Nylon Suture Research Articles

Full- versus partial-thickness sutures: experimental models of corneal injury repair.

To evaluate the performance of full-thickness (FT) versus partial-thickness (PT) sutures in a full-thickness corneal wound in an animal model. This is a prospective, experimental, comparative, longitudinal study. A 6-mm linear, full-thickness corneal incision was performed on the right eye of eight domestic pigs. Eyes were randomly assigned for repair with interrupted PT (80-90% depth) sutures or FT 10-0 nylon sutures. Anterior segment OCT, corneal pachymetry and clinical photographs were obtained 1, 4 and 8weeks postoperatively. Corneal thickness, depth of suture placement, perilesional edema, coaptation of wound edges and complications were noted. Histopathologic examination was performed at 8weeks. 100% of the eyes with FT sutures developed a linear, less opaque scar. 100% of the eyes with PT developed a dense, opaque stromal scar (p = 0.02). Vascularization of the cornea was present in 75% of PT group and 25% in the FT group (p = 0.50). As the corneas healed, there was a marked trend toward thicker corneas in the PT group versus FT group with a median difference of - 63µm at week 1 [median 788µm vs. 725µm, (p = 0.11)], - 38µm at week 4, (724µm vs. 686µm, (p = 0.63)) and - 47µm median difference at week 8 with (670µm vs. 623µm, (p = 0.06)). Histopathology showed disorganization of the collagen fibers and the formation of a retrocorneal fibrous membrane in the PT group. The FT group presented less corneal edema at week 8 with a more linear and less opaque scar. Histopathology showed a better-organized scar and endothelialization without the formation of a fibrous membrane.

SUTURELESS VERSUS SUTURED CONJUNCTIVAL AUTOGRAFT FOR SURGICAL TREATMENT OF PTERYGIUM

Background: Pterygium is a degenerative ocular surface disorder with wing-shaped fibrovascular growth of the subconjunctival tissue onto the cornea. Objectives: The purpose of this study was to compare the surgical outcomes of sutureless technique versus graft suturing technique for conjunctival autograft fixation following pterygium excision. Patients and Methods: This prospective interventional case study included 20 eyes with pterygium requiring surgical excision. Operated eyes were divided into 2 equal groups. group A, where the conjunctival auto graft was placed without using sutures and with placing a tight bandage for 24 hours after excision, and group B where the conjunctival auto graft was fixed by 8/0 nylon sutures. Results: The surgical time for group A was significantly less as compared to group B. Postoperative symptoms were seen in less number of patients and were of shorter duration in group A as compared to group B. Recurrence rate and conjunctival granuloma formation rate for group A and for group B were statistically insignificant. Visual acuity and astigmatism showed improvement in both group with no statistically significant difference between both divided groups. Conclusion: Suture-less and glue free limbal conjunctival autograft was safe, effective, economical, option for pterygium surgery.

Simple Approach for Internal Fixation of Repositioned Fat Pedicles in Transconjunctival Lower Eyelid Blepharoplasty.

To introduce an easy and effective approach for internal fixation of repositioned fat pedicles in transconjunctival lower eyelid blepharoplasty. Thirty-six consecutive patients underwent fat repositioning transconjunctival lower blepharoplasty from August 2016 to January 2018. After release of the orbicularis oculi muscle and exposure of the intraorbital fat pedicles, a supraperiosteal pocket was dissected. A 6-0 nylon suture was passed through the shaft of a hypodermic needle from the sharp tip, then the hypodermic needle was pierced through the cheek skin about 5 to 8 mm below the orbital rim into the dissected pocket, the hypodermic needle was next pull out and pierced through the same pinhole but different pathways into the dissection pocket again. The hypodermic needle was curved accordingly and passed through the lower surface tissue of the pocket, the needle was then taken out. Two ends of the 6-0 nylon suture were both brought out through the transconjunctival incison. One end of the 6-0 nylon suture was sewed through the free margin of the fat pedicle and tied tightly with the other end. The fat pads were transferred and blended well with midface fat. The severity of tear trough deformity were evaluated according to Barton's grading system by two independent plastic surgeons pre and post-operatively. Tear trough deformity was improved in most cases. There were significant differences in preoperative and post-operative tear trough deformity grades (P < 0.5). All patients recover very well without significant complications. Three patients had transient mild to moderate lumpiness over the tear trough area, which were all resolved spontaneously eventually. One patient complained of retained fat tissue, and a revision surgery was given. In summary, The authors offered a new, simple, and effective approach to help fix the repositioned fat pads in transconjunctival lower lid blepharoplasty.

Photographic assessment of postsurgical facial scars epidermally sutured with rapidly absorbable polyglactin 910 or nylon: A randomized clinical trial

Surgeonsuse absorbable and nonabsorbable sutures for epidermal wound closure. No large, randomized studies have compared the effect of these suture types on facial scar appearance. To assess postsurgical facial scar appearance using either rapidly absorbable polyglactin 910 or nylon for epidermal closure. Randomized, blinded, split-scar clinical trial. A total of 105 patients with facial wounds resulting from Mohs micrographic surgery excisions were randomly assigned for epidermal closure with rapidly absorbable 5-0 polyglactin 910 (Vicryl Rapide) on one half of the repair and 5-0 nylon (Ethilon) on the other half. Two physicians (1 dermatologist and 1 plastic surgeon), unaware of the original suture location, examined photographs of each healed wound at 6months after surgery and graded the appearance of each half of the scar using the visual analog scale, wound evaluation scale, and Stony Brook Scar Evaluation Scale. At 6months, there was no significant difference in the combined mean (standard deviation) visual analog scale scores (83.1 [14.2] and 83.0 [13.7]), Stony Brook Scar Evaluation Scale scores (4.3 [0.9] and 4.4 [0.9]), or wound evaluation scale scores (5.3 [1.1] and 5.2 [1.1]) for rapidly absorbable polyglactin 910 versus nylon (P=.72, .57, and .21, respectively). Single institution. Both rapidly absorbable polyglactin 910 and nylon sutures placed through the epidermis resulted in an equivalent photographic appearance of facial scars at 6months after surgery.

Percutaneous Tenodermodesis for Mallet Fingers: An Office-based Procedure.

Mallet fingers are injuries to the extensor tendon at the distal interphalangeal (DIP) joint and can present as a bony avulsion or as a soft tissue injury. Nonbony mallet fingers are frequently splinted in extension between 6 and 8 weeks. If splinted correctly, most results are good with a mean DIP joint extension lag between 5 and 10 degrees. However, decreased swelling, hygienic considerations and patient compliance can lead to splint removal and a less favorable outcome. We present a percutaneous tenodermodesis using only a digital block and a 4.0 nylon suture. This office-based procedure provides joint reduction and prevents joint movement during the immobilization period. The suture can be removed after 8 weeks, allowing active mobilization of the DIP joint. We present the results of 8 patients with a mean follow-up of 3 months and mean initial extension lag of 32 degrees, resulting in a mean final extension lag of 2 degrees and excellent outcomes using the Crawford criteria.

Ventriculoperitoneal Shunt without Hair Shaving Using Absorbable Suture Materials.

ObjectiveInfection is one of most devastating complications in ventriculoperitoneal (VP) shunt surgery. Preoperative hair removal has traditionally been performed to reduce infectious complications. We performed VP shunt surgeries and evaluated the prevalence of infection in patients who were shaved and those who were unshaven. MethodsA retrospective analysis was conducted of 82 patients with hydrocephalus of various pathologies who underwent VP shunt surgery, with or without having the head shaved, between March 2010 and March 2017. For patients in the non-shaved group (n=36), absorbable suture materials were used for wound closure, and Nylon sutures or staples were used in the shaved group (n=46). We evaluated the infection outcomes of patients in the two groups. ResultsThere was no difference in the average age of patients in the two groups. In the non-shaved group, there were no infections, while two patients in the shaved group required revision because of shunt infection. ConclusionNon-shaved shunt surgery may be safe and effective, with no increase of infection rate. We recommend that shunt procedures could be performed without shaving the hair, which may increase patients’ satisfaction without increasing infection risk.

Outcome of a low-cost glaucoma drainage device with posterior chamber/pars plana insertion of the tube.

The Aurolab aqueous drainage implant (AADI) is a low-cost glaucoma drainage device that is modelled on the Baerveldt glaucoma implant. Studies on AADI have reported absolute success rates of 41.8-93.1% at 1 year. Most studies report on tube placement in the anterior chamber. We report on results of tube insertion in the sulcus/pars plana. A retrospective chart review of all patients who had undergone AADI implantation (with insertion of tube in the sulcus/posterior segment) between June 2015 and November 2018 was done. Patients were asked to stop anti-glaucoma medications on the 40th post-operative day. The mean age was 57.4 ± 13.8 years (n = 30). The mean IOP prior to surgery was 34.4 ± 6.1 mmHg which reduced to 15.4 ± 8.6 mmHg on the 45th post-operative day (p < 0.001). The absolute success at last review was 10% and the qualified success was 80%. The complication rate was 26.7%. Three patients had hypotony related complications noted at/after the 45th day review (none before 40th day). The incidence of ocular motility disturbances was 26.7% though none of the patients reported diplopia. One patient had sideways rotation of the scleral patch graft resulting in tube exposure. This complication was not seen after we shifted to using 9-0 nylon sutures to anchor the graft. Six patients had loss of best corrected visual acuity and one patient developed endophthalmitis. The endophthalmitis was preceded by conjunctival retraction and sloughing off of the scleral patch graft. AADI implantation results in a substantial drop in IOP. However, many patients continue to require anti-glaucoma medications. Allowing overlap of scleral/corneal patch graft onto the scleral flap may be effective in preventing peritubular leak. It may be advisable to use 9-0 nylon sutures to secure the scleral patch graft anti-glaucoma medications can be temporarily suspended after the 40th post-operative day to minimize hypotony related complications. Melting of the scleral patch graft may be an early sign of endophthalmitis. It would be prudent to specifically look for ocular motility problems in patients undergoing AADI implantation.

Copper-Eluting Fibers for Enhanced Tissue Sealing and Repair.

Copper ions play an important role in several physiological processes, including angiogenesis, growth factor induction and extracellular matrix remodeling, that modulate wound healing and tissue repair. In this work, copper-loaded alginate fibers were generated and used as surgical sutures for repair of incisional wounds in live mice. Approximately 95% of initially loaded copper ions were released from the sutures within the first 24 h following an initial burst release. This localized delivery of copper at the incision site resulted in significantly higher recovery in tissue biomechanical strengths compared to conventional nylon and calcium alginate sutures at early times following surgery. Irradiation of copper alginate sutures with near-infrared light resulted in a robust photothermal response and led to efficacies similar to those seen with nonirradiated sutures. Histopathology and immunohistological analyses indicated significantly reduced epithelial gap and higher number of CD31+ cells, which is indicative of increased angiogenesis around the incision site. Delivery of copper ions did not result in toxicity under the conditions employed. Our findings demonstrate that delivery of ionic copper from sutures resulted in efficacious approximation and healing of incisional wounds, and copper-eluting fibers may have translational potential for accelerating repair in surgical and trauma wounds.

Ginkgo biloba and Its Constituent 6-hydroxykynurenic-acid as well as Its Proanthocyanidins Exert Neurorestorative Effects against Cerebral Ischemia.

Neuroprotective effects against cerebral ischemia/reperfusion (I/R) injury by Ginkgo biloba leaves are commonly attributed to the antioxidant activity of its proanthocyanidins. Furthermore, preliminary experiments identified 6-hydroxykynurenic acid (6-HKA) as a major contributor to this effect of extract of G. biloba leaves (EGb) prepared according to the Chinese Pharmacopoeia (ChP). In order to elucidate the specific contribution of both proanthocyanidins and 6-HKA to the overall neurorestorative effects of this extract according to ChP, EGb ChP was separated into pure 6-HKA and a newly developed Ginkgo proanthocyanidin extract (GPE), enriched in proanthocyanidins but not containing 6-HKA. Male Sprague-Dawley rats were divided into the groups: sham: 8; model (placebo): 25; GPE 80 mg/kg: 13; GPE 40 mg/kg: 13; GPE 20 mg/kg: 16; grape seed extract (negative control) 40 mg/kg: 18; nimodipine (positive control) 2 mg/kg: 8. All non-sham animals were subjected to cerebral I/R injury by occluding the middle cerebral artery with a nylon suture that was removed after 2 h of ischemia to establish reperfusion. For comparison, a parallel series of experiments were performed with 6-HKA. In these in vivo experiments, neurological dysfunctions were reduced by both GPE and 6-HKA, and both average infarct size and concentrations of malondialdehyde (MDA) and super oxide dismutase (SOD) were significantly ameliorated as compared to the model group. This data, therefore, demonstrates that the neuroprotective effects of EGb cannot be explained by a purely chemical antioxidative effect alone as has been previously proposed, especially with regards to the proanthocyanidins. A pharmacological neurorestorative effect of EGb on neurons and brain tissue itself seems to be a much more straightforward explanation for the presented observations. This effect is most likely explained by the synergistic action of both its numerous phenolic constituents (GPE) and 6-hydroxykynurenic acid (6-HKA), which could be identified as onemajor contributor to the observed activity.

Spontaneous Corneal Perforation

A male patient, 59 years of age, who had undergone a pterygium operation 45 days ago in another center, applied to our clinics for itching and burning complaints. The patient was examined and thinning of the cornea at the perilimbal region and intense hyperemia, inflammation and scarred tissue in the nasal conjunctiva were observed. Additionally, the patient had chronic dacryocystitis. Firstly, an external dacryocystorhinostomy (DSR) operation was applied. Three days after the operation, corneal perforation and iris prolapse occurred. An autograft, including conjunctiva, limbus and neighbouring corneal tissue with lamellar excision from the superior region of the same eye, was taken. With the help of 10/0 monofilament nylon sutures, the autograft was implanted. In the postoperative period, the patient’s cataract, which was present before the operation, progressed. In the postoperative 6th month, a cataract operation was performed. By the postoperative 7th month, the patient’s visual acuity was 0.00 logMAR and the perforation region had recovered completely.

Reconstruction and repair of atraumatic extensor tendon ruptures in rheumatoid wrists: Less extension lag after direct repair than interposition tendon grafting

The purpose of this study was to investigate the outcomes of extensor tendon repair involving the original stump in atraumatic extensor tendon rupture of rheumatoid wrists. For this study, 16 cases were reviewed involving 14 patients with rheumatoid arthritis. A total of 52 ruptured tendons impacted 36 fingers; 51 tendons were repaired in 35 fingers. The ruptured tendon stumps were repaired either directly by end-to-end suture or by free interposition tendon graft. The 8- to 10-strand core suture method was used for direct repair with a looped 4-0 nylon suture. In all patients, the extensor retinaculum was released and repaired under the tendons. Postoperatively, a volar splint with the wrist and fingers extended was applied for 3 to 4 weeks, followed by a removable splint and gentle active flexion until 6 weeks. The mean follow-up period was 32 months. All fingers recovered active metacarpophalangeal (MCP) joint extension, including independent and active extension of the little finger. Overall, the mean extension lag at the MCP joint was 1.7°. The mean fingertip-to-palm distance with the MCP joint flexed was 0.24mm. The mean extension lag at the MCP joint was significantly greater after interposition tendon grafting (3.2°) than after direct repair (0°). There was no significant difference in the mean fingertip-to-palm distance between direct repair (0.38mm) and interposition tendon grafting (0.13mm). No re-rupture or additional extensor tendon rupture was observed. Repair of the original extensor tendon stump yields satisfactory outcomes and appears to be a viable alternative to tendon transfers in patients with rheumatoid wrists with atraumatic extensor tendon ruptures. Direct repair reduces postoperative extension lag without a significant difference in flexion deficit when compared with interposition tendon grafting.

Global Health Microsurgery Training With Cell Phones.

Lack of surgical care for trauma, burns, congenital anomalies, and other surgical diseases is a growing portion of global disability and death accounting for 30% of the global disease burden. Global surgical and anesthesia care aim to achieve excellence and equality of clinical care through leadership, innovation, teaching, research, and advocacy. Stanford University Division of Plastic Surgery faculty partnered with ReSurge International to teach reconstructive microsurgery in low- and middle-income countries. Global surgery teaching and training are challenged by limited resources. Surgical loupes and operating microscopes used to perform complex microsurgery magnify the surgical field are very expensive. Our goal was to identify low-cost alternatives to teach and practice microsurgery suturing. Use cell phone camera with zoom capacity to teach and practice microsurgery suturing. Cell phones with zoom feature are widely available even in low- and middle-income countries. A cell phone was placed on a stand over a microsurgery practice station. The camera was used to zoom and focus on the suturing station to mimic a surgical field with loupes or microscope magnification. Nine attending surgeons and 7 residents practiced microsurgery with microsurgical instruments and 9-0 nylon suture under the magnification of a cell phone camera. The Stanford Microsurgery and Resident Training Scale was used to track their progress. A feedback survey was given to the participants to identify the usefulness of the cell phone setup for microsurgery suture practice. Global surgery teaching and training face many challenges especially limited resources. Identifying low-cost alternative is crucial. Cell phone camera with zoom is a low-cost alternative to loupes or operating microscope for microsurgical teaching and training.

Assessment of Lymphovenous Anastomosis Patency: Technical Highlights.

Assessment of Lymphovenous Anastomosis Patency: Technical Highlights.

Trocar-assisted, flanged sutureless scleral-fixated intraocular lens implantation combined with silicone oil injection after penetrating keratoplasty surgery.

We describe a combined technique of trocar-assisted sutureless scleral-fixated intraocular lens implantation and silicone oil injection at the same session. Two 3 mm scleral tunnels were created 2 mm away from and parallel to the limbus with the 23-gauge vitrectomy trocars entering the sclera transconjunctivally at an angle of approximately 10° at the 3 o’clock and 9 o’clock meridians. After the 3-piece foldable IOL was delivered to the anterior chamber through the corneal incision, the tip of one of the IOL haptics was grasped with a 23-gauge serrated retinal forceps entered through the trocar located at the 3 o’clock meridian. Then the haptic was removed from the scleral tunnel together with the trocar out of the globe. The same procedure was applied to the other haptic. A transconjunctival secure 10-0 nylon suture was placed at the scleral tunnel entry site around the haptic. The ends of the haptics were cauterized to make a flange. The resultant flanges of the haptics were pushed back and fixed into the scleral tunnels. Perfluorooctane was taken out of the eye with vitreoretinal surgery and the silicone was injected into the eye to prevent hypotonia. No complications were seen intraoperatively or postoperatively. After 1-month follow-up period, IOL was seen stabilized.

The clinical outcome of three procedures for extraarticular stabilization of cranial cruciate ligament injuries in dogs

The objective of this study was to evaluate the long-term outcomes in dogs with cranial cruciate ligament injury in which the stifle was stabilized with lateral suture stabilization, lateral suture stabilization-modified, or Securos lateral bone anchor tibial suture and monofilament nylon sutures placed at quasi-isometric points of the stifle. It is a retrospective study comprising a sample population of 49 client-owned dogs. Medical records from 2014?2016 were reviewed to identify dogs that had a cranial cruciate ligament rupture in which the stifle was stabilized using one of the aforementioned methods. The overall complication rate was 16.3% and the documented complication rate requiring implant removal was 0%. Owners reported full or acceptable function in 96% of cases. There were no significant statistical differences between the 3 techniques. Stabilization of cranial cruciate ligament-deficient stifles in dogs with lateral suture stabilization, lateral suture stabilization-modified, or Securos lateral bone anchor tibial suture is reliable with acceptable complication rates. The 3 procedures tested may be appropriate in medium-sized nonathletic dogs whose owners have limited budgets.

ADVERSE EVENTS OF THE ARGUS II RETINAL PROSTHESIS: Incidence, Causes, and Best Practices for Managing and Preventing Conjunctival Erosion.

To analyze and provide an overview of the incidence, management, and prevention of conjunctival erosion in Argus II clinical trial subjects and postapproval patients. This retrospective analysis followed the results of 274 patients treated with the Argus II Retinal Prosthesis System between June 2007 and November 2017, including 30 subjects from the US and European clinical trials, and 244 patients in the postapproval phase. Results were gathered for incidence of a serious adverse event, incidence of conjunctival erosion, occurrence sites, rates of erosion, and erosion timing. Overall, 60% of subjects in the clinical trial subjects versus 83% of patients in the postapproval phase did not experience device- or surgery-related serious adverse events. In the postapproval phase, conjunctival erosion had an incidence rate of 6.2% over 5 years and 11 months. In 55% of conjunctival erosion cases, erosion occurred in the inferotemporal quadrant, 25% in the superotemporal quadrant, and 20% in both. Sixty percent of the erosion events occurred in the first 15 months after implantation, and 85% within the first 2.5 years. Reducing occurrence of conjunctival erosion in patients with the Argus II Retinal Prosthesis requires identification and minimization of risk factors before and during implantation. Implementing inverted sutures at the implant tabs, use of graft material at these locations as well as Mersilene rather than nylon sutures, and accurate Tenon's and conjunctiva closure are recommended for consideration in all patients.

Anal Atresia and Structural Malformations of the Perineum and Anus in a Mare

Background: Anal atresia is a congenital defect and is related to the flaw of an opening in the membrane that separates the endoderm of the posterior intestine from the ectodermic anal membrane. This anomaly can cause debilitating disease, death, or abnormal development of the animal. Clinical presentation of urethrorectal fistula in domestic animals differs between males and females, as in the former there is passage of the urine through the anus, whereas in females there is elimination of the feces through the vulva. The absence of description of this disease in horses stimulated describing a case of surgical resolution of anal atresia, rectal bulb agenesis, and pneumovagina of an adult mare.Case: Mare with a history of defecating through the vagina. In the anamnesis, it was determined that the owner noticed the problem after observing the animal during a walk. Clinical examination verified absence of the anus with stool evacuation through the vagina, pneumovagina, and signs of cystitis, as the animal frequently urinated small volumes. Complementary laboratory tests of blood and urine were carried out for the diagnosis of cystitis, serum biochemistry, hemogram, and urinalysis being evaluated. The operation was scheduled for eight days after clinical tests and sodium ceftiofur was prescribed, at a dose of 4.4 mg/kg, administered intramuscularly for seven days. On the date chosen for surgical intervention, the animal was fasted for the previous 12 h; procedures began with the containment of the animal in a stock, followed by pre-anesthesia with detomidine, at a dose of 20 µg/kg, administered intravenously in solution at 1%. Anesthesia was a low peridural with 2% lidocaine at a total dose of 15 mL, to be able to work in the quadruped position. After containment of the tail and taking antiseptic and aseptic care, sutures were made in the skin and vaginal mucous, as it exhibited a solution of continuity. In the mucous, suture consisted of separate simple stitches made with perforation needle and 2-0 polyglactin 910 suture, while in the skin Wolff stitches were applied using a blade needle and 2-0 nylon suture. Then, a circular incision was made in the skin in the anus region to remove local skin; this revealed the rectum which, being it far from the required location, was pulled to the new opening. The rectum was fixed to the skin by suture: four simple stiches, with a perforation needle and zero nylon suture, to serve as repairs, followed by simple stitches between the repairs, with the same type of suture. Regarding the pneumovagina, reconstruction of the perineum and application of modified Calisck surgical technique were performed to correct the vulva defect. In the post-operative phase, 4.4 mg/kg of sodium ceftiofur was administered intramuscularly for seven days, and Flunixin Meglumine, at a dose of 1.1 mg/ml for every 50 kg of body weight, was administered intravenously for four days. Furthermore, rectal enemas (3 L of warm aqueous solution associated with glycerin) were administered every eight hours for 14 consecutive days, and the wound was cleaned with 2% chlorhexidine degerming solution. The skin sutures were removed after 15 days and the animal was discharged.Discussion: Alteration of the digestive tract in horses presents nuances in genetic dependence, embryology, and congenital defects, among others. Regarding the possibility of surgical correction, it is necessary to observe the characteristics of the lesion, the handling to which the animal is subjected, care of the surgical wound, and physical conditions where surgical procedures are carried out. The results obtained with this intervention and pre-, trans-, and post-operative care were effective in reestablishing the patient.

Craniosquise with Meningocelis in Newborn Calf

Background: Cranioschisis is a malformation that occurs during embryological development and results in incomplete closure of the skull, leaving an opening through which the intracranial tissue can project. Meningocele consists of herniation of the meninges containing cerebrospinal fluid through the cranial defect. In cattle, this association usually manifested by the appearance of a floating saccular protrusion of variable size and volume in the frontal or parietal region of the cranium. This manuscript aims to report a case of cranioschisis associated with meningocele and neurological deficit in a newborn calf in the northwestern region of the state of Paraná.Case: A 2-day-old crossbred female calf was diagnosed with cranioschisis associated with meningocele in the frontal region of the head. On initial clinical examination, an ovoid mass with floating appearance was observed, extending from the supraorbital curvature of the frontal bone to the end of the nasal bones following the midline. The patient had normal parameters for the species and age and a positive sucking reflex. Neurological examination showed permanent lateral decubitus position, spastic paresis of the thoracic limbs and opisthotonus. Complementary imaging studies, including x-rays and ultrasonography, showed a failure in the frontal bone, approximately 5 cm in diameter. Despite the unfavorable prognosis, surgical reduction was chosen. After drainage of the cerebrospinal fluid, excision of the meningeal sac was continuously performed, exposing the subarachnoid space, showing circular failure in the frontal bone with a diameter of 4.5 cm, making it possible to observe part of the right frontal lobe. We opted for occlusion of the bone defect by covering it with the dura mater. Absorbable 0 catgut suture was applied in a simple continuous pattern for coaptation of the meningeal edges. The technique used proved to be viable, but due to lack of therapeutic response and maintenance of the neurological picture, the animal was euthanized three days after surgery.Discussion: The clinical signs of meningocele are generally observed in newborn calves, and the pathology is not reported in aborted animals, which explains the fact that all cases reported in the literature are of calves born at term. Treatment success is variable. In general, it depends on the absence of neurological symptoms, which are invariably linked to morphological alterations in nervous tissue. Thus, animals with neurological symptoms have poor prognosis and may even die spontaneously. In some cases surgical reduction without the use of grafts, as in this report, was successfully performed. The authors reported covering a 7-cm circular gap in the frontal bone thought coaptation of the meningeal edges using a simple continuous pattern of nylon suture, followed by dehorning. In this case, the animal showed no neurological abnormalities and had a good prognosis. We conclude that the surgical treatment of cranioschisis associated with meningocele in bovine species presented in this report had an unfavorable prognosis. As observed in other cases, when the animals have neurological symptoms the prognosis is bleak, probably due to morphological and functional changes of congenital origin in the nervous tissue, as described in the literature. More case studies are needed to elucidate the etiology and pathogenesis of this disorder in bovines, since the cases described in the literature are not associated with the most commonly reported causes, such as the ingestion of certain plants.

Coxofemoral Joint Luxation in Dogs Treated with Toggle Rod Stabilization: A Multi-Institutional Retrospective Review with Client Survey.

Coxofemoral luxation is the most common type of joint luxation observed clinically in dogs. This retrospective study determines the complications and outcomes of open reduction and internal fixation of coxofemoral luxations using a toggle rod stabilization in 58 dogs. The purpose of the study was to compare the results with previous studies to ascertain commonalities and differences. A majority of the canine luxations were stabilized using a 4.0 or 3.2 mm commercial toggle rod and either one or two strands of OrthoFiber, FiberWire, or monofilament nylon suture. Postoperative complications developed in 25 of the 58 (43%) dogs, with major complications in 9 cases (15.5%). The most common major complication was reluxation, which occurred in 6 dogs (10%). Five of the 6 cases of reluxation received monofilament suture, although there was not a statistically significant relationship between suture type and reluxation. Owner responses to a questionnaire reported good to excellent results for satisfaction with the procedure in 90% of cases. Results of the present study suggest that toggle rod stabilization remains an effective method for the treatment of coxofemoral joint luxation in dogs.

Comparative Evaluation of Three Skin Closure Materials- A Microbiological Pilot Study

Introduction: The goal of a skin closure technique is to precisely approximate the wound edges without tension for sufficient time, to allow healing to take place. The presence of a suture in surgical wounds has been found to increase the tissue’s susceptibility to infection. Increased microbial colonisation in a particular area results in higher risk of infection. There are limited studies investigating the presence and the type of microbial colonisation with respect to different skin closure techniques, especially metal staples. Aim: To compare and analyse microbial colonisation and wound complications in association with the use of surgical staples, nylon and polypropylene suture material; and to compare and analyse the incidence of wound complications in association with these three materials. Materials and Methods: A cross-sectional study was conducted on 60 patients, of which 20 underwent closure by prolene, 20 by nylon and 20 by metal staples. The prolene sutures, nylon sutures and staples were removed on 8th to 14th day postoperatively. The removed suture fragments and the staples were inoculated aerobically in suitable culture media according to the standard methodology to look for microbial growth. The results were derived using repeated measures ANOVA and Chi-square test. Results: A total of 70% of the patients from prolene group were found to have bacterial growth on microbial colonisation, whereas 30% did not show any growth. In the nylon group, 50% of the patients demonstrated bacterial growth whereas the rest of the 50% showed no growth. In the staples group 95% of the patients did not show any bacterial growth on culture media and only 5% showed positive bacterial growth. All of these differences were highly statistically significant (p&lt;0.001). The most common colonising bacteria was Staphylococcus aureus followed by Klebsiella spp followed by Pseudomonas aeruginosa. Conclusion: The findings of this study suggested that prolene was most prone to bacterial colonisation followed by nylon and staples. The most common micro-organisms found were Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella spp.