAMPLE POPULATION: Soft palates (n = 60) harvested from mesaticephalic canine cadavers METHODS: One centimeter of tissue was excised from the caudal border of each soft palate, and the oral and nasopharyngeal mucosal surfaces were apposed with 2‐0 bidirectional Quill Monoderm knotless closure device barbed suture (Q), 3‐0 Monocryl in a simple continuous (MC) pattern, or 3‐0 Monocryl in a simple interrupted (MI) pattern (n = 20 per group). Duration of closure was compared between groups. Tissues were tested under tension to failure, and mode of failure data were collected by video capture. RESULTS: Closure time was longer for MI closures than for Q and MC closures, with means of 259.9, 215.4, and 196.7 seconds, respectively (P

OBJECTIVE To determine the effect of partial vs complete circumferential epitendinous suture (ES) placement in addition to a core suture on the biomechanical strength and gapping characteristics of repaired canine tendinous constructs. STUDY DESIGN Ex vivo, biomechanical study. SAMPLE POPULATION Thirty-six canine superficial digital flexor tendons. METHODS Superficial digital flexor tendons were randomly assigned to three groups (n = 12), sharply transected and repaired with a core locking-loop suture with Group 1 a partial circumferential ES, 180° on the palmar side; Group 2 a complete circumferential ES, 360° and double knotting technique; or Group 3 a complete circumferential ES, 360° and single knotting technique. After preloading, constructs were distracted to monotonic failure. Failure mode, gap formation, yield, peak, and failure forces were analyzed. RESULTS Mean yield (group 1 = 68.6 N, group 2 = 106.5 N, group 3 = 114 N, P

Objective To compare leak pressures and construct completion time of six intestinal anastomoses and report normal canine gastrointestinal thickness. Study design Experimental study. Animals Grossly normal jejunal segments (n = 140) from 10 fresh canine cadavers. Methods Gastrointestinal thickness was recorded. Eight-centimeter cooled canine cadaveric jejunal segments were randomly assigned to a control group (20 segments) and six treatment groups (20 segments/group [10 constructs/group]): (1) handsewn anastomosis (HSA), (2) functional end-to-end stapled anastomosis (FEESA)-blue thoracoabdominal (TA; FEESA-TAB), (3) FEESA-green TA (FEESA-TAG), (4) FEESA TA-gastrointestinal anastomosis (GIA), (5) FEESA with suture oversew (FEESA-O), and (6) skin staples (SS). Construct assembly time, initial leak pressure (ILP), maximum intraluminal pressure (MIP), and leakage location were compared. Results Initial leak pressures (mean ± SD) for control (308.38 ± 115.91 mm Hg), HSA (41.96 ± 15.97), FEESA-TAB (31.71 ± 15.71), FEESA-TAG (27.24 ± 14.11), FEESA-GIA (25.62 ± 11.22), FEESA-O (31.01 ± 17.38), and SS (44.42 ± 28.88) groups were compared. No difference in ILP (P > .24) or MIP (P > .17) was detected between treatment groups. Sutured anastomoses took up to 10 times longer to complete (P = .0025). The stomach, duodenum, jejunum, and ileum mural thicknesses (mean ± SD) were 3.99 ± 0.44 mm, 2.34 ± 0.16, 2.49 ± 0.28, and 2.30 ± 0.31, respectively. Conclusion The ILP of all anastomoses exceeded maximum intraluminal peristaltic pressures. Stapled anastomoses were faster to complete. Clinical significance All anastomoses may be considered when performing an intestinal resection and anastomosis, with stapled anastomoses resulting in a shorter surgical time. Canine intestinal thickness may warrant use of a larger staple size.

Objective To compare tensile properties of synthetic, absorbable, monofilament suture material before and after incubation in phosphate-buffered saline (PBS). Study design Two sizes (2-0 and 3-0) of Biosyn, Maxon, Monocryl, PDS II, Securocryl, and Securodox were tested. Sample population Ten suture loops per group. Methods Tensile strength, elongation, and modulus of suture loops were measured at baseline and after 7, 14, 21, or 28 days of incubation in PBS. Results Size, suture material, and size × suture material interaction influenced maximum breaking load, maximum elongation, and modulus of elasticity. At baseline, 2-0 and 3-0 Maxon had the highest breaking loads (111.67 N and 79.71 N, respectively) for their size, and 2-0 PDSII and 3-0 Securodox had the lowest (68.71 N and 48.73 N, respectively). Maxon 2-0 and 3-0 had the greatest elongations (9.68 mm and 8.45 mm, respectively) for their size, and 2-0 Biosyn and 3-0 Securocryl had the least (7.21 mm and 6.58 mm, respectively). Biosyn 2-0 and 3-0 had the highest modulus. With incubation, Maxon (2-0), PDS II (2-0, 3-0), and Securodox (2-0, 3-0) maintained or gained strength over 4 weeks. Strengths of 2-0 and 3-0 Biosyn and 3-0 Maxon were maintained for 2 weeks, while Monocryl and Securocryl lost 20% to 44% of baseline strength within 1 week and 60% to 72% within 2 weeks. Day 7 strengths of 2-0 Biosyn and 2-0 Monocryl were greater than baseline strength of 2-0 PDS II. Strength of 3-0 Biosyn at day 14 was greater than strength of Monocryl at days 7 and 14 and greater than strength of 3-0 PDS II, 3-0 Securodox, and 3-0 Securocryl at baseline and days 7 and 14. Conclusion Suture tensile properties varied with suture size, composition, and brand. At baseline, Maxon suture had the greatest strength and elongation, and Biosyn had the greatest stiffness. Clinical significance Tensile strength retention, when reported as a percentage of original strength, provides insufficient information for comparison of suture tensile properties.

OBJECTIVE To describe the surgical method, operative time, safety, and usefulness of 3-port laparoscopic ovariohysterectomy (LOHE) using an ultrasonic coagulation and incision device in dogs

Intestinal wounds require precise closure after intestinal biopsy, enterotomy, or enterectomy in small animals. Preexisting factors such as intra-abdominal sepsis and hypoalbuminemia as well as poor surgical technique increase the risk of intestinal dehiscence, with considerable negative impact on patient morbidity and mortality. Live dog studies have demonstrated the dangers of mucosal eversion especially in the septic abdomen. Approximating patterns preserve luminal diameter, heal optimally, and have equal bursting strength compared with inverting patterns after 24 hours. Simple interrupted and simple continuous suture patterns and disposable skin staples are established alternatives for manual wound closure. Knotless quilled suture currently used in laparoscopic gastropexy techniques shows bursting strength equal to monofilament sutures in dog cadaveric intestine. Dehiscence rates with hand sewn vs titanium automated stapling anastomosis are similar in uncomplicated cases; however, auto stapling devices may be the preferred method of anastomosis when preexisting abdominal sepsis is present and when patient size allows it. Regardless of the technique, current standard of care involves leak testing and omental wrapping, followed by early postoperative feeding. The past decade has ushered in an exciting new era of laparoscopic assisted techniques that have the potential to reduce postoperative pain and patient morbidity. An understanding of these applications will establish the future of minimally invasive small animal intestinal surgery for veterinary specialists. In summary, surgeons have a variety of methods at their disposal for optimal clinical outcome in small animal intestinal surgery.

Objective To determine the effect of the length of incision and of the number of suture lines on the load to failure of incisional gastropexy in an ex vivo model. Study design Ex vivo study. Sample population Thirty-six hound-mix fresh canine cadavers. Methods Specimens were randomly divided into four groups of incisional gastropexies varying in length of incision (2 or 4 cm) and number of suture lines (one or two). Load to failure was measured. Number of suture bites on each side of the gastropexy and number of inadvertent full thickness gastric suture bites were recorded. Results Incisional gastropexies performed with one or two suture lines sustained loads to failure of 53.80 ± 12.10 N and 53.30 ± 10.60 N (P = .887), respectively. Loads to failure equal to 49.70 ± 10.80 N and 57.30 ± 10.60 N (P = .048) were measured on incisional gastropexies performed with 2- or 4-cm-suture lines, respectively. There was no interaction between the length of the incision and the number of suture lines (P = .634). Conclusion Length of incision but not number of suture lines influenced the biomechanical properties of gastropexies in this acute cadaveric model. Clinical significance According to this acute in vitro experiment, gastropexy can be performed with either one or two suture lines.

Objective To report outcomes of dogs with common calcanean tendon (CCT) ruptures treated with a platelet-rich plasma (PRP) enhanced nonabsorbable loop-suture technique. Study design Retrospective case series. Animals Client-owned dogs (n = 12). Methods Medical records (2015-2017) of dogs with CCT ruptures repaired with a loop-suture tenorrhaphy and autogenous leukoreduced PRP were reviewed for signalment, history, type of injury, treatment, and clinical follow-up. Outcomes were assessed by functional anatomic measurements and Canine Orthopedic Index (COI) scores transformed to percentages, with 100% representing no problems. Results Twelve tendons were treated. Two dogs had major complications that were successfully revised. Follow-up was available in 11 of 12 dogs, with a median time of 12 months (range, 4-36), including COI for 11 dogs and anatomic measurements for 6 dogs. Anatomic measurements did not differ between treated and normal contralateral limbs (midthigh muscle mass P > .99, cranial tibial muscle mass P = .37, CCT diameter P = .08, tibiotarsal joint angle P > .99). Owners scored function (COI) as 96.4% (range, 93.3%-97.8%) and quality of life as 94.6% (range, 92%-98.2%). Conclusion Loop-suture tenorrhaphy with application of autogenous leukoreduced PRP at the repair site resulted in restoration of functional anatomic measurements, high COI, and client satisfaction. Clinical significance Loop-suture tenorrhaphy with local application of autogenous leukoreduced PRP appears to offer an acceptable option to treat CCT injuries in dogs.

OBJECTIVE To determine the influence of suture patterns on resistance to gap formation after tendon plating STUDY DESIGN: Ex vivo study SAMPLE POPULATION: Suspensory ligament and superficial and deep digital flexor tendons harvested from 16 neonatal cadaver foal limbs. METHODS Each tendon/ligament from a given limb was randomly assigned to one of three treatment groups consisting of a 7-hole veterinary cuttable plate fixed with alternating simple interrupted, figure-8, or hybrid suture patterns. The constructs were distracted at a rate of 1.0 mm/s to failure, as determined by the formation of a 1 mm gap for initial failure and a 3 mm gap for ultimate failure. The mode of failure was also recorded. RESULTS Constructs prepared with hybrid and figure-8 patterns sustained over 2× higher (p

OBJECTIVE To compare conventional and intracorporeal vesicourethral anastomosis (VUA) in canine cadaveric tissue. STUDY DESIGN Cadaveric ex vivo study. STUDY POPULATION Twenty-eight canine bladders with urethra. METHODS Specimens after prostatectomy were randomly divided into intracorporeal (I) group or conventional (C) group. For the I group, VUA was performed in a simulator with laparoscopic needle holders and telescope. For the C group, the anastomosis was performed in vitro with standard instruments. The VUA was performed with 4-0 monofilament absorbable suture and was completed with two simple continuous sutures. Surgical time, leakage pressure, site of leakage, and number of suture bites were recorded. RESULTS Fourteen samples were entered in each group. The dorsal side of the anastomosis was initially performed, followed by the ventral side. The median suturing time was 30.8 minutes (range, 19.3-39.2) for the I group and 17.3 minutes (range, 9.2-21.3) for the C group (P

OBJECTIVE To evaluate a prototype dynamic laryngoplasty system (DLPS) in a static airflow model. STUDY DESIGN Experimental. SAMPLE POPULATION Ten equine larynges. METHODS The right arytenoid was fixed in abduction in all specimens. A left-sided laryngoplasty was performed with No. 2 Fiberwire and a FASTakII anchor. Each larynx was tested in a static airflow model. The system was adjusted to a flow rate of 55 L/s and prelaryngeal pressure of 12 mm Hg prior to testing in maximal arytenoid abduction. In phase 1, the left suture was loosened, shortened, and tested in 3-mm steps from 0 to 30 mm. In phase 2, the suture was tied with the DLPS in position at a target left-to-right quotient angle (LRQ) of 0.5. The DLPS was activated to target psi of 0, 25, and 50 for testing. Translaryngeal impedance (TLI), LRQ, cross-sectional areas (CSA), and resultant change in LRQ and CSA between, before, and during airflow testing were calculated. RESULTS In phase 1, TLI was reduced by suture shortening up to 6 mm (P = .001) but not by additional shortening (P > .05). In phase 2, activation of the DLPS reduced the TLI from 0 psi (0.43 ± 0.08 mm Hg/L/s) to 25 psi (0.16 ± 0.04 mm Hg/L/s, P

OBJECTIVE To compare the use of stainless steel staples with absorbable staples for closure of skin incisions in dogs undergoing tibial plateau leveling osteotomy (TPLO). STUDY DESIGN Prospective study. SAMPLE POPULATION Client-owned dogs (n = 80). METHODS With client consent, dogs were randomly assigned a staple type (stainless steel or absorbable) immediately prior to closure of a TPLO skin incision. Incisions were compared for length, staple type and number, and an inflammation-infection score 2 weeks after surgery. RESULTS Overall, 18.8% of incisions were diagnosed with inflammation or infection. No difference was found between inflammation-infection scores, incision length, number of staples used, or general anesthetic time between the 2 staple groups. However, wound closure was faster with stainless steel staples (22.50 seconds; range, 11-180) by approximately 30 seconds compared with absorbable staples (56.50 seconds; range, 18-190; P

Objective: To compare cutaneous wound closure with mesh and 2-octyl cyanoacrylate (MOC) vs an intradermal suture pattern (ISP) in terms of time of application and biomechanical properties. Sample population: Experimental study with 12 female beagle dogs. Methods: A skin incision was created from the xiphoid to the pubis as part of an ovariohysterectomy; the linea alba and subcutaneous tissue were closed routinely. Half of the skin incision was closed with MOC, and the other half was closed with an ISP. Tissue samples were collected from both sections at days 14 and 28 and tested for ultimate strength and stiffness. Results: Closure with MOC (72.8 +/- 14.0 s) was faster than with an ISP (398.4 +/- 36.4 s; P = .001). The ultimate load and stiffness increased with time for MOC (P = .005 and P = .005, respectively) and ISP (P < .001 and P < .001, respectively). On day 14, ultimate load and stiffness were greater in wounds closed with MOC compared with ISP (P = .014 and P = .02, respectively). No difference between groups was detected at day 28. Conclusion: Cutaneous wound closure with MOC was faster and resulted in superior strength at 14 days compared with closure with an ISP in this healthy population. Clinical significance: Mesh and 2-octyl cyanoacrylate offers an attractive alternative to ISP for skin closure after celiotomy in dogs, especially if surgical/anesthesia time is a concern.

Objective To compare biomechanical properties and mechanism of failure of 3 regions of ventral abdominal wall in cats by using 2 suture materials, 2 suture bite‐to‐stitch intervals (SBSI), and full‐thickness versus fascia‐only closure. Study Design Randomized, cadaveric, ex vivo mechanical testing. Sample Population 16 adult cat cadavers, 3 samples per cat. Methods Three regions of ventral abdominal wall were mechanically tested (N = 48 samples). Preumbilical, umbilical (U), and postumbilical (POU) regions were harvested by using a template. The thickness of the linea alba was recorded. Six samples without celiotomy served as controls. Twenty‐eight samples were randomized to SBSI (2 × 2 or 5 × 5 mm) and suture material (3‐0 polyglactin 910 or 3‐0 polydioxanone) for simple continuous celiotomy closure. Fourteen samples were randomized to full‐thickness or fascia‐only closure. Samples were tested by linear distraction; tensile strength and mechanism of failure were recorded. Effects of body weight, thickness of linea alba, anatomic region, SBSI, type of closure, and suture material were evaluated by mixed model linear analysis. Load to failure was compared between males and females, full‐thickness and fascia‐only closure by independent t test, with P

Objective To compare laparoscopic single-layer versus double-layer closure of experimental, full-thickness incisions in adult equine urinary bladders using unidirectional and bidirectional barbed suture. Study design Experimental, ex vivo, surgical study. Sample population Thirty adult equine cadaver urinary bladders. Methods Bladders were randomly divided into 5 groups (n = 6): intact controls, bladders sutured with unidirectional or bidirectional barbed suture in a single-layer closure, and bladders sutured with unidirectional or bidirectional barbed suture in a double-layer closure. A 5-cm apical incision was created in each bladder assigned to a suture group, prior to closure in a laparoscopic trainer. After suturing, bursting pressures (BPs) were determined by filling the bladders with saline to failure. Continuous variables were compared among groups using generalized linear modeling with post hoc testing between groups, and categorical variables were compared using Fisher's exact test. Significance was set at P

Objective To compare two suturing techniques for prophylactic laparoscopic gastropexy in healthy dogs. Study design Retrospective case series. Animals Thirty healthy client-owned dogs from breeds predisposed to gastric dilation volvulus. Methods Medical records of dogs presented for prophylactic laparoscopic gastropexy performed with knotless unidirectional barbed suture were reviewed. Dogs were grouped based on the device used for suturing, consisting of an endoscopic needle driver (END) vs an endoscopic suturing device (ESD). Signalment, weight, surgery time, number of suture bites per side of gastropexy, and intraoperative complications were compared between groups. Results The END group consisted of 10 dogs, with a median age of 1.09 years (range 0.5-2.67), weight of 41.5 kg (range 25-66), surgical time of 49.5 minutes (range 35-77), and a median of 5 suture bites per side (range 4-6). The ESD group included 20 dogs, with a median age of 1.75 years (range 0.6-8.75, P = .0944), weight was 37.5 kg (range 20-62, P = .5823), surgical time of 55 minutes (range 30-76, P = .808), and a median of 6 suture bites for the first side (range 4-7, P = .072) and 7 for the second side (range 4-8, P = .003). No major complications and no conversion to open celiotomy occured in either group. Minor complications occurred in 3 dogs in the ESD group, all related to device dysfunction and suture breakage. Conclusion Laparoscopic gastropexy may be performed effectively with either of these suturing techniques.

Objective To determine the biomechanical properties of 5 suture constructs in the equine cricoid under cyclic loading and load to failure testing. Study design Ex vivo study. Samples Seventy-five equine cadaver larynges. Methods Each larynx was implanted with 1 of 5 cricoid-suture constructs. The standard laryngoplasty, where a suture is passed once through the cricoid, including its caudal edge, was used in 2 constructs: 1 with 5 USP Ethibond (ES) and 1 with 2 mm Fibertape (FS). In the third construct, the 2 mm Fibertape was passed twice through the cricoid including its caudal edge (Double Loop—DL). Constructs 4 and 5 used 2 mm Fibertape in a U-shaped loop passed through the cricoid but excluding its caudal edge. One construct was supported with a metallic button (MB) on the caudo-ventral aspect of the cricoid while the other included only the U-shaped loop (U). Constructs were subjected to cyclic loading and to single cycle to failure. Reduction of the left-to-right arytenoid angle quotient (LRQ), suture migration, and load at failure were compared. Results LRQ reduction after cyclic loading was lower in MB and U than ES constructs. During cyclic loading, suture migration was reduced in MB, U, and DL compared to ES constructs. Mean load at failure was lower in FS and U than in ES constructs. Conclusion Loss of abduction after equine laryngoplasty may be reduced and pullout forces increased by applying a MB construct in the cricoid cartilage. In vivo testing is required to verify these results.

Objective To determine the degree and ease of arytenoid abduction achieved with abaxial placement of a FASTak II suture anchor compared to 2 suture patterns with different directions of insertion—caudomedial to craniolateral and medial to lateral. Study design Ex vivo experimental. Study population Cadaveric larynges from 10 Standardbred racehorses. Methods Each larynx was sequentially instrumented with all 3 arytenoid suture attachment in random order: (1) abaxial placement of a FASTak II suture, (2) caudomedial to craniolateral suture, and (3) medial to lateral suture placement. Each construct was abducted at 5N increments from 0 to 25N and the left to right quotient angle ratio (LRQ) measured from digital pictures acquired at each sequential increment. Results Arytenoid abduction (higher LRQ) was greater with FASTak II construct than either of the suture patterns. The largest difference occurred at 5N. Approximately 50% less force was required to achieve an LRQ of 1.0 with the FASTak II anchor compared to the suture patterns. No difference was detected between the 2 suture constructs throughout the study. Conclusion Use of the FASTak II suture anchor improved arytenoid abduction compared to 2 suture patterns and minimized the suture loads required to achieve maximum arytenoid abduction. Clinical relevance Use of the FASTak II anchor may decrease the suture load required to achieve arytenoid abduction in clinical cases. This may reduce the load placed on the laryngoplasty, thereby, minimizing postoperative loss of abduction.

Objective To investigate the effect of hemicerclage suture on the occurrence of fractures during advancement of an elongated bi-directional hinged osteotomy (EBHO) for tibial tuberosity advancement (TTA) in dogs. Study design Experimental ex vivo study. Animals Canine cadavers (n = 14) Methods A uniform EBHO was performed in 28 cadaveric hind limbs (n = 28) from 14 skeletally mature, medium-sized, mixed breed dogs. Paired limbs were randomly assigned with or without hemicerclage suture. The osteotomy was slowly spread (TTA) at a rate 1.5 mm every 15 seconds to a maximum distance of 24 mm or until a fracture was detected as an audible crack, visible propagation of the distal osteotomy or transverse fracture of the cortical bridge. The occurrence of fractures was compared between limbs with hemicerclage and without hemicerclage (control) suture using a chi-square analysis. The advancement distance at the time of fracture was compared using a paired t test. A P value

Objective To compare the mode of failure, load at yield, ultimate load to failure and stiffness of non-barbed polydioxanone, non-barbed polyglyconate and barbed glycolide-trimethylene carbonate (GTC) suture in canine cadaveric fascia. Study Design Ex vivo biomechanical study. Sample Population 18 fascia lata specimens from 9 canine cadavers. Methods 6 fascia lata specimens were sutured with polydioxanone, 6 with polyglyconate, and 6 with barbed GTC suture. Load at yield, stiffness, ultimate load to failure were measured using tensile strength testing. Statistical analysis was used to compare outcomes between suture materials. The mode of failure was recorded and described. Results The load at yield and ultimate load to failure were significantly greater for polydioxanone than barbed GTC (P=.045 and P=.016, respectively). The load at yield and ultimate load to failure was not significantly different between polydioxanone and polyglyconate (P=.687 and P=.586, respectively). The load at yield and the ultimate load to failure was not significantly different between polyglyconate and barbed GTC (P=.194 and P=.109, respectively). Stiffness was not different between constructs (P=.103). Polydioxanone and polyglyconate failed by suture breakage and suture pullout. Barbed GTC failed by suture slippage and suture breakage. Conclusion Our results showed that under the conditions of this study, 4-0 monofilament polydioxanone had a greater load at yield and load to failure than similarly sized, barbed copolymer suture in the fascia lata. This finding may help direct suture choice for fascial closure.

Objective To compare the biomechanical strength and histologic features of 3-0 Glycomer™ 631 barbed suture (V-LOC™ 90 Absorbable Wound Closure Device, Covidien, Mansfield, MA) to non-barbed 3-0 Glycomer™ 631 suture (Biosyn™, Covidien) for intradermal skin wound closure in the dog. Study Design Randomized, factorial, in vivo. Animals Eighteen purpose-bred, mature male, and female hound dogs. Methods Eighteen adult hound dogs were randomly assigned to 1 of 3 groups designated by postoperative day of assessment. Six skin incisions were made along the dorsum in the thoracolumbar region of each dog with an equal number (n=3) randomly assigned to closure with barbed or non-barbed suture. Six dogs were euthanatized on postoperative days 3, 10, and 14, respectively. Two additional incisions were made on each dog after euthanasia for baseline data (Day 0). The skin incision specimens were harvested for biomechanical testing and histologic evaluation. Results Non-barbed closure had significantly higher maximum load at failure (P

Objective To describe a technique for laparoscopic incisional gastropexy using an articulated endoscopic suturing device with knotless unidirectional barbed suture in healthy large breed dogs. Study Design Prospective case series. Animals Healthy client-owned dogs presented for prophylactic gastropexy and weighing >20 kg (n=7). Methods Incisional gastropexy was performed using a single port access system with an articulated endoscopic suturing device. An additional 5 mm cannula was placed in the right caudal abdomen. A 2-0 knotless unidirectional barbed suture was used to complete the gastropexy with 2 separate simple continuous suture lines. All dogs underwent a focal abdominal ultrasound to evaluate the gastropexy site 3–12 months postoperatively. Results Median weight of the dogs was 33.5 kg (range, 20–51 kg) and the median age was 2 years (range, 0.6–8.5 years). Median surgical time was 60 minutes (range, 39–88). The articulated suturing device malfunctioned twice. On abdominal ultrasound between 3 and 12 months, all gastropexy sites were intact. No motion was detected between the stomach and body wall during distal antral contractions or respiratory motion and a focal thickening of the gastric wall was present in dog. No complications were reported in the postoperative periods as of the 2 week suture removal visit or as of the time of their ultrasound appointment. Conclusion This technique using an endoscopic articulated suturing device with a knotless unidirectional barbed suture provides a feasible technique to perform laparoscopic gastropexy.

Objective To determine if instruction using simulated small intestine (SSI) is as effective as using cadaveric small intestine to teach the Gambee suture pattern to second year veterinary students. Study Design Prospective, randomized, blinded study. Sample Population Second year veterinary students (n=59). Methods Students were randomly assigned to groups using SSI or equine cadaver small intestine (CSI) to learn the Gambee suture pattern. The same educator, an experienced surgical instructor, instructed all students. Instruction consisted of verbal description of the technique with a schematic diagram followed by a demonstration. Students then practiced the technique with supervision and verbal feedback. One week later, 3 board certified surgeons experienced in surgical instruction evaluated each student suturing equine CSI and scored them using a rubric developed and validated for surgical skills assessment. Results Fifty-nine students were enrolled (4 students were absent for the lab during which the assessment was performed; 55 students were available for evaluation). Of the 55 students evaluated, 26 were in the SSI group and 29 were in the CSI group. There was no significant difference between CSI and SSI groups in ability to perform the Gambee suture pattern using equine CSI 1 week following training. Conclusion SSI is as effective as equine cadaveric small intestine tissue to teach the Gambee suture pattern to second year veterinary students. If cadaver tissue is unavailable or undesirable, SSI could be used to instruct suture placement techniques.

OBJECTIVE To evaluate the feasibility of laparoscopic cholecystoduodenostomy in canine cadavers using barbed self-locking sutures. STUDY DESIGN In vivo experimental study. ANIMALS Fresh male Beagle cadavers (n=5). METHODS Surgery was performed by a single veterinary surgeon. Dogs were placed in dorsal recumbency and 15° reverse Trendelenburg position. The surgical procedure was performed with four 5 mm entry ports and a 5 mm 30° telescope. The cholecystoduodenostomy technique included dissection, incision of the gallbladder, and lavage, followed by gallbladder transposition over the duodenum, incision of the duodenum, and anastomosis. The latter was performed with a 4-0 barbed self-locking suture (V-Loc® 180). Subsequently, a leak test was performed by submerging the anastomosis in saline and insufflating air into the duodenum through a catheter. Total operative time and completion times for each procedural step were recorded. RESULTS The median total operative time was 151 minutes (range, 129-159). One conversion to open surgery occurred because of vascular hemorrhage. The 3 longest intraoperative steps were posterior wall anastomosis, gallbladder dissection, and anterior wall anastomosis. Intraoperative anastomotic leakage sites were identified in 3 of 5 dogs. Leaks were managed by placement of a single reinforcing conventional intracorporeal suture, which was adequate to obtain a watertight anastomosis. CONCLUSION This technique cannot be recommended in clinical practice until further studies are performed and the technique is further refined.

Objective To evaluate adhesions created by abomasopexies using either chromic gut or polydioxanone suture through a right paramedian approach and determine whether a laparoscopic toggle technique is an acceptable alternative to open abomasopexy using an ovine model. Study Design Experimental study. Animals Mature ewes (n=30). Methods Ewes received 1 of 3 abomasopexy techniques (n=10): right paramedian approach using chromic gut or polydioxanone, or a laparoscopic toggle technique. After euthanasia 8 weeks postoperatively, adhesions were removed en bloc and adhesion cross-sectional area (width × length) and depth (distance from abdominal wall to abomasum) were measured and given a grade of 0–3 based on the quality of adhesion. Surgical time was recorded and compared for each technique. Significance was set at P≤.05. Results Abomasopexies performed with either suture material resulted in a significantly larger mean cross-sectional area and higher adhesion grades compared to those performed using the toggle. Width and length of adhesions formed using chromic gut or polydioxanone were not significantly different; however, both were significantly wider and longer than those formed using the toggle. The laparoscopic toggle technique required significantly less surgical time than the sutured techniques. Conclusion Polydioxanone is as effective as chromic gut suture material in inducing abomasal adhesion formation in our sheep model. The clinical significance of the size and grade of adhesions formed is unknown and requires further investigation before the laparoscopic toggle technique can be recommended as a replacement for paramedian abomasopexy in cattle for the treatment of displaced abomasum.

Objective To compare a knotless, barbed suture to standard suture using laparoscopic suturing methods in an ex vivo model of equine bladder repair. Study Design Cadaveric study. Sample Population: Equine cadaver bladders (n=42). Methods A 5-cm incision was created and repaired in a laparoscopic training box with 4 different suture materials. Groups 1 and 2 used 2-0 poliglecaprone and 2-0 glycomer knotless, barbed suture, respectively, placed using laparoscopic instruments. Groups 3 and 4 used 0 and 2-0 polyglyconate knotless, barbed suture, respectively, placed using an automated laparoscopic suturing device. All groups used a double-layer inverting pattern. Time for suture placement was recorded. Bladders were inflated with water and bursting strength pressures recorded, including a control group of intact bladders. Statistical analysis using a linear model and taking into account the unequal variances was followed by a post-hoc Tukey's test. Significance was set at P

Objective To evaluate the properties of a ZipFix® (ZipFix) implant in equine laryngeal cartilages. Study Design Ex vivo biomechanical study. Sample Population Equine arytenoid (n=36) and cricoid cartilages (n=18). Methods Suture bites were placed in arytenoid or cricoid cartilages using a ZipFix® implant or a single strand of USP 5 braided polyester (TiCron™), and arytenoid and cricoid cartilages were separately subjected to single load to failure (25 N preload) or cyclic loading for 1,000 cycles, followed by single load to failure. Load, distraction, and stiffness were recorded. Results Four arytenoid-ZipFix cartilages fractured on implant placement. Under single load, arytenoid-ZipFix (n=9) failed at a greater mean load (359.01 ± 57.98 N) than arytenoid-Ticron (159.11 ± 22.98 N; n=12; P

Objective To report and compare the duration of surgery, the frequency of complications, and the frequency of open conversion for elective surgeries performed with 2 laparoscopic techniques: a single incision port access system (SPAS) and a multiple port access system (MPAS) using a Veress needle. Study Design Retrospective case series. Animals Ninety-eight consecutive, client owned dogs. Methods Medical records of dogs undergoing an elective laparoscopic procedure were reviewed. Dogs were classified as SPAS or MPAS according to the initial surgical approach. Duration of surgery, intraoperative complications, reason for open conversion, and postoperative complications were recorded and compared. Results The duration of surgery for SPAS gastropexy (P = .0039), ovariectomy (P = .0052), and gastropexy/ovariectomy combined (P = .0002) were significantly reduced compared to corresponding MPAS procedures. Nine splenic punctures occurred during MPAS. The frequency of intraoperative complications was significantly less for SPAS (0/44) than MPAS (12/54, P = .004). Elective conversion was performed because of gastric malpositioning in 1 dog and emergent conversion was required because of bleeding from the ovarian pedicle in 2 dogs (0/44 SPAS, 3/54 MPAS, P = .250). There were 14/76 dogs with followup to suture removal with postoperative complications, all incisional (7/31 SPAS, 7/45 MPAS, P = 1.0). Conclusion The use of SPAS for laparoscopy reduced surgical time and intraoperative complications in elective procedures.

Objective To describe the diagnosis and surgical management of congenital laxity of the fibularis tendon resulting in hyperextension of the tarsus in calves. Study Design Case series. Animals Fourteen calves (3 unilateral, 11 bilateral) diagnosed with congenital tarsal instability caused by laxity of the fibularis musculotendinous unit resulting in hyperextension of the tarsus. Methods Diagnosis was made by clinical and radiologic assessments. The tarsus was surgically prepared and an incision made on the dorsal surface of the tarsus after intrathecal anesthesia with the calf sedated. A locking-loop suture (4 loops) was applied to the fibularis tendon using polyglactin 910. The free ends of the suture were then tied to the shank of a cortical bone screw inserted in the proximal metatarsus. Results The calves were evaluated on postoperative days 15, 30, and 60 and were walking normally. Conclusion Congenital tarsal instability because of laxity of the fibularis musculotendoninous unit is described and surgical treatment directed at shortening the tendon shows promising results.

Objective To compare the load to ultimate failure, load to a 2 mm gap, mode of failure, and gap at failure (mm) of the Teno Fix® (TF) to the 3-loop pulley (3LP) for repair of equine tendon lacerations. The use of 4TF devices versus 5TF devices on load to ultimate failure and load to a 2 mm gap was also compared. Study Design Ex vivo biomechanical study; unbalanced incomplete block (horse) design. Samples Cadaveric equine forelimb superficial digital flexor tendon (n = 20 paired tendons). Methods Ten tendon pairs were selected randomly and repaired with a 3LP and 4TF pattern, and 10 tendon pairs repaired with a 3LP and 5TF pattern. Load to ultimate failure, load to a 2 mm gap, mode of failure, and gap at failure were obtained using materials testing. Results The 3LP had a significantly greater ultimate load to failure (P

Objective To compare 2 sutured techniques with a skin stapled technique for typhlotomy closure in bovines. Study Design Ex-vivo study. Sample Population Bovine fresh cadaveric ceca (n = 27). Methods Typhlotomies (4 cm in length) were made on the cecal apex and closed with 1 of the following techniques: hand-sewn, 2-layer suture consisting of a continuous, full-thickness layer oversewn with a Cushing layer (Group FC); hand-sewn, double inverting suture consisting of a 1st Cushing layer oversewn with an additional Cushing layer (Group CC); skin staples (Group S). Closure time, bursting pressure, and related costs of each technique were calculated and compared. Results Median (range) construction time for group S was 1.12 (0.49–1.3) min and was significantly shorter than for group FC 5.14 min (3.45–7.44), and for group CC 4.26 min (2.3–5.52) (95% CI 3.342–4.851), (P = .007). There was no significant difference between bursting pressures of group S (91.67 ± 15.41 mmHg, 95% CI 79.82–103.5) compared with group FC (119.4 ± 40.03 mmHg, 95% CI 88.67–150.2) (P = .160) and compared with group CC (103.3 ± 32.31 mmHg, 95% CI 78.5–128.2) (P = .707) Conclusion Hand-sewn techniques are effective but fairly demanding in terms of time. Skin staples are less time-consuming, and resist pressures comparable to those resisted by handsewn techniques. For this reason, an SKS technique may be a valid option for typhlotomy closure in cattle.

Objective To describe a suture-free ureterovesical anastomosis using a microvascular anastomotic system (MAS) and compare the surgical time and bursting pressure to a sutured ureterovesical anastomosis (SA) with and without an extravesical seromuscular tunnel (EVSMT). Study Design Randomized, unblocked design, ex vivo study. Animals Three canine cadavers. Methods For each cadaver, the ureters were sectioned into 3 equal lengths. The 6 sections were randomly assigned to receive either the MAS or end-side SA. The first cadaver (3 MAS, 3 SA) was used to refine the technique, and the remaining 2 cadavers were used for evaluation. Surgical time and bursting pressure of the anastomosis were compared between MAS and SA (n = 6 per technique). After bursting pressure testing of each anastomosis, an SMT was created over the anastomoses. Bursting pressures were again recorded and compared across techniques. Results The surgery time was significantly shorter for MAS (median 5.4 minutes) than SA (median 15.8 minutes; P = .002). The bursting pressure was significantly higher for MAS (median 189.5 cmH2O) than SA (median 64 cmH2O; P = .002). The bursting pressure for MAS-EVSMT (median 398.5 cmH2O) was not significantly different from the SA-EVSMT (median 321 cmH2O, P = .567); however, the creation of an SMT significantly increased the bursting pressure for both techniques (P = .028, respectively). Conclusion This study demonstrated the feasibility of a suture-free ureterovesical anastomosis in the canine cadaver using a commercially available MAS. The MAS anastomosis was faster and resulted in higher bursting pressures than SA. The creation of an SMT improved the bursting resistance of both techniques but there was no difference between the techniques covered by an EVSMT.

Objective To describe a ventral midline preputial approach to the caudal abdominal cavity of male dogs. Study Design Retrospective clinical study. Sample Population Client-owned dogs (n=12). Method Medical records of dogs which underwent a ventral midline preputial approach to the caudal abdominal cavity were reviewed. The procedure, outcome, and complication were recorded. Results Dogs underwent the preputial approach to the caudal abdominal cavity for various conditions. All dogs had an uneventful postoperative recovery and no major complications were recorded until suture removal at 10–14 days postoperative. Two dogs had minor complications treated conservatively which resolved. Conclusion The use of ventral midline preputial approach is an option for access to the caudal abdomen. The approach preserves the protractor preputii muscles, obviates ligation of the branches of the caudal superficial epigastric vessels and eliminates the need for extensive subcutaneous dissection.

Objective To compare the in vitro biomechanical properties of a novel subcuticular stapling device to current methods of abdominal skin closure for equine abdominal surgery. Study Design In vitro randomized, matched design. Sample Population Equine ventral median abdominal skin specimens (n = 24 horses). Methods Subcuticular absorbable staples (SAS), metallic staples (MS), polyglyconate suture (PG), and nylon monofilament (NYL) were applied to longitudinally transected portions of equine ventral midline skin. Loads that resulted in an initial failure point and the ultimate failure load and mechanism were recorded. Results Mean ± SD loads at initial failure for PG (86 N ± 64 N), NYL (81 N ± 142 N), and SAS (70 N ± 20 N) were not significantly different from each other. PG and SAS were significantly higher than MS (43 N ± 17 N; P

Objectives To (1) develop a model of cyclical adduction force on an abducted left arytenoid cartilage that mimics swallowing or coughing; (2) determine if arytenoid abduction by a clamp before knot tying will improve the maintenance of abduction under cyclical adduction testing. Study Design Experimental. Sample Population Cadaveric equine larynges (n = 14). Methods Left laryngoplasty performed using a single suture of #5 Ethibond with (n = 7) and without (n = 7) abducting the arytenoid with a clamp before knot tying. Each laryngoplasty was loaded cyclically from 2 to 26 N at 0.5 Hz for 5000 cycles in a servohydraulic test frame. Arytenoid displacement data were collected at 1 Hz intervals and median percent loss of abduction compared between groups. Significance was set at P

Objective To evaluate the effect of onlay mesenteric flaps (MFs) with end-to-end jejunojejunostomy on stomal diameter, length of jejunum with reduced stomal diameter, abdominal adhesion formation, and healing. Study Design Experimental study. Animals Healthy adult horses (n = 6). Methods Two hand sewn end-to-end jejunal anastomoses using a 1 layer simple continuous serosubmucosal suture pattern were performed in each horse ∼2 and 5 m oral to the ileocecal fold. Using a random design for selection anastomosis location (oral or aboral), 1 anastomosis was covered with 2 adjacent onlay MFs secured with interrupted sutures and cyanoacrylate glue. Two weeks later, adhesion formation, stomal diameter, length of reduced jejunal stomal diameter, and healing were evaluated. Results Use of onlay MFs decreased stomal diameter (P = .05), increased length of reduced peristomal jejunal diameter (P = .05), surgical time (P = .003), and serosal fibrosis (P = .05). No difference was evident for adhesion formation, and degree of inflammation between techniques. Conclusion End-to-end jejunojejunostomy covered with 2 onlay MFs is not recommended because this technique results in luminal reduction.

Objective To evaluate load to failure of laparoscopic incisional gastropexy performed with intracorporeal suturing using knotless polyglyconate (KP). Study Design Cadaveric study. Animals Canine cadavers (n = 12). Methods Laparoscopic incisional gastropexy using 2 strands of KP was performed in 6 canine cadavers and by an open approach in 6 cadavers. Length of the gastropexy, number of suture bites on each side of the gastropexy, and number of inadvertent full thickness gastric suture bites were recorded. Load to failure was measured. Results There was no significant difference in mean (±SD) gastropexy load to failure for the open (46.3 ± 19.6 N) and laparoscopic (69.0 ± 26.0 N) approaches (P = .123). No significant differences between laparoscopic and open approaches were detected for mean stomach (3.1 ± 0.1 cm; 3.0 ± 0.2 cm; P = .353) or abdominal wall (3.1 ± 0.2 cm; 3.0 ± 0.2 cm; P = .553) incision lengths. There was no significant difference between groups for number of suture bites medially (P = .448) or laterally (P = .363). There were 3 instances of a single gastric intraluminal suture for the laparoscopic group and none for the open approach (P = .023). Conclusion Incisional gastropexy performed with laparoscopic intracorporeal suturing and KP has a load to failure that is comparable with an open method. Load to failure was similar to reported values for open incisional gastropexy with knotless glycomer 631.

Objective To compare the ability of the Tightrope® (TR) cranial cruciate ligament (CCL) technique, percutaneous lateral fabella suture (pLFS) technique, and normal CCL to control cranial tibial translation (CTT). Study Design In vitro biomechanical study. Sample Population Cadaveric canine pelvic limbs (n = 18 pairs). Methods Six small animal surgical residents (1 pair each) and a Diplomate of the American College of Veterinary Surgeons (10 pairs) performed TR and pLFS techniques on paired limbs. Two intact limb pairs served as controls. Limbs were assessed by palpation, radiographs, and dissection before mechanical testing of resistance to CTT. Forces resisted during displacement were compared between groups with a mixed ANOVA and post hoc tests. Results With 5 mm of displacement, the pLFS resisted 72 ± 45 N and the TR resisted 66 ± 48 N of load. The intact CCL resisted 400 ± 35 N. The intact CCL resisted displacement significantly more than either surgical technique. Conclusions TR and pLFS had similar ability to resist CTT but neither restored the biomechanical properties of an intact CCL.

Objective To compare level of difficulty, deviations from technical description and postoperative assessment during the training of veterinary students, small animal surgical residents, and a board certified surgeon for Tightrope® (TR) and percutaneous lateral fabella suture (pLFS) techniques for cranial cruciate ligament (CCL) repair. Study Design Prospective study. Sample Population Cadaveric canine pelvic limbs (n = 32). Methods Sixteen 3rd year veterinary students, 6 small animal surgical residents and a Diplomate of the American College of Veterinary Surgeons performed the TR and pLFS techniques on paired limbs. Perceived level of difficulty, duration of surgery, and technical deviations were assessed by questionnaire, radiographs, and dissection. Results were compared between techniques with McNemar's test. Results The TR procedure was perceived as more technically demanding than the pLFS by veterinary students and residents. Technical deviations were overall more common after TR than pLFS, and in limbs repaired by students, regardless of procedure. The most difficult aspect of the TR consists of the bone tunnels whereas for pLFS it was passing the suture around the femorofabellar ligament. The sensitivity of radiographs for detection of technical deviations was 39% after TR and 50% after pLFS. Conclusion Technical deviations are more common during the training phase of TR than pLFS, and the sensitivity of radiographs to detect those is low. Repeated practice on cadavers followed by dissection is recommended before use in patients.

Objective To evaluate the quasi-isometric points (nearest isometric points) between the distal aspect of the femur and fabella and the proximal aspect of the tibia for placement of a lateral suture in cats. Study Design Radiographic study. Animals Cadaveric cat stifles (n = 7 cats; 14 stifles). Methods Specimens were secured in a mounting frame to maintain rigid fixation of the femur and allow free range of motion of the stifle joint and proximal tibia. Two anatomic landmarks were identified: the center of the lateral fabella (Ff) and a point 4 mm proximal to the insertion of the patellar tendon adjacent to the tibial cortex (Tt). Radiopaque spheres were placed at predefined landmarks in the femur (caudal aspect of the lateral femoral condyle distal [F1] and proximal [F2] to the lateral fabella) and in the tibia (caudal to the proximal aspect of the extensor groove [T1]; cranial to the proximal aspect of the extensor groove [T2]; 2 mm proximal and caudal to the insertion of the patellar tibial tendon [T3] and 3 mm caudal to the insertion of the patellar tibial tendon [T4]. For each stifle, 4 radiographic projections were made: in extension (166°), in flexion (45°), and 2 intermediate stance phases (90°, 130°). ANOVA was used to compare means of the distance between the point pairs and means of the percent change in variation of distance (VOD%) using the 45° measurement as a reference. Results Mean VOD% nearest to zero, over all the different angles tested, was produced by Ff-Tt, which was statistically significantly different from each of the other point pairs. Conclusion Ff-Tt provides the best quasi-isometric points for placement of lateral sutures in cats, compared with all combinations tested. Further assessments with biomechanical studies are needed to evaluate the reproducibility of these landmarks for stabilization of CCL rupture in cats.

OBJECTIVE: To evaluate use of the Advanced Locking Plate System (ALPS) in dogs and cats and report outcome. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs (n 09= 0929) and cats (n 09= 0942). METHODS: The medical records (April 2007-April 2010) of dogs and cats treated with ALPS were reviewed evaluated. Data retrieved included signalment, indication for surgery, complications, and outcome. RESULTS: ALPS was used for 54 fractures, 12 tarsal or carpal ligament injuries and in 6 cases, to prevent or treat fractures during total hip replacement. Complications needing revision surgery occurred in 4 cases (5.5%): fixation failure was identified in 3 (2 fracture-fixations, 1 pancarpal arthrodesis), and a fracture occurred through a screw hole. The most common complication after tarsal arthrodesis was suture dehiscence. All cases had healed by study end. CONCLUSIONS: ALPS offers a reliable alternative for fracture treatment and some other orthopedic conditions in small animals.

Objective To evaluate the applicability of single-incision laparoscopic ovariectomy (SILOVE) in cats using a single-incision laparoscopic port (SILP); to compare surgical time, complications, and postoperative pain after SILOVE using a LigaSure (SILOVE-LS) or extracorporeal suture (SILOVE-ECS), and open ovariectomy (open-OVE). Study Design Randomized, blinded, prospective study. Animals Healthy, domestic female cats (n = 24). Methods Cats underwent physical examination, packed cell volume, total solids and blood urea nitrogen analysis. Cats were randomly assigned to 1 of 3 groups: SILOVE-LS (n = 8), SILOVE-ECS (8) or open-OVE (8). Surgical time, complications, and postoperative pain scores were recorded. Results Single-incision laparoscopic ovariectomy was successful in (n = 8) SILOVE-LS cats and (n = 5) SILOVE-ECS cats. Surgical time was significantly longer for the SILOVE-ECS group compared with the SILOVE-LS (P

Objective To compare a unidirectional barbed suture (V-Loc™) to its suture material equivalent (Biosyn™) in a single-layer end-to-end anastomosis of equine jejunum. Study Design Experimental in vitro study. Animals Jejunal sections from adult horses (n = 5) without gastrointestinal disease. Methods Jejunal end-to-end anastomoses (n = 9) were performed for each group (V-Loc™, Biosyn™) with a continuous Lembert pattern with an interruption every 120°. Anastomosis construction time, luminal diameter, and number of suture bites were recorded. Anastomosis constructs were distended with fluid at 1 L/min until failure. Location and intraluminal pressure at failure were recorded and all measurements were compared between groups. Results V-Loc™ anastomoses were significantly faster to perform (13.1 ± 0.35 minutes) when compared to the Biosyn™ group (15.6 ± 0.72 minutes; P = .0004). No differences were observed for anastomotic index or number of suture bites. V-Loc™ anastomosis constructs had a significantly decreased bursting pressure (160 ± 11.6 mmHg) compared to Biosyn™ constructs (184 ± 16.9 mmHg; P = .01). Conclusions V-Loc™ allowed faster construction time and did not cause a decreased anastomosis luminal diameter when compared with Biosyn™. V-Loc™ had a decreased bursting strength compared with Biosyn™, albeit well above pathologic pressures encountered clinically. Use of V-Loc™ may be beneficial for decreasing the amount of exposed suture material because of the absence of knots after construction and has the potential to result in decreased adhesions.

Objective To (1) describe a surgical technique for repair of lacerations of the ventral aspect of the cervix in anesthetized mares in Trendelenburg position; and (2) report conception rates and foaling after repair. Study Design Case series. Animals Mares (n = 18). Methods Cervical lacerations were repaired in 2 layers with anesthetized mares in Trendelenburg position. The cervix was retracted caudally with stay-sutures, and after excision of the healed margin of the laceration, the internal cervical mucosa and fibromuscular tissue were sutured in 1 layer with a continuous Lembert pattern. The external cervical mucosa was sutured using a simple-continuous suture pattern. Number of foals produced by each mare before and after surgical repair was obtained from client/farm communication and from a commercial record keeping service. Results Mean repair time for 1 laceration was 22 minutes and for 2 lacerations was 29 minutes. Nine mares conceived and 7 had at least 1 live healthy foal. Conclusion Trendelenburg position allows for efficient repair of a ventrally located cervical laceration in anesthetized mares.

Objectives: To evaluate the effect of 3 laryngeal prostheses alone or in combination on rima glottidis area in horses. Study Design: Experimental randomized design. Sample Population: Cadaveric equine larynges (n=22). Methods: Three prostheses were preplaced in each of 14 larynges. Rima glottidis area was measured after loading each suture in 5Newton (N) increments from 0N to 35N. In 8 larynges, the 3 prostheses were tied alone or in combination at a fixed load of 15N and rima glottidis area measured. Results: Rima glottidis cross-sectional area increased as the load on each prosthesis increased with maximum area reached at 20N for each prosthesis. At a fixed load of 15N, tying 2 and 3 prostheses in combination resulted in a larger rima glottidis cross-sectional area than achieved with each prosthesis alone. Conclusions: A combination of 2 or 3 prostheses tied at a fixed load of 15N optimized rima glottidis cross-sectional area irrespective of the anatomic location of the prosthesis.

OBJECTIVE: To determine the effect of horse age and laryngeal prosthesis location on rima glottidis area in cadaveric larynges. STUDY DESIGN: Experimental study. ANIMALS: Cadaveric equine larynges (n = 40). METHODS: Specimens were grouped by age: group 1, ≤5 years (n = 18); group 2, >5 to ≤10 years (n = 12); group 3, >10 years (n = 10). A cranial prosthesis was placed through the dorsal cricoid spine at 70% of the distance of the total cricoid length measured from the caudal rim. A dorsal prosthesis was placed through the caudal rim of the cricoid on the dorsal midline. A lateral prosthesis was placed 1.5 cm lateral to the dorsal prosthesis. All prostheses passed through the muscular process. Rima glottidis area was determined after progressively tightening each suture in 5 N increments from 0 N to 35 N using a tensiometer. RESULTS: There was no significant effect of age on the area of the rima glottidis at any load for any of the three prosthesis locations. CONCLUSIONS: Age did not affect the area of the rima glottidis when prostheses were loaded between 5 N and 35 N.

Objective To compare bursting strength and failure mode between ventral median celiotomies closed with USP 7 braided polydioxanone (7PD) or USP 2 polyglactin 910 (2PG). Study Design Ex vivo experimental. Animals Equine cadavers (n = 10). Methods A 25 cm ventral median celiotomy was created in fresh equine cadavers. A 200 L polyurethane bladder was inserted into the abdomen. Celiotomies were closed in a simple continuous pattern with 2 sections of 7PD or 2PG. The bladder was inflated with compressed air until construct failure. The horses' signalment, body weight, suture type, failure mode (suture or abdominal wall), and bursting strength (mmHg) were recorded. Interactions between independent and dependent variables were assessed with statistical tests including linear regression. Results Failure mode was significantly different by suture type (P = .01). Four of 5 celiotomies closed with 2PG failed at the suture; whereas, 0 celiotomies closed with 7PD failed at the suture. In celiotomies closed with 7PD, increasing age was highly and negatively correlated with bursting strength (r = −0.99). When the effect of age was controlled, 7PD had a significantly higher bursting strength than 2PG (P = .024). Conclusion 7PD has a higher bursting strength compared with 2PG. Suture failure was the main failure mode for 2PG; whereas, all celiotomies closed with 7PD failed at the abdominal wall.

Objective To compare bursting strength and failure mode between ventral median (VM) and right ventral paramedian (RVP) celiotomies closed with 1 section of USP 7 braided polydioxanone (7PD). Study Design Ex vivo experimental. Animals Equine cadavers (n = 12). Methods A 25 cm VM or RVP (positioned 5 cm lateral to the linea alba) celiotomy was created in fresh equine cadavers. A 200 L polyurethane bladder was inserted into the abdomen. Celiotomies were closed in a simple continuous pattern with 1 section of 7PD. The bladder was inflated with compressed air until construct failure. Horse signalment, body weight, celiotomy type, failure mode (suture or abdominal wall), failure location (adjacent or remote from the celiotomy), and bursting strength (mmHg) were recorded. Interactions between independent and dependent variables were assessed with statistical tests including linear regression. Results Increasing age (P = .002) and Quarter horse-type breed (P = .01) had a negative effect on bursting strength. When age and breed were controlled, RVP celiotomies had a lower bursting strength compared with VM celiotomies (P = .039). None of the celiotomies failed at the suture. Conclusion VM celiotomies have a greater bursting strength than RVP celiotomies when age and breed are controlled. Celiotomy bursting strength decreases with increasing age and is lower in Quarter horse-type breeds compared with non-Quarter horse-type breeds.