Objective-To compare functional indices of end-to-end (EEA) jejunojejunal anastomosis using skin staples in horses with a 2-layer inverting hand-sewn technique. Study Design-Experimental study. Sample Population-Jejunal segments from 8 fresh equine cadavers. Methods-For each bowel segment, 2 EEA anastomoses were created: one 2-layer hand-sewn and one 1-layer using skin staples. Time for anastomosis creation was recorded and compared. Lumen diameter of each anastomosis was measured on digital radiographs after intraluminal instillation of contrast medium and inflation of the jejunal segments to 14 mm Hg. Anastomotic indices (a compensated measure of stoma diameter) and bursting pressure were determined. Results-EEA jejunal anastomosis using skin staples was significantly faster than use of a 2-layer hand-sewn technique. Anastomotic index, a measure of lumen size, was significantly larger with the skin-staple technique; however, the bursting pressure of stapled anastomoses was significantly less than for the hand-sewn technique, but the values were well above those reported for other anastomotic techniques. Conclusions-An anastomotic technique using skin staples was easy to learn and perform, effective and faster, and mechanically comparable with a hand-sewn 2-layer technique. Clinical Relevance-The staple technique could be beneficial in equine gastrointestinal surgery by reducing anastomosis time, although further in vivo studies are needed to establish clinical safety. r

Objective To compare 4 techniques for pelvic flexure enterotomy closure in horses. Study Design Ex‐vivo study. Sample Population Cadaveric ascending colon specimens (n = 48 horses). Methods Pelvic flexure enterotomies of different lengths (5 cm, 10 cm) were performed and closed with 1 of 4 techniques: handsewn 2 layer (HS2); handsewn 1 layer (HS1); skin staples (SKS); or TA90 stapling device (TA90). Time to close each enterotomy, bursting pressure, luminal reduction, and cost were calculated and compared. Results HS2 was significantly more time consuming to perform in the 5 cm group whereas in the 10 cm group, only the HS1 and SKS were faster than the other techniques. Luminal reduction was not different between techniques in either group. HS2 resulted in consistently higher bursting pressure compared with SKS and TA90 in the 5 cm group and compared to all other techniques in the 10 cm group. Conclusion The TA90 technique had the lowest bursting pressure and highest cost. The HS2 technique was strongest.

BackgroundHoney, alone or in combination, has been used for wound healing since ancient times and has reemerged as a topic of interest in the last decade. Pectin has recently been investigated for its use in various biomedical applications such as drug delivery, skin protection, and scaffolding for cells. The aim of the present study was to develop and evaluate a pectin-honey hydrogel (PHH) as a wound healing membrane and to compare this dressing to liquid honey.MethodsThirty-six adult male Sprague-Dawley rats were anesthetized and a 2 × 2 cm excisional wound was created on the dorsum. Animals were randomly assigned to four groups (PHH, LH, Pec, and C): in the PHH group, the pectin-honey hydrogel was applied under a bandage on the wound; in the LH group, liquid Manuka honey was applied; in the Pec group, pectin hydrogel was applied (Pec); and in the C group, only bandage was applied to the wound. Images of the wound were taken at defined time points, and the wound area reduction rate was calculated and compared between groups.ResultsThe wound area reduction rate was faster in the PHH, LH, and Pec groups compared to the control group and was significantly faster in the PHH group. Surprisingly, the Pec group exhibited faster wound healing than the LH group, but this effect was not statistically significant.ConclusionThis is the first study using pectin in combination with honey to produce biomedical hydrogels for wound treatment. The results indicate that the use of PHH is effective for promoting and accelerating wound healing.

A closed, 1-layer inverting technique could be considered for equine jejunal anastomosis but requires in vivo evaluation before recommendation for clinical use.

Objective: To report a technique for semiclosed 1-layer side-to-side jejunocecal anastomosis in horses. Study Design: Experimental study and clinical reports. Sample Population: Part 1-In vitro: Intestinal specimens from 24 horses collected immediately after death at an abattoir. Part 2-Clinical cases: 10 horses with clinical signs of colic requiring jejunocecostomy. Methods: Mean time to perform twelve 2-layer handsewn (HS2L) and 12 semiclosed 1-layer modified handsewn (SC) jejunocecal anastomoses was compared. Mean bursting pressures of anastomoses measured with a modified tank inflation test were compared. The SC technique was used in 10 horses that required jejunocecal anastomosis with and without resection (complete or incomplete ileocecal bypass). Results: The SC technique was significantly quicker to perform than HS2L technique. Clinically, the technique appeared safe with a major complication, associated with obstruction from kinking of the anastomosis, occurring in 1 horse. Conclusions: The SC technique was easy to perform with very little mucosal exposure in comparison to the HS2L technique, and was safe and effective in restoring intestinal continuity in clinical cases. Clinical Relevance: The SC technique should be considered for jejunocecostomy in horses because it reduces anastomosis time and mucosal exposure compared with other techniques.Handsewn and stapled jejunocecostomy techniques have been evaluated 1 for incomplete cecal bypass or jejunocecal or ileocecal anastomosis and until recently were considered better for establishing intestinal continuity after partial ileal resection than ileoileal or jejunoileal anastomosis.2 Handsewn techniques have been described for side-to-side and end-to-side anastomosis, 3 whereas intestinal staplers have be used for side-to-side jejuno(ileo)cecostomy. 3Stapled techniques are associated with less bowel manipulation and contamination, and decreased surgical time if staple lines are not oversewn. In some cases stapled anastomoses carry a higher risk of complications, like adhesions, stricture formation, hemorrhage, and leakage. Our purpose is to describe a technique for jejunocecal side-to-side anastomosis with minimal mucosal exposure, bowel manipulation, and reduced surgical time. We compared functional characteristics of this technique with those of a handsewn 2-layer (HS2L) jejunocecal anastomosis. To test this we constructed jejunocecal anastomosis in fresh intestinal segments and measured construction time, bursting pressure and evaluated failure mode. The technique was then evaluated in 10 horses that required jejunocecal anastomosis. MATERIAL AND METHODS Part 1-In vitro StudyIntestinal specimens consisting of distal jejunum, ileum, ileocecal valve, and cecum from 24 horses were collected at an abattoir, washed, and transported at room temperature in lactated Ringer solution (LRS).4,5 Twelve segments were used to create a 2-layer inverting jejunocecal anastomoses and 12 to create semiclosed 1-layer inverting jejunocecal anastomoses. All anastomoses were...

The giant and transfixing knot techniques have comparable haemostatic capability and parietal tunic tensile strength, but the giant knot requires less suture material. In open castration, using the emasculator alone may produce adequate haemostasis. In closed castration, using the giant knot in combination with the emasculator increases the bursting pressure and possibly reduces the incidence of haemorrhage. In closed castration, application of a ligature may reduce the risk of evisceration.

BackgroundThe use of autologous platelet-rich plasma (PRP) and plasma rich in growth factors (PRGF) has been proposed for the treatment of several acute and chronic syndromes, such as corneal epithelial defects and dry eye syndrome, gum bleeding during oral surgery, and in orthopaedic surgery. We hypothesized that PRGF, rather than PRP, could be more effective because of its intrinsic characteristics in promoting the healing of intestinal anastomosis. The purpose of the present study was to evaluate and compare the effects of PRP and PRGF on various parameters of anastomotic healing in a swine model.MethodsEight female pigs were randomly assigned to two groups and subjected to hand sewn jeujuno-jejunal appositional extramucosal anastomoses. For each animal, a total of six anastomoses were performed: two were considered controls and received no treatment, while the remaining four anastomoses were treated with PRP or PRGF of which both were prepared at a platelet concentration that was respectively 3.4-fold and 2.81-fold higher than the original platelet count. In each animal, either PRP or PRGF was used as a treatment, to avoid interference among products. Animals were euthanized after 8 days and the anastomoses were evaluated and compared for the presence of adhesions, anastomotic leakage, bursting pressure, and histological appearance.ResultsThe concentration of platelets in PRP was 3.41-fold higher (range, 3.20–4.24) that the concentration in whole blood, while the concentration in PRGF was 2.81-fold higher (range, 2.89–4.88).The results obtained from the present study highlighted that there are no differences between anastomotic samples treated with either PRP or PRGF preparations, except for a significant increase in epithelization of the intestinal mucosa at the anastomotic site in the PRGF group.ConclusionsBoth PRP and PRGF suspensions should be considered a safe strategy and represent a relatively low-cost technology that is flexible enough to be applied in several therapeutic fields. No true benefit could be proven in our study compared to the no treatment following anastomoses formation, with the exception of enhanced epithelization of the mucosa in the PRGF group.Electronic supplementary materialThe online version of this article (doi:10.1186/s12917-017-1102-8) contains supplementary material, which is available to authorized users.

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