Quiz Question
In Gant 2025 et al., on skin prep and SSI, which two combinations were compared for their impact on SSI?
🔍 Key Findings
- No statistically significant difference in overall SSI rates: 9.2% (chlorhexidine) vs. 7.38% (iodophor) (p = .25).
- Significant drape lift occurred in 13.2% of cases; those with lift had 2.72× increased risk of SSI (p = .026).
- Increased body weight was a statistically significant risk factor for SSI (p = .008): each 1 kg increased SSI risk by 3%.
- Use of glutaraldehyde was associated with a 2.38× increased risk of SSI (p = .055, approaching significance).
- No difference in SSI rates based on surgeon training level or surgical classification (clean, clean-contaminated, contaminated).
Veterinary Surgery
3
2025
Influence of skin preparation on surgical site infection and lift of adhesive surgical drapes
2025-3-VS-gant-2
In Viljoen 2022 et al., on surgical hand prep protocols, which of the following statements is TRUE about CHX and BAC hand preparations?
🔍 Key Findings
- Pre-ABHR hand preparation lowered CFUs at 120 minutes post-gloving compared to ABHR alone (P = .001)
- pH-neutral soap followed by ABHR outperformed ABHR alone despite being nonmedicated (P = .001)
- CHX and BAC prewashes showed better immediate CFU reduction post-preparation than pHN (P = .012)
- No significant difference in total log10 CFU reduction across all four groups over the full surgical period (P = .362)
- Glove perforation in the thumb was a significant contamination factor (P = .036)
- All dogs recovered without surgical site infections, though SSI incidence was not a primary outcome
- Neutralizer validation lacking, so CHX results interpreted cautiously
- Study supports a 1-minute hand wash with pH-neutral soap prior to ABHR as effective and safe
Veterinary Surgery
3
2022
Comparative antimicrobial efficacy of 4 surgical hand‐preparation procedures prior to application of an alcohol-based hand rub in veterinary students
2022-3-VS-viljoen-2
In Canever 2022 et al., on labial flap vascular anatomy, which tissue layer was most critical to include to ensure arterial perfusion of the flap?
🔍 Key Findings
- Superior and inferior labial arteries in cats perfuse robust angiosomes, which support musculomucosal axial pattern flaps.
- Cadaver angiography confirmed vascular anatomy, with consistent patterns between sides and among specimens.
- The vascular supply is located primarily in the musculomucosal layer, not the skin, critical for flap viability.
- Flap harvest requires inclusion of the orbicularis oris (± buccinator) muscle to ensure vascular integrity and flap survival.
- Two clinical cases demonstrated successful use of superior and inferior labial musculomucosal flaps for palatal reconstruction with complete flap survival and resolution of clinical signs.
- Intraoperative transillumination aided vessel localization, facilitating surgical planning and flap design.
- No cases of distal flap necrosis or dehiscence occurred, although mild donor site morbidity (lip retraction, mucosal denuding) was noted.
- These flaps offer a valuable option when local tissues are compromised, especially after failed previous repairs or radiation therapy.
Veterinary Surgery
4
2022
Evaluation of the superior and inferior labial musculomucosal flaps in cats: An angiographic study and case series
2022-4-VS-canever-3
In Evers 2022 et al., on bone-to-tendon plate fixation, what fixation technique was used to secure the plate to the tendon?
🔍 Key Findings
- Bone-to-tendon plate fixation allowed successful stabilization of a highly comminuted calcaneus fracture in a dog with fragments too small for traditional fixation.
- The plate was sutured to the common calcaneal tendon using a figure-of-8 pattern, bypassing the need for screw fixation into small proximal fragments.
- Radiographic union was achieved by 17 weeks, though considered delayed, with the dog returning to normal function by 36 weeks post-op.
- A second surgery was required to replace the tendon-anchored plate with a calcaneus-only plate due to skin ulceration and implant prominence.
- Implant-associated infection was suspected; cultures confirmed Staphylococcus pseudintermedius, managed with doxycycline and clindamycin.
- Use of human placental matrix (hPM) and both autogenous and allogenic bone grafts supported healing, though their specific contribution remains uncertain.
- Postoperative complications included delayed union and skin ulceration, emphasizing challenges of implant design and soft tissue management.
- This is the first report of using a bone-to-tendon plate for a calcaneus fracture in dogs and demonstrates its potential in cases where traditional methods are not viable.
Veterinary Surgery
5
2022
Use of a bone‐to‐tendon plate to stabilize a comminuted calcaneus fracture in a dog
2022-5-VS-evers-4
In Ritson 2025 et al., on feline hilar lobectomy sealants, what was the **design benefit** of the double-shank (DS) titanium clip?
🔍 Key Findings
- No leakage occurred using pretied ligature loops (PLL) or double-shank (DS) titanium clips up to 40 cm H₂O airway pressure.
- 1/10 stapled lobes leaked at supraphysiologic pressure (40 cm H₂O), but this was not statistically significant (p = .33).
- All techniques sealed effectively under physiologic and supraphysiologic pressures in cadaveric feline lungs.
- PLL and DS clips required less working space than staplers, making them more practical for small thoracic cavities.
- DS titanium clips offer enhanced security due to dual shanks and tissue-gripping design, reducing clip slippage.
- Leak testing was cyclic and submerged, simulating physiologic ventilation and allowing robust evaluation.
- Stapling failure occurred along the staple line, highlighting risks of air leakage due to staple misalignment or poor hilar access.
- PLL and DS clips may be cost-effective and efficient alternatives for open or minimally invasive feline lung lobectomy.
Veterinary Surgery
7
2025
Ex vivo comparative evaluation of feline hilar lung lobectomy using linear stapler, pretied ligature loop, and double-shank titanium clips
2025-7-VS-ritson-3
In Chik 2024 et al., on cholangioscopy feasibility, what was the most distal biliary region consistently visualized using the 3.8 mm disposable flexible endoscope?
🔍 Key Findings
- Open transcholecystic cholangioscopy was feasible using a 3.8 mm disposable flexible endoscope in all 8 canine cadavers.
- Visualization was consistently achieved up to the junction of the hepatic ducts, common bile duct, and cystic duct.
- Advancement past the junction was limited by the endoscope diameter (3.8 mm) and anatomical flexure.
- The 1.9 mm flexible ureteroscope could visualize the entire biliary tree, including the major duodenal papilla, in a large dog (43.8 kg).
- Endoscopic tools (e.g., 3 Fr grasping forceps) could be passed through the working channel only after removing the irrigation line.
- Standard biopsy forceps were incompatible with the disposable endoscope's 1.2 mm working channel.
- Cadaver study showed no rupture, but clinical extrapolation is limited due to lack of diseased tissue.
- Disposable endoscope setup cost (~$6,100) was significantly lower than traditional endoscopy systems (~$75,000–100,000), improving accessibility.
Veterinary Surgery
7
2024
Feasibility of open cholangioscopy with disposable flexible endoscopes
2024-7-VS-chik-1
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, which knot had the poorest performance, especially without a locking throw?
🔍 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-5
In Duffy 2022 et al., on barbed suture oversew, which repair method demonstrated the **shortest completion time** during oversew of the transverse staple line?
🔍 Key Findings
- Oversewing the transverse staple line using barbed suture showed no difference in initial (ILP) or maximum leakage pressure (MLP) compared to monofilament suture (p = .439 and .644).
- Barbed suture repairs were ~18% faster (25 seconds faster; p < .001) than monofilament suture.
- No difference was found between unidirectional and bidirectional barbed sutures in leakage resistance or repair time (p = .697).
- Mean ILP and MLP were significantly higher in control jejunal segments (6.6x and 5.1x greater respectively; p < .001).
- Leakage consistently occurred at the crotch of the FEESA in all oversew groups (>80%), not the staple line.
- All oversewn techniques leaked at supraphysiologic pressures, indicating clinical safety against in vivo leakage.
- No leakage was observed from barbed suture holes, addressing concerns of tissue trauma due to barb design.
- The study supports barbed suture as a viable alternative to conventional monofilament suture for FEESA oversew in dogs.
Veterinary Surgery
5
2022
Influence of barbed suture oversew of the transverse staple line during functional end-to-end stapled anastomosis in a canine jejunal enterectomy model
2022-5-VS-duffy-1
In Tani 2022 et al., on FCU tendon reconstruction, what was the main reason for using a fascia lata autograft in Case 1?
🔍 Key Findings
- Fascia lata autograft reconstruction of the FCU tendon successfully treated carpal hyperextension in both dogs.
- Primary repair was not possible in one dog due to complete rupture; a fascia lata graft bridged the tendon gap.
- In the second case, elongated tendon was corrected and reinforced with fascia lata to prevent recurrence.
- Type I external skeletal fixation was used for 6 weeks to support tendon healing in both dogs.
- Postoperative gait and range of motion returned to normal, with no recurrence at 36-month follow-up.
- Ultrasonography aided diagnosis, revealing thinning and echogenic changes in the FCU tendon.
- Histologic findings showed mild, nonspecific muscle changes, suggesting injury rather than a systemic disease.
- No complications occurred, and fascia lata showed potential for biological integration and remodeling into tendon-like structure.
Veterinary Surgery
8
2022
Reconstruction of the flexor carpi ulnaris tendon with a fascia lata autograft in two dogs with carpal hyperextension
2022-8-VS-tani-1
Quiz Results
You answered 7 out of 10 questions correctly
Key Findings