Quiz Question
In Bresciani 2022 et al., on modified urethrostomy outcomes, what was the reported outcome for voluntary urination post-surgery?
🔍 Key Findings
- Modified prepubic urethrostomy (mPPU) was effective for managing proximal urethral obstructions in male cats.
- All 8 cats regained voluntary urination within 24 hours postoperatively.
- Early urinary incontinence and peristomal dermatitis occurred in all cats but were self-limiting.
- Two cats (25%) required surgical revision due to stomal obstruction from weight gain and abdominal fat.
- No intraoperative complications were reported in any of the 8 cats.
- Follow-up (13–84 months) showed sustained urinary continence and owner satisfaction in all cases.
- The rectus abdominis muscle tunnel likely increased outflow resistance, minimizing persistent incontinence.
- Recurrent hematuria and dysuria occurred in 3 cats but were managed conservatively.
Veterinary Surgery
2
2022
Modified prepubic urethrostomy with body wall tunneling: Description of technique and long-term outcome in eight male cats
2022-2-VS-bresciani-3
In Duffy 2022 et al., on crotch suture techniques, why are two simple interrupted sutures (TCS) or SCCS considered superior to a single suture (SICS)?
🔍 Key Findings
- Augmenting FEESA with two simple interrupted crotch sutures (TCS) or simple continuous crotch suture (SCCS) significantly increased initial leakage pressure (ILP) compared to no suture or a single suture (NCS, SICS).
- SCCS had the highest ILP (47.6 mm Hg), followed by TCS (37.8 mm Hg), SICS (33.0 mm Hg), and NCS (27.1 mm Hg).
- All crotch suture types increased maximal leakage pressure (MLP) compared to no crotch suture.
- Leakage from the crotch occurred most commonly in NCS (67%) and SICS (50%), but only 8% with TCS and 0% with SCCS.
- SCCS was the only technique where leakage never occurred at the crotch site.
- SCCS had the highest MLP (100.6 mm Hg), supporting its use in clinical settings with high-risk patients.
- Intraluminal pressures during leakage in NCS constructs were sometimes below normal physiologic pressures, emphasizing risk of leakage without crotch suture.
- The transverse staple line never leaked in any group, indicating the crotch is the primary weak point.
Veterinary Surgery
4
2022
Influence of crotch suture augmentation on leakage pressure and leakage location during functional end-to-end stapled anastomoses in dogs
2022-4-VS-duffy-5
In Kalmukov 2022 et al., on cell salvage efficacy, what was a noted potential **benefit** of cell salvage over allogeneic transfusion in dogs?
🔍 Key Findings
- Direct suction salvaged more red blood cell mass (rbcM) than swab washing: 88.43% vs 84.74% (p = .015)
- Swab washing still achieved high recovery (84.74%), making it a viable adjunct when suction is not possible
- No significant difference in post-salvage PCV between methods (~34% for Su and ~33.9% for Sw)
- Total salvaged blood volume was significantly higher using direct suction (143 mL vs 139.8 mL; p < .001)
- Leukocytes are removed during salvage, potentially lowering risk of cytokine-mediated transfusion reactions
- Expired pRBCs were used, but device still achieved high RBC recovery, supporting clinical utility
- Swab washing via manual agitation may cause more RBC destruction than direct suction
- Cell salvage may avoid complications of allogeneic transfusions, like storage lesions and immunologic reactions
Veterinary Surgery
8
2022
Ex vivo evaluation of a novel cell salvage device to recover canine erythrocytes
2022-8-VS-kalmukov-5
In Wood 2024 et al., on knot security and locking throws, how did the failure mode differ between locking and non-locking constructs?
🔍 Key Findings
- Adding a single locking throw significantly increased holding security for specific knots, including the surgeon's throw (p = .0001) and square throw (p = .0002).
- For the Miller's throw (p = .166) and strangle throw (p = .808), no significant improvement was observed with a locking throw.
- After locking throw addition, all five knots leaked at similar pressures (p = .5233), and these pressures exceeded physiologic arterial pressures.
- Surgeon's throw without a locking throw had the lowest leak pressure (62.5 ± 46.2 mm Hg), below physiologic arterial values.
- The square throw without locking also leaked below physiologic pressures (148.7 ± 109.4 mm Hg), though it outperformed the surgeon's throw.
- Miller’s and strangle throws performed significantly better than square or surgeon’s throws without locking, achieving leak pressures >200 mm Hg.
- All knots used 2-0 polyglyconate monofilament (Maxon); no comparisons across suture types or sizes were performed.
- Authors concluded that correct tensioning and locking throw addition are key to safe vascular ligation. Miller’s, strangle, or slip knots are preferred for challenging surgical fields.
Veterinary Surgery
4
2024
Influence of a single locking throw on the in vitro holding security of five friction knots using two monofilament suture materials in a canine model
2024-4-VS-wood-2
In Ibrahim 2022 et al., on scrotal arterial supply, which artery was identified as the **dominant** source of scrotal perfusion in dogs?
🔍 Key Findings
- Dorsal scrotal arteries, branching from the ventral perineal arteries, are the dominant arterial supply to the scrotum in dogs.
- The ventral scrotal arteries, arising from the external pudendal arteries, perfused only the cranial scrotal border and were inconsistently present or absent in some dogs.
- A scrotal flap based on the dorsal scrotal arteries showed strong perfusion and may be a viable axial pattern flap.
- Perfusion was consistent across fresh and frozen cadavers, showing no difference due to preservation method.
- Poor flap survival (27%) occurred when based on cranial supply alone (i.e., ventral scrotal arteries), confirming importance of preserving caudal supply.
- There are anastomoses between dorsal and ventral scrotal arteries, offering collateral flow but insufficient alone for complete perfusion.
- Scrotal flaps based on the caudal pedicle may be applicable for reconstruction of proximal medial/lateral thigh wounds.
- Proposed flap requires careful preservation of ventral perineal arteries, ideally designed 2.5–3 cm lateral to midline in large dogs.
Veterinary Surgery
4
2022
Arterial supply to the scrotum: A cadaveric angiographic study
2022-4-VS-ibrahim-1
In Kalmukov 2022 et al., on cell salvage efficacy, what was the main advantage of swab washing during intraoperative blood salvage?
🔍 Key Findings
- Direct suction salvaged more red blood cell mass (rbcM) than swab washing: 88.43% vs 84.74% (p = .015)
- Swab washing still achieved high recovery (84.74%), making it a viable adjunct when suction is not possible
- No significant difference in post-salvage PCV between methods (~34% for Su and ~33.9% for Sw)
- Total salvaged blood volume was significantly higher using direct suction (143 mL vs 139.8 mL; p < .001)
- Leukocytes are removed during salvage, potentially lowering risk of cytokine-mediated transfusion reactions
- Expired pRBCs were used, but device still achieved high RBC recovery, supporting clinical utility
- Swab washing via manual agitation may cause more RBC destruction than direct suction
- Cell salvage may avoid complications of allogeneic transfusions, like storage lesions and immunologic reactions
Veterinary Surgery
8
2022
Ex vivo evaluation of a novel cell salvage device to recover canine erythrocytes
2022-8-VS-kalmukov-4
In Banse 2022 et al., on skill retention methods, what was the observed benefit of spaced instruction (SI) over massed instruction (MI) in veterinary students?
🔍 Key Findings
- Spaced instruction (SI) improved immediate performance on the first learned skill compared to massed instruction (MI) in both LSU and LMU cohorts.
- Cognitive load was higher in MI students at LMU, particularly in physical demand, effort, and frustration, while LSU showed no significant cognitive load differences.
- Skill performance differences disappeared after 2 weeks of supervised practice, regardless of instructional format.
- Time to complete skills improved over time, but this did not always correlate with improved checklist or global rating scores.
- Intrinsic cognitive load increased when teaching more complex or related surgical tasks in the same session.
- Initial skill complexity and prior exposure may influence effectiveness of spaced vs massed instruction.
- Supervised practice sessions are critical to eliminate initial skill disparities between instructional methods.
- Massed instruction may still be acceptable if followed by scheduled practice opportunities.
Veterinary Surgery
7
2022
Teaching veterinary surgical skills: Comparison of massed versus spaced instruction
2022-7-VS-banse-1
In Davies 2024 et al., on lymphaticovenous anastomosis, what is the proposed advantage of creating a TD to AV anastomosis over traditional TD ligation and cisterna chyli ablation?
🔍 Key Findings
- Lymphaticovenous anastomosis (TD to AV) was successfully performed in all 8 feline cadavers using a microvascular anastomotic coupler (MAC).
- Anastomotic patency was confirmed intraoperatively and postoperatively in 7/8 cats via contrast lymphography or retrograde venography.
- Dissection and anastomosis took a median of 120 minutes, with minimal technical complications.
- A 1.5 mm MAC was used in 6 cats, and a 2.0 mm in 2 cats; TD diameter ranged 1.0–1.5 mm, AV up to 2.25 mm.
- Challenges included vessel twisting and luminal patency issues, resolved intraoperatively with minor adjustments (e.g., repeat pinning, tacking suture).
- MAC use eliminated need for hand-suturing, lowering skill demands but requiring precise alignment.
- Technique provides direct lymphatic-to-venous drainage, potentially reducing the stimulus for collateral vessel formation.
- May serve as a future treatment option for feline idiopathic chylothorax, warranting further in vivo studies.
Veterinary Surgery
7
2024
Lymphaticovenous anastomosis of the caudal thoracic duct to the azygous vein: A feline cadaver study
2024-7-VS-davies-5
In Wood 2024 et al., on knot security and locking throws, what was the effect of a single locking throw on holding strength?
🔍 Key Findings
- Adding a single locking throw significantly increased holding security for specific knots, including the surgeon's throw (p = .0001) and square throw (p = .0002).
- For the Miller's throw (p = .166) and strangle throw (p = .808), no significant improvement was observed with a locking throw.
- After locking throw addition, all five knots leaked at similar pressures (p = .5233), and these pressures exceeded physiologic arterial pressures.
- Surgeon's throw without a locking throw had the lowest leak pressure (62.5 ± 46.2 mm Hg), below physiologic arterial values.
- The square throw without locking also leaked below physiologic pressures (148.7 ± 109.4 mm Hg), though it outperformed the surgeon's throw.
- Miller’s and strangle throws performed significantly better than square or surgeon’s throws without locking, achieving leak pressures >200 mm Hg.
- All knots used 2-0 polyglyconate monofilament (Maxon); no comparisons across suture types or sizes were performed.
- Authors concluded that correct tensioning and locking throw addition are key to safe vascular ligation. Miller’s, strangle, or slip knots are preferred for challenging surgical fields.
Veterinary Surgery
4
2024
Influence of a single locking throw on the in vitro holding security of five friction knots using two monofilament suture materials in a canine model
2024-4-VS-wood-3
In Logothetou 2024 et al., on SPF complications, which flap type had the lowest complication rate on univariable analysis?
🔍 Key Findings
- Complication rate for subdermal plexus flaps (SPFs) in dogs was 53.6%.
- Skin staples had a numerically higher complication rate (72.2%) than sutures (49.3%), but not statistically significant due to small sample size.
- Most common complication was wound dehiscence (35%), followed by seroma (14%) and wound discharge (14%).
- Increased body weight was significantly associated with higher complication risk (OR = 1.056 per kg; p = .029).
- Advancement flaps were associated with a lower incidence of complications on univariable analysis (p < .001).
- Head region flap closures had fewer complications, while proximal pelvic limb closures had the highest complication rate.
- Age was a risk factor—each additional year increased odds of complications (OR = 1.019; p = .004).
- Closure technique did not significantly influence complication severity, though staple use was numerically worse.
Veterinary Surgery
3
2024
Complications and influence of cutaneous closure technique on subdermal plexus flaps in 97 dogs (2006–2022)
2024-3-VS-logothetou-4
Quiz Results
You answered 7 out of 10 questions correctly
Key Findings