Horizontal Mattress Research Articles

The use of a horizontal mattress suture and notches in 3% bismuth tribromophenate–impregnated petrolatum gauze tie-over bolster dressings to improve surgical outcomes after skin grafts

The use of a horizontal mattress suture and notches in 3% bismuth tribromophenate–impregnated petrolatum gauze tie-over bolster dressings to improve surgical outcomes after skin grafts

Biomechanical comparison of three epitendinous suture patterns as adjuncts to a core locking loop suture for repair of canine flexor tendon injuries.

To determine the effects of different epitendinous sutures (ES) in addition to core locking-loop (LL) sutures on the mechanical properties and gap formation in a canine cadaveric tendon model. Experimental, ex vivo, biomechanical study. Seventy-two cadaveric superficial digital flexor tendon specimens. Superficial digital flexor tendon specimens were divided into four groups (n = 18): sharply transected and repaired with LL, LL + simple continuous ES, LL + Silfverskiöld cross-stitch ES, and LL + interlocking horizontal mattress ES. Constructs were loaded to monotonic failure. Failure modes, gapping, yield, peak, and failure forces were analyzed. Significance was set at P < .05. Yield, peak, and failure forces increased by 2.5-fold, two-fold, and twofold, respectively when ES groups were compared with core LL suture patterns alone (P < .0001). Resistance to 1- and 3-mm gap formation was greater in ES groups compared with core LL constructs alone (P < .0001). No differences in yield, peak, failure force, or gapping were observed among ES patterns (P > .827). Adding an ES reduced gap formation and increased yield, peak, and failure forces of tenorrhaphies. No difference was detected between the epitendinous patterns tested in this study. The addition of an ES seems more relevant than the specific type of pattern to improve the biomechanical properties of flexor tendon repairs. In vivo studies are warranted to determine the biological implications of the patterns tested here.

Labiaplasty with Clitoropexy.

Supplemental Digital Content is available in the text.

Reduced rate of dehiscence after implementation of a novel technique for creating colonic anastomosis in pediatric patients undergoing intestinal anastomosis in a single institute.

We aimed to investigate the new continuous horizontal mattress anastomosis for pediatric patients who underwent emergency or electively laparotomy.From June 2012 to June 2017, 858 patients undergoing intestinal anastomosis were reviewed retrospectively, including 369 patients with the new continuous horizontal mattress anastomosis and 489 patients with traditional 2 layer interrupted anastomosis, served as control. Propensity score matching was performed to adjust for selected baseline variables. The primary outcome, anastomosis complications and clinical outcomes, including postoperative gastrointestinal function recovery, overall expenditure, and postoperative hospital stay were compared between the 2 groups.Patients with the new manual anastomosis had advantageous postoperative outcomes than those with the traditional 2 layer interrupted anastomosis. A mean of 11.4 minutes was required to construct the new manual single-layer anastomosis versus 18.5 minutes for the traditional anastomosis (P < .001). A reduction trend for postoperative anastomotic complications was indicated in patients receiving horizontal mattress anastomosis (odds ratio [OD] (95% confidence interval [CI]), 0.56 (0.37–0.84); P = .004), including peritonitis or abscess (OD [95% CI], 0.56 (0.32–0.98); P = .026), anastomotic leakage (OD [95% CI], 0.39 [0.12–1.27]; P = .088), and anastomotic strictures (P = .26). Mean length of stay was 10.9 ± 2.9 days for the new manual anastomosis group and 11.3 ± 3.5 days for traditional 2-layer anastomosis patients (P = .12).Beneficial effects of the new manual anastomosis were demonstrated in terms of anastomotic complications, and length of hospital stay in the pediatric patients. Furthermore, it is a novel, feasible and safe method that may simplify the surgical procedure in anastomoses.

Surgical Correction of the Lying Ear Deformities.

In contrast to prominent ear, lying ear can be defined when the antihelix of the ear is excessively folded, i.e., the conchoscaphal angle is much less than 90°. In such case, ears may look smaller than the face. These patients want their ears to be exposed more. In Asia, there is also a tendency to prefer large and long ears. The objective of this study was to present a surgical method for correcting lying ear deformities. From August 2017 to June 2018, 37 patients (72 ears) underwent surgery using our surgical method for lying ear deformities. After the cartilage was exposed on the posterior auricular surface, the fibrous band present at the conchoscaphal angle was released. Two longitudinal cartilage incisions were performed along the border of the antihelix. Horizontal mattress sutures were performed on the cartilage until the conchoscaphal angle was close to 90°. Onlay cartilage grafting was performed for the most severe portion of the deformity. We performed reoperation for four patients due to recurrence (n = 2), under-correction (n = 1), and cartilage exposure (n = 1). Most patients obtained satisfactory aesthetic results. There have been few reports of the surgical method for lying ear deformities. Our surgical method can provide satisfactory clinical outcomes for correcting lying ear deformities. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Single-incision laparoscopic repair of a cesarean scar defect

To evaluate the feasibility of laparoscopic single-incision repair for a cesarean scar defect (CSD). Step-by-step explanation of surgery using an instructive video, with Institutional Review Board approval. University Hospital, Shandong Province, People's Republic of China. A 36-year-old G2P1011 woman presented with postmenstrual spotting and pelvic pain that was resistant to medical management. Transvaginal ultrasound revealed a CSD measuring 1.08 × 0.71cm with a residual myometrial thickness of 1.5mm. She desired to preserve fertility and had cosmetic concerns related to surgery. We performed single-incision laparoscopic CSD repair. After abdominal entry, the overlying peritoneum and bladder adhesion were dissected using a monopolar hook, cold scissors, and a grasper. Diagnostic hysteroscopy was performed to identify CSD boundaries. Cold scissors were used to resect the scar tissue, avoiding the use of thermal energy to prevent injury that would impair wound healing. Closure was performed using 2/0 Ethibond suture (Ethicon); the first layer was a running full-thickness vertical suture, and the second layer was a horizontal mattress suture to reduce incisional tension. Single-incision intracorporeal knot tying was successfully accomplished by forming a triangle with the straight laparoscopic forceps and the articulated instrument. Successful repair of CSD via single-incision laparoscopic surgery. Operative time was 50minutes; blood loss was 50mL. At the postoperative visit, the umbilical wound had properly healed with excellent cosmetic results. Abdominal ultrasound demonstrated that the CSD had disappeared. Cyclic menses resumed without postmenstrual spotting or pelvic pain. Our case suggests that single-incision laparoscopic repair is a feasible approach to treat CSD that can provide excellent cosmetic results. Additional studies should investigate the clinical utility of single-incision laparoscopic CSD repair in a larger sample to compare the outcomes with the vaginal and hysteroscopic approaches.

Arthroscopic Knotless Remplissage for the Treatment of Hill-Sachs Lesions Using the PASTA Bridge Configuration

Recurrent glenohumeral dislocations can produce Hill-Sachs lesions—bony defects on the humeral head resulting from the humerus hitting the glenoid during dislocations. Some of these lesions can engage on the glenoid during motion, producing instability and potentially affecting the success of a labral repair. The remplissage was developed to address these Hill-Sachs lesions and improve stability. French for “filling,” the goal of the remplissage is to fill the Hill-Sachs lesion with the infraspinatus tendon, preventing the margins of the lesion from engaging with the glenoid. Analogous to restoring the rotator cuff footprint during repair, a primary goal of the remplissage is to have the infraspinatus cover the Hill-Sachs lesion. The partial articular supraspinatus tendon avulsion (PASTA) bridge was originally developed for partial-thickness rotator cuff repair in situ, but additional uses have been found in other settings. The PASTA bridge uses a medial row horizontal mattress with a lateral anchor to create a linked construct to effectively distribute force and provide adequate coverage of the lesion. Knotless anchor technology used in this procedure prevents the need for arthroscopic knot tying and potentially damaging knot stacks. This Technical Note describes a remplissage technique using the PASTA bridge configuration to address Hill-Sachs lesions associated with recurrent glenohumeral instability.

New Flexible Internal Annular Fixation Rings for Tricuspid Aortic Valves.

Although aortic annulus repair has a long history, there are still no ideal devices to control an aortic annulus. We have developed a new method involving the use of an expanded polytetrafluoroethylene graft with the support of a metallic ring holder during implantation from inside an aorta, with no dissection of the surrounding aortic annulus. We used aortic annular rings of 18 to 24 mm made of Gore-Tex tubed grafts (W.L. Gore & Associates, Flagstaff, AZ, USA) and metallic ring holder. After cutting the graft circumferentially to a 5-mm thickness, it was compressed manually to decrease the thickness. Then, a metallic ring holder corresponding to the graft size was inserted into the graft. The metallic ring holder was fixed to the graft with one 4-0 monofilament suture using 6 holes and the side trench on the metallic ring holder. The proper size for the graft was determined, and the appropriate annuloplasty ring was selected. A row of 4-0 double-needle braided sutures with expanded polytetrafluoroethylene spaghettis was sewn from the aortic side into the left ventricular outflow tract with a horizontal mattress stitch. After all sutures around the annulus were placed, they were tied down and the metallic ring holder was removed. The leaflets were repaired if necessary. A total of 9 patients with tricuspid aortic valve have undergone this procedure since January 2015. The sizes of the aortic annular rings were 20 mm ( n = 3), 22 mm ( n = 5), and 24 mm ( n = 2). Aortic leaflets were repaired in 6 patients (6 central plications). Concomitant procedures were total aortic arch replacement ( n = 2), mitral valve repair ( n = 2), tricuspid valve repair ( n = 1), and coronary artery bypass grafting ( n = 2). There were no hospital deaths and no major morbidities. All patients were checked for mild or less than mild aortic regurgitation during the mean follow-up period of 13 months. Postoperative echocardiograms showed excellent peak pressure gradients compared with preoperative echocardiograms. Postoperative cardiac computed tomography scans were performed in 6 patients. The discrepancies between the ring size used and postoperative annular size were <1-mm diameter in all patients. This new flexible ring is easy to use to fix an aortic annulus from the inside. Early results reveal excellent control of aortic regurgitation with the projected annular size. Further investigations are needed to ensure the effectiveness of the ring.

Diaphragm and transdiaphragmatic injuries.

The incidence of traumatic diaphragmatic rupture (TDR) is around 0.5% of all trauma patients, located more frequently on the left side (80%), with penetrating trauma being more predominantly the cause (63%) than blunt injuries (37%). TDR typically develops during thoracoabdominal injuries and outcome depends on the severity of the associated organ lesion. Diagnosis is sometimes very difficult: chest X-ray can verify TDR in only 25-70% of cases, although the specificity of a multidetector computed tomography (MDCT) is 100% and 83% for left and right-sided ruptures, respectively. When TDR is a part of a polytrauma, the management of the patient must follow the ATLS (Advanced Trauma Life Support) protocol and surgery is rarely based on the primary survey. The usual scenario involves cases detected during the secondary survey. In acute cases approach is determined by the site of the life-threatening injuries. In the daily surgical routine, in cases of acute TDR, laparotomy provides the best approach to manage the associated abdominal injuries and diaphragmatic rupture. Alternatively a transthoracic approach offer access to reconstruction in cases of delayed. A transdiaphragmatic procedure is offered when during an exploration (laparotomy or thoracotomy), any sign of an injury (bleeding, perforation) is verified through the rupture of the diaphragm in the other cavity (abdomen or chest and vice versa): the injury via a transdiaphragmatic way can be managed. Usually, a simple and small rupture up to 5-6 cm can be reconstructed with No. 0 or 1 monofilament non-absorbable or absorbable interrupted sutures, while for larger defects, interrupted figure-of-eight or horizontal mattress sutures are required. Mesh prosthesis is rarely needed.

Evaluation of two biological matrices for repairing of ventral hernia in bucks

The aim of this study was to estimate the changes in ventral hernia repairing in Iraqi bucks by using two biological matrixes derived from bovine (pericardium and urinary bladder matrix) through histopathological examination. All bucks right lower flank awas prepared surgically, sedation were done by using (2% Xylazine hydrochloride) at a dose of 0.2mg/kg intramuscular, and surgical site anesthetized through an inverted (L) shape local infiltration technique using lidocaine hydrochloride (2%) at a dose of 8mg/kg. Ventral abdominal hernias were induced in (24) bucks through elliptical resection of abdominal muscles to made hernia ring (6-8cm) with avoiding peritoneum perforation. After 30 days of operation bucks were divided into two equal groups. cellular Bovine pericardium group and cellular urinary bladder matrix group. In two groups hernias were treated with only replacement of acellular bovine pericardium and cellular urinary bladder matrix respectively which fixed with interrupted horizontal mattress 2cm far from hernia ring by Polypropylene (No.1) suture material. Histopathological biopsies were taken at 2nd, 8th and 16th week post treatment (4 bucks\ period). Both groups’ successes in reconstruction of large hernia in bucks through prevent recurrent or others post-operative complications. In addition the histopathological examination showed that the acellular urinary bladder matrix superior than acellular bovine pericardium matrix in enhance healing based on acellular urinary bladder matrix role in augment early initiation of inflammatory cells infiltration, fibroblast proliferation and marked collagen deposition, in addition to its early degradation, incorporation and remodeling.

Biomechanical Comparison of 3 Novel Repair Techniques for Radial Tears of the Medial Meniscus: The 2-Tunnel Transtibial Technique, a “Hybrid” Horizontal and Vertical Mattress Suture Configuration, and a Combined “Hybrid Tunnel” Technique

Background: Historically, radial meniscal tears were treated with partial or near-total meniscectomy, which usually resulted in poor outcomes. Radial meniscal tears function similar to a total meniscectomy and are challenging to treat. Repair of radial meniscal tears should be performed to prevent joint deterioration and the need for salvage procedures in the future. Purpose/Hypothesis: The purpose was to compare 3 repair techniques for radial tears of the medial meniscus: the 2-tunnel, hybrid, and hybrid tunnel techniques. It was hypothesized that there would be no differences among the 3 groups in regard to gapping and ultimate failure strength. Study Design: Controlled laboratory study. Methods: Thirty human male cadaver knees (10 matched pairs, n = 20; 10 unpaired, n = 10) were used to compare the 2-tunnel, hybrid, and hybrid tunnel repairs. A complete radial tear was made at the midbody of the medial meniscus. Repairs were performed according to the described techniques. Specimens were potted and mounted on a universal material testing machine where each specimen was cyclically loaded for 1000 cycles before experiencing a pull to failure. Gap distances at the tear site, ultimate failure load, and failure location were measured and recorded. Results: After 1000 cycles of cyclic loading, there were no significant differences in displacement among the 2-tunnel repair (3.0 ± 1.7 mm), hybrid repair (3.0 ± 0.9 mm), and hybrid tunnel repair (2.3 ± 1.0 mm; P = .4042). On pull-to-failure testing, there were also no significant differences in ultimate failure strength among the 2-tunnel repair (259 ± 103 N), hybrid repair (349 ± 149 N), and hybrid tunnel repair (365 ± 146 N; P = .26). However, the addition of vertical mattress sutures to act as a “rip stop” significantly reduced the likelihood of the sutures pulling through the meniscus during pull-to-failure testing for the hybrid and hybrid tunnel repairs (4 of 16, 25%) as compared with the 2-tunnel repair (7 of 9, 78%; P = .017). Conclusion: The results showed equivalent biomechanical testing with regard to gap distance and pull-to-failure strength among the 3 repairs. The addition of the vertical mattress sutures to act as a rip stop was effective in preventing meniscal cutout through the meniscus. Clinical Relevance: Effective healing of radial meniscal tears after repair is paramount to prevent joint deterioration and symptom development. Each tested repair showed a biomechanically equivalent and stable construct to use to repair radial meniscal tears. The authors recommend that rip stop vertical mattress sutures be used, especially in poor-quality meniscal tissue, to prevent suture cutout.

AZODO suture: A simple periodontal pocket reduction treatment technique

AZODO suture is a simple, easy, success-oriented periodontal pocket reduction and gingival papilla reconstruction procedure. It starts with obtaining informed consent for the procedure followed by scaling, root planing, and curettage of the diseased pocket and then by an interrupted suture with polyglycolic resorbable suture. When the pockets on two adjacent teeth exist, a modification (MODIFIED AZODO suture) in the form of horizontal mattress suturing technique is used. The hypothesized mechanism of action is that the suturing of the gingiva apposes the facial and lingual side of the interdental gingiva with the tissues filling the interdental space-generating pressure that facilitates the apposition of the gingiva on the distal/mesial surfaces of the tooth with pocket. The consequent tissue modeling facilitates a proper interdental papilla. This prevents food impaction, ensures cleanliness, facilitates healing, and restores the interdental health.

A detailed description and 16-year validation of a new suturing method for stabilizing connective tissue grafts at recipient sites for root coverage and gingival augmentation

Which are the different ways of stabilizing connective tissue grafts (CTGs) for root coverage and gingival augmentation by means of placement of sutures? There are various defined and undefined ways of stabilizing CTGs depending on experience and personal preferences. Most of the techniques profess use of absorbable sutures in separate interrupted fashion (sutures at the corners of the graft wherever possible). This paper describes a new suturing method, "the lingually-tied horizontal mattress contouring suture," for stabilization of CTGs with or without epithelialized collar at the recipient site, for use with papilla retention and sparing techniques to treat marginal tissue recessions. The suturing technique is described in detail. It can be indicated for good number of root coverage cases, with additional objectives of gingival augmentation, specifically developed for papilla sparing and papillary buccal de-epithelialization recipient site preparations. Over a period of last 16 years this suturing technique showed promising results in terms of graft stabilization and survival. The main advantage of this technique lies in the use of cost-effective nonabsorbable sutures that usually retain some amount of tension on the soft tissues longer. The primary objective of the suturing technique, per se, is to stabilize the CTG firmly along the contours of the root surface and to expedite a very close adaptation to the interdental soft tissues as well. The secondary objective of the article or publication is to disseminate the knowledge acquired through long periods of performance and observation for the benefit of the periodontal community as whole. Further validation is advocated.

Mallet Toe of the Hallux Treated by Bridging Suture Technique Using Suture Anchors: A Case Report and Literature Review

An avulsion fracture of the extensor hallucis longus at the distal end of the great toe is called “mallet toe” of the hallux. It is a rare injury and the treatment options are conservative treatment using a splint, percutaneous or open Kirschner wire fixation similar to that in the mallet finger, or suture anchor fixation. We present a case treated by the bridging technique using two suture anchors. A 57-year-old Japanese man injured his left great toe after a fall while walking barefoot on the bed. His great toe was forced into a hyperplantarflexion position. Plain radiography and computed tomography showed a small bone fragment at the base of the dorsal distal phalanx, suggesting an avulsion fracture of the extensor hallucis longus. He was treated by bridging suture technique with two suture anchors. At first, two suture anchors were inserted to the fracture bed of the distal phalanx, and then the bone fragment and extensor hallucis longus tendon were secured with two horizontal mattress sutures. Finally, bridging sutures were performed using the remaining sutures and the sutures used for mattress suturing. He obtained bony union and symmetric range of motion of the interphalangeal joint. This technique allowed us to fix the small bone fragment rigidly and mobilize the interphalangeal joint earlier to preserve the range of motion. It would be a valuable procedure when the bone fragment is small.

Exteriorization of genital system of Awassi ewes with laparotomy in standing position

The study were undertaken on 16 Iraqi Awassi ewes, presented in the farm of college of veterinary medicine, Al- Fallujah University/ Fallujah, during the end of February to the half of the march, 2018. The age of the animals ranged between 2 to 4 years. All the ewes were examined by ultrasonography by specialist in order to be sure that the animals not pregnant with B- mode system. All the animals has been synchronized with vaginal sponges impregnated in 40 mg flurogestone acetate (intervet, B.V. Boxemeer, Holland). The animals were put in a standing position clipping and shaving of the left flank area then the site washed with antiseptic and disinfected with tincture iodine. The animals anesthetized locally using 2% xylocaine hydrochloride using 10 ml subcutaneously and intra muscular. left flank sharp dissection about 10-12 cm were made through the skin, muscle and peritoneum. Exteriorization of the uterus and ovaries were done to detect the pregnancy through a symmetry of uterine horns and the enlargement of pregnant horn or to detect the numbers of follicles and corpora lutea after that the peritoneum and the muscles were sutured with catgut no.1 with lock stich pattern. The skin was sutured with silk no.1 using horizontal mattress interrupted pattern. Systemic long acting tetracycline were applied I.M (200 mg/ ml: 100mg/kg B.W) for one day and another for 3 injection. Local antibiotic spray was applied to treat the surgical wounds for 7 days. The suture materials of the skin were removed after 7 days of the operation. The animals were examined daily for general health condition (temperature, heart rate, pulse rate, appetite). The wound also examined for presence of swelling, hematoma, pus or infection or hernia Positive results were considered when the animal in a good general health condition and the wound showed normal healing without presence of swelling, hematoma, pus or infection or hernia. This technique is simple, easily done, save time and cost as well as reduce the surgical trauma with few suture materials. The study was the first of its kind all over the world in exteriorization of genital organs in standing position in ewes.

Do One Then See One: Sequencing Discovery Learning and Direct Instruction for Simulation-Based Technical Skills Training.

When teaching technical skills, educators often include a mix of learner self-regulation and direct instruction. Appropriate sequencing of these activities-such as allowing learners a period of discovery learning prior to direct instruction-has been shown in other domains to improve transfer of learning. This study compared the efficacy of learners trying a novel simulated suturing task before formal instruction (Do then See) versus the more typical sequence of formal instruction, followed by practice (See then Do) on skill acquisition, retention, and transfer. In 2015, first-year medical students (N = 36) were randomized into two groups to learn horizontal mattress suturing. The See then Do group had access to instructors before independent practice, whereas the Do then See group explored the task independently before accessing instructors. Participants were assessed at the transition between interventions, and as training ended. Skill retention, and transfer to a novel variation of the suturing task, were assessed after one week. Performance was scored on a five-point global rating scale by a blinded rater. The groups did not differ significantly on immediate posttest or retention test (F[1,30] = 0.96, P < 0.33). The Do then See group (N = 16) outperformed the See then Do group (N = 16) on the transfer test; 2.99 versus 2.52 (F[1,28] = 10.14, P < 0.004, η(2) = 0.27). Sequencing discovery learning before direct instruction appeared to improve transfer performance in simulation-based skills training. Implications for future research and curricular design are discussed.

The PASTA Bridge – A Repair Technique for Partial Articular-Sided Rotator Cuff Tears: A Biomechanical Evaluation of Construct Strength

Partial articular-sided supraspinatus tendon avulsion (PASTA) tears are a common clinical problem that can require surgical intervention to reduce patient symptoms. Currently, no consensus has been reached regarding the optimal repair technique. The PASTA Bridge technique was developed by the senior author to address these types of lesions. A controlled laboratory study was performed comparing the PASTA Bridge with a standard transtendon rotator cuff repair to confirm its biomechanical efficacy. A 50% articular-sided partial tear of the supraspinatus tendon was created on 6 matched pairs of fresh-frozen cadaveric shoulders. For each matched pair, 1 humerus received a PASTA Bridge repair, whereas the contralateral side received a repair using a single suture anchor with a horizontal mattress suture. The ultimate load, yield load, and stiffness were determined from the load-displacement results for each sample. Video tracking software was used to determine the cyclic displacement of each sample at the articular margin and the repair site. Strain at the margin and repair site was then calculated using this collected data. There were no significant differences between the 2 repairs in ultimate load (P = .577), strain at the repair site (P = .355), or strain at the margin (P = .801). No instance of failure was due to the PASTA Bridge construct itself. The results of this study have established that the PASTA Bridge is biomechanically equivalent to the transtendon repair technique. The PASTA Bridge is technically easy, percutaneous, reproducible, and is associated with fewer risks.

Comparative effect of turmeric (Curcuma longa) and durba (Cynodon dactylon) on the healing of surgical wounds in cattle (Bos indicus)

Herbal preparations are used traditionally in wound management to promote wound healing process. In Bangladesh, there are limited researches on the use of herbal products to assist healing process. Therefore, this experiment was carried out to exploit turmeric (Curcuma longa) and durba (Cynodon dactylon) pastes in the treatment of surgical wounds in cattle and to study their healing effect on wound sutured with horizontal mattress using nylon. A total of 36 surgical wounds were made in six cattle. Tincture benzoin was used as control group. Follow-up information was recorded from day 0 to day 21 postoperatively. Some morphological characters such as swelling area of wound, elevation of sutured line from the skin surface, width of sutured area and contraction length per week were recorded to determine the healing process of the wounds. Bacteriological and histopathological studies were also performed. All wounds were closely monitored to observe any complications such as swelling, wound dehiscence, suture abscess, local infection and exudation etc. Results showed that Tr. Benzoin seal caused marked tissue reaction in wounds in comparison to turmeric and durba paste. Turmeric paste showed splendid results in the healing of the wounds produced in cattle. Durba paste also has wound healing activity but less effective than that of turmeric. This study could help veterinarians to consider herbal products especially turmeric for healing of wounds with minimum complications. Dissemination of these findings among the farmers may prevent skin degradation caused by the postoperative complications of the wound and thus improve the health status of livestock.Asian J. Med. Biol. Res. June 2018, 4(2): 164-171

Feasibility and safety of arthroscopic medial glenohumeral ligament and subscapularis tendon repair with knotless anchors: A cadaveric study in dogs.

To test the feasibility and safety of an arthroscopic imbrication of the medial glenohumeral ligament (MGHL) and the subscapularis tendon with knotless anchors in dogs. Cadaveric study. Ten limbs. Cranial and caudal arms of the MGHL were imbricated with a 2.9- or a 2.4-mm knotless anchor. A horizontal mattress suture secured with a 3.5-mm knotless anchor was used to imbricate the subscapularis tendon. Computed tomography measurements included (1) the bone stock around the anchors, (2) the angle between the anchor and the joint surface (insertion angle), and (3) the angle formed by lines tangent to the cortices of the bones (safety angle). Limbs were dissected to assess the position of anchors. Safety and insertion angles and bone stock were compared among anchors with a Kruskal-Wallis test (P < .05). Surgical repairs were achieved in all limbs, with only 2 of 30 anchors incorrectly placed, both in the glenoid. The safety angle of the humeral anchor (HA; median, 89°) was greater than that of the cranial glenoid anchor (CrGA; P = .0017) and the caudal glenoid anchor (CdGA; P < .001). The insertion angle of the HA (median, 68°) was also greater than that of the other anchors (P < .001 and P = .001). The insertion angle of the CrGA (median, 26°) was greater (P = .0191) than that of the CdGA (median, 7°). All anchors were inserted at the MGHL and subscapularis footprint. Arthroscopic imbrication of MGHL and subscapularis tendon was feasible. HA were safer to place than glenoid anchors. The results of this feasibility study justify further evaluation of the indications and outcomes of this technique in dogs with shoulder instability.

Minimally invasive video-assisted rumenostomy in sheep

The aim of this study was to establish a minimally invasive rumenostomy technique in sheep. Five 8-month old male sheep underwent exploratory laparoscopy using two 10-mm portals. The trocars were inserted in the paralombar fossa of the animals using thee technique of Hasson. During the examination, the rumen was visualized and grasped with a babcock forceps then brought near to the second portal and, simultaneously, the abdomen was deflated. Using a scalpel blade, a puncture incision was made in the rumen, through which a Foley Catheter (5 mL, 2-Way, 18 Fr/Ch, 6.0 mm) was inserted. After the cuff was inflated, a purse-string suture was performed around the catheter, penetrating only the serous layer of the rumen. Then two cruciate sutures were applied for rumenopexy. Finally, the muscle layer was synthesized, followed by skin suture, with two horizontal mattress sutures lateral to the catheter. A single dose of 20 mg/kg of oxytetracycline was administered and, if necessary, rescue analgesia with 5 mg/kg of tramadol. Ruminal fluid was collected daily to test the viability of the catheter, and wound healing around the surgical wound was evaluated. Surgical time and trans-surgical complications were recorded and post-surgical pain was also assessed, using a behavioral scale. After 65 days, the animals were sent to the slaughterhouse where carcass analysis was performed, mainly observing the place where the Foley Catheter was placed. All animals presented satisfactory recovery, and no need for analgesia at any time. Throughout the entire period, there was no extravasation of rumenal fluid through the surgical wound, not even when the catheter was removed. This study shows that the minimally invasive technique of rumenostomy performed was efficient, with extremely advantageous results, both in the execution of the technique and well-being of the animals. It may be still very important for nutritional and digestibility studies, as well as for relapsing tympani therapy.