Search Results

Abstract

OBJECTIVE To compare security of continuous intradermal suture lines closed by use of barbed suture with 3 end-pass configurations or without an end-pass configuration.

SAMPLE 40 full-thickness, 4-cm-long, parasagittal wounds in canine cadavers.

PROCEDURES Each continuous intradermal closure was terminated with 1 of 3 end-pass techniques or without an end-pass configuration (control group). A servohydraulic machine applied tensile load perpendicular to the long axis of the suture line. A load-displacement curve was generated for each sample; maximum load, displacement, stiffness, mode of construct failure, and load at first suture slippage at termination (ie, terminal end of the suture line) were recorded.

RESULTS Values for maximum load, displacement, and stiffness did not differ significantly among the 3 end-pass techniques, and load at first suture slippage at termination was not significantly different among the 4 groups. A 1-pass technique slipped in 5 of 9 samples; 3 of these 5 slips caused failure of wound closure. A 2-pass technique slipped in 3 of 9 samples, none of which caused failure of wound closure. Another 2-pass technique slipped in 4 of 10 samples; 2 of these 4 slips caused failure of wound closure. The control group had slippage in 10 of 10 samples; 9 of 10 slips caused failure of wound closure

CONCLUSIONS AND CLINICAL RELEVANCE An end-pass anchor was necessary to terminate a continuous intradermal suture line, and all 3 end-pass anchor techniques were suitable to prevent wound disruption. The 2-pass technique for which none of the suture slippages caused wound closure failure provided the most reliable configuration.

Abstract

Objective—To compare volumes of square knots and Aberdeen knots in vitro and evaluate security of these knot types when used as buried terminal knots for continuous intradermal wound closures in canine cadavers.

Design—Experimental study.

Sample—24 surgically closed, full-thickness, 4-cm, epidermal wounds in 4 canine cadavers and 80 knots tied in vitro.

Procedures—Continuous intradermal closures were performed with 4–0 polyglyconate and completed with a buried knot technique. Surgeon (intern or experienced surgeon) and termination knot type (4-throw square knot or 2 + 1 Aberdeen knot; 12 each) were randomly assigned. Closed wounds were excised, and a servohydraulic machine applied tensile load perpendicular to the long axis of the suture line. A load-displacement curve was generated for each sample; maximum load, displacement, stiffness, and mode of construct failure were recorded. Volumes of 2 + 1 Aberdeen (n = 40) and 4-throw square knots (40) tied on a suture board were measured on the basis of a cylindrical model.

Results—Aberdeen knots had a mean smaller volume (0.00045 mm³) than did square knots (0.003838 mm³). Maximum load and displacement did not differ between construct types. Mean stiffness of Aberdeen knot constructs was greater than that of square knots.

Conclusions and Clinical Relevance—The 2 + 1 Aberdeen knot had a smaller volume than the 4-throw square knot and was as secure. Although both knots may be reliably used in a clinical setting as the termination knot at the end of a continuous intradermal line, the authors advocate use of the Aberdeen terminal knot on the basis of ease of burying the smaller knot. (J Am Vet Med Assoc 2015;247:260–266)

Abstract

OBJECTIVE To quantitatively measure the amount of pressure induced at the calcaneus and cranial tibial surface of dogs by use of 2 cast configurations.

ANIMALS 13 client- or student-owned dogs.

PROCEDURES Pressure sensors were placed over the calcaneus and cranial tibial surface. Dogs then were fitted with a fiberglass cast on a pelvic limb extending from the digits to the stifle joint (tall cast). Pressure induced over the calcaneus and proximal edge of the cast at the level of the cranial tibial surface was simultaneously recorded during ambulation. Subsequently, the cast was shortened to end immediately proximal to the calcaneus (short cast), and data acquisition was repeated. Pressure at the level of the calcaneus and cranial tibial surface for both cast configurations was compared by use of paired t tests.

RESULTS The short cast created significantly greater peak pressure at the level of the calcaneus (mean ± SD, 0.2 ± 0.07 MPa), compared with peak pressure created by the tall cast (0.1 ± 0.06 MPa). Mean pressure at the proximal cranial edge of the cast was significantly greater for the short cast (0.2 ± 0.06 MPa) than for the tall cast (0.04 ± 0.03 MPa).

CONCLUSIONS AND CLINICAL RELEVANCE A cast extended to the level of the proximal portion of the tibia caused less pressure at the level of the calcaneus and the proximal cranial edge of the cast. Reducing the amount of pressure at these locations may minimize the potential for pressure sores and other soft tissue injuries.