Adolfo Maria Tambella

Autologous Platelet Gel to Treat Chronic Decubital Ulcers: A Randomized, Blind Controlled Clinical Trial in Dogs

OBJECTIVE To determine the efficacy of topical application of the autologous platelet gel (PG) in canine chronic protracted decubital ulcers. STUDY DESIGN Prospective, randomized, blind controlled clinical trial. ANIMALS Dogs (n = 18) with bilateral chronic wounds caused by protracted decubitus ulcers. METHODS For each dog, wound side was randomized to receive either platelet gel (group PG) every 5 days for 5 dressing changes, or paraffin gauzes dressings (group C), as negative control. Wound healing and wound surfaces were compared at admission and then evaluated every 5th day, until day 25. Outcome variables were: open wound area, reduction of open wound surface compared to admission and to each preceding dressing change, time to complete epithelialization. RESULTS Significant differences in healing process were observed at day 5 and continued throughout the entire study period (P < .00001). At 25 days, mean percent reduction in wound area was 93.5% in group PG and 13.2% in group C (P < .00001). CONCLUSIONS Appropriately prepared autologous PG, an inexpensive, readily available blood derivative, applied topically results in more rapid healing of chronic non-healing decubital ulcers in dogs than those treated by use of paraffin-impregnated gauzes.

Use of autologous platelet-rich plasma for a delayed consolidation of a tibial fracture in a young donkey

A 9-month-old filly donkey was referred for a comminuted diaphyseal fracture of the right tibia. Surgical osteosynthesis, with multiple lag screws and a neutralization plate, was performed for anatomical reconstruction. Despite a good gait condition, delayed bone consolidation and a bone gap were evident on follow up radiographic evaluations. Due to delayed healing, autologous platelet-rich plasma (PRP) was injected on the surface of the tibia. Increased bone consolidation was evident on radiographs one month after the PRP injection. Progressive filling of both the fracture lines and bone gap continued during the six-month follow up. Clinical outcome was excellent. Autologous PRP should be considered as a practical adjuvant therapy in bone healing process in donkeys.

Platelet-rich plasma to treat experimentally-induced skin wounds in animals: A systematic review and meta-analysis

The objective of the study was to review current literature to determine whether the topical application of platelet-rich plasma (PRP) promotes healing in experimentally-induced full-thickness skin wounds in animals. The hypothesis was that the adjunct of PRP has a positive effect on wound healing. An electronic search was carried out on the following databases: Web of Science, Cochrane Library, PubMed, Research Gate, Cochrane Wounds Group, Veterinary Information Network. No publication date nor language restrictions were applied. Randomised and not randomised controlled clinical trials comparing PRP with placebo or with other treatments were included. The reduction of open wound area in PRP-treated (test) wounds compared to control wounds was the primary outcome. Secondary outcomes were healing time and number of healed cases in test group compared to control. The following effect sizes were calculated: the Hedges’ g for continuous variables; the odds ratio for binary data. Eighteen controlled clinical trials were included in the qualitative and quantitative synthesis, with a total of 661 wounds. All studies were published in the period 2007–2016. Eight studies were carried out on rodent/lagomorph mammals and 10 on non-rodent/lagomorph mammals. In all included studies, control wounds underwent placebo or were left untreated. The PRP group showed a better healing performance than the control group in each outcome. The effect size was statistically significant considering the primary outcome and the overall aggregation of the three outcomes. The effect size, although in favour of the treatment with PRP, was not significant considering the healing time and the number of healings. The overall heterogeneity was mild or moderate. Five studies reported a high risk of selection bias. The publication bias was always mild or absent. The results support the hypothesis of the positive effects of the PRP when compared to control groups in the treatment of experimentally-induced full-thickness skin wounds in animals. PRP can therefore be considered an effective adjunctive therapy in stimulating second intention healing of acute wounds in healthy animals.

Innovative, intra-articular, prosthetic technique for cranial cruciate ligament reconstruction in dogs: a cadaveric study

The purpose of this study was to describe and assess the feasibility of a new intra-articular approach in the treatment of cranial cruciate ligament deficiency in dogs using an artificial ligament and a new bone-anchor system. Twelve canine cadavers weighting 26 to 45 kg were used in this ex-vivo study. Special tibial and femoral screws, two helicoils, and a high resistance artificial fiber compose the implant. Surgery was performed using the cranio-lateral approach to the stifle joint. Helicoil and tibial screw, connected to the fiber, were inserted in the center of the tibial insertion area of the cranial cruciate ligament. The fiber was passed over-the-top, tensioned, and fixed to the femoral screw, previously inserted with the helicoil in the distal part of the femur. Surgery was completed in all the cases. Occasional problems found during the insertion of the helicoils and screws were resolved with simple procedures. Post-operative clinical assessment showed negative cranial drawer test, negative cranial tibial thrust, and normal range of motion. Radiographic evaluation showed an appropriate positioning of both tibial and femoral implants in all the cases. The results of the first surgical appraisal of this new technique are encouraging, although further studies are necessary to demonstrate the in vivo efficacy of this procedure.

Bilateral cervical ribs in a mixed breed dog

A 4-year-old intact female, mixed breed dog was presented with a complaint of dyspnea. Clinical examination revealed symptoms related to disease of the upper airways. Radiographic findings were consistent with tracheal collapse associated with anomalies involving the seventh cervical vertebra and the first ribs bilaterally. Radiographs were highly suggestive of cervical ribs; computed tomography and ultrasound examination allowed complete characterization and better localization of the anomalies with relationship to the adjacent muscle and vasculature. Cervical ribs are malformations widely described in human medicine, but only sporadically in dogs. Herein, we discuss etiological, clinical, diagnostic and therapeutic aspects of cervical ribs and possible correlations between the cervical ribs and other anatomical anomalies noted in this dog.

Colonic cyst in a cat presenting recurrent constipation and abdominal pain.

A 5-year-old domestic short-haired spayed female cat was presented for abdominal pain and suspended defecation. Abdominal radiographs confirmed constipation; abdominal ultrasonography showed a cystic oval structure attached to the colon. The structure exhibited a well-defined wall, composed of three layers. Its content was mildly echogenic and inhomogeneous. Laparotomy was performed and complete resection of the structure, and of part of the colon, was required (end-to-end anastomosis). Histopathology confirmed the structure to be a cystic formation of the colon with some areas of mucosal metaplasia. However the question whether the cystic structure was consistent with an intestinal duplication cyst - which is the most likely type of cyst in this particular case - a Meckels diverticulum remnant, a vitelline duct cyst or a cystic diverticulum of the colon could not be resolved. Postoperatively, no further other episode of constipation occurred.

Use of Nanohydroxyapatite in Regenerative Therapy in Dogs Affected by Periodontopathy: Preliminary Results

Background: The present study aims to analyse the in vivo behaviour of nanohydroxyapatite and to assess its regenerative capacity in dogs affected by periodontal disease. Methods and findings: The dogs employed in the study were randomly subdivided into a control group and an experimental group. After clinical, instrumental and radiological examinations, all the subjects underwent dental prophylaxis and a bioptic sample was taken. A histopathological examination of the periodontal tissues, in correspondence to teeth with periodontopathy ranging between stages 2 and 3, followed. Regenerative therapy with applications of nanohydroxyapatite was administered only to the dogs of the experimental group. After a period of between 35 and 40 days, a further clinical, instrumental and radiological examination was carried out and a bioptic sample taken solely on the dogs whose histological examinations showed changes ascribable to periodontal disease. The results of the histopathological examination demonstrated that only the dogs in the experimental group, who underwent dental prophylaxis together with the administration of nanohydroxyapatite, showed clear signs of improvement with respect to their initial condition. Conclusions: In conclusion the study demonstrated that the nanohydroxyapatite represents a valid osteoconductive and osteoinductive graft product and confirmed its regenerative potential in periodontal therapy in dogs.

Use of Wallace Distractor in Canine Stifle Arthroscopy

Objectives: To assess the value of the intra-articular Wallace distractor in stifle arthroscopy in the dog. Methods-Ex-vivo study: ten cadaver limbs of dogs were used to explore the stifle joints by arthroscopy each once without and once with the aid of a Wallace distractor. Radiographs and observational data were used to assess the degree of joint distraction and to evaluate any collateral intra-articular damages. In vivo study: distractor-assisted arthroscopy was thereafter performed in 12 consecutive clinical cases of dogs with cranial cruciate ligament rupture. The use of the Wallace distractor, clinical setting, time to complete joint evaluation were recorded. Results: In the cadaver study, radiographic findings showed a significant increase of the joint space after the insertion of the distractor. Visual range during arthroscopy employing the Wallace distractor increased substantially and facilitated the assessment of all visible intra-articular structures. Mean time to evaluate the femoropatellar space was 4,1 minutes, to observe cruciate ligaments 6,5 minutes and to complete joint inspection 10,1 minutes. In the clinical study, the use of Wallace distractor allowed improved arthroscopic observation of all relevant structures, without sub-patellar fat pad removal. Mean time to complete joint inspection was 28,5 minutes. Clinical significance: The use of the Wallace joint distractor may be helpful in the arthroscopic assessment of the canine stifle. It is easy to insert, it allows a considerable distraction of the joint making it easier visibility and reducing the possible need to remove the sub patellar fat pad. With its blunt pins Wallace joint distractor limits the risk of iatrogenic damage and can be easy to use even for surgeons who do not have much experience in knee arthroscopy.