Vassiliki Tsioli

The past, present and future in scaffold-based tendon treatments

Tendon injuries represent a significant clinical burden on healthcare systems worldwide. As the human population ages and the life expectancy increases, tendon injuries will become more prevalent, especially among young individuals with long life ahead of them. Advancements in engineering, chemistry and biology have made available an array of three-dimensional scaffold-based intervention strategies, natural or synthetic in origin. Further, functionalisation strategies, based on biophysical, biochemical and biological cues, offer control over cellular functions; localisation and sustained release of therapeutics/biologics; and the ability to positively interact with the host to promote repair and regeneration. Herein, we critically discuss current therapies and emerging technologies that aim to transform tendon treatments in the years to come.

Incisional Block With Bupivacaine for Analgesia After Celiotomy in Dogs

A blind, placebo-controlled clinical trial was performed to evaluate the postoperative analgesic effect of preoperative infiltration of the incision site with bupivacaine in dogs undergoing celiotomy. Sixty dogs were randomly allocated into four groups: preoperative bupivacaine, postoperative bupivacaine, preoperative saline, and postoperative saline. All dogs were premedicated with acepromazine and meperidine; then they were anesthetized with thiopentone and isoflurane. Each group received either bupivacaine or normal saline before midline incision or just before skin closure. After surgery, pain scores were assigned using a numerical rating scale. Preoperative bupivacaine was associated with significantly lower pain scores and a significantly lower need for opioid administration. The authors conclude that a preoperative incisional block with bupivacaine seems to be a useful adjunct for controlling pain after celiotomy in dogs.

Use of a temporary incontinent end-on colostomy in a cat for the management of rectocutaneous fistulas associated with atresia ani.

A 2 1/2-month-old cat was evaluated for the presence of multiple draining tracts ventral to the tail of 8 days duration. Clinical and radiographic examination revealed that the cat had rectocutaneous fistulas and type II atresia ani. The cat underwent a temporary end-on colostomy for faecal diversion. Sixty days after surgery and after the fistulas resolved the animal underwent a second surgery for colostomy closure and anal reconstruction. Two years after surgery the cat was reported to be in good health with no faecal incontinence.

Uterine leiomyosarcoma and pyometra in a dog

A seven-year-old entire female, mixed-breed dog, weighing 19 kg, was presented with a 2-day history of abdominal distension, reduced appetite and general dullness. Abdominal palpation revealed a large mass. Radiography showed a large mass occupying the left mid-abdominal area and convoluted loops of tubular fluid opacity occupying the right mid-abdominal area. Ultrasonography revealed a large heterogeneous mass with an anechoic area and some hyperechoic foci, indicative of calcification, in the mid-abdominal area. Furthermore, hypoechoic areas were found in the middle and caudal abdominal area and were presumed to be the fluid-filled uterine horns. At laparotomy, a 10·5×14·5-cm firm mass was found in the uterine body, while the uterine horns were filled with a thick red-brownish exudate; ovariohysterectomy was subsequently performed. A diagnosis of uterine leiomyosarcoma associated with pyometra was established by histopathology and immunohistochemistry.

Comparison of three skin-stretching devices for closing skin defects on the limbs of dogs

Our objective was to evaluate the effectiveness of skin-stretching devices for closing defects on the extremities of dogs. Antebrachial skin defects were created on the limbs of 24 dogs randomly divided into three groups. Skin stretchers included staples and sutures passing through them (group A), sutures and hypodermic needles (group B), and Pavletic device (group C). Wounds on the left were further undermined in all groups. Tension and blood perfusion were assessed. After removing the stretchers on day 3, the defects were sutured and wound healing was clinically scored. Histological variables evaluated were cellular infiltration, edema, collagen orientation, and thickness of epidermis. Significant differences in tension were found among groups (p < 0.0005) and between measurement times for undermined (p = 0.001) or non-undermined (p < 0.0005) wounds. In contrast, blood perfusion values did not differ significantly. Clinical scores for group B seemed to be better than those for groups A and C, but differences were not significant. Primary wound closure using the Pavletic device was not feasible. No significant differences in histological variables were found between groups. Skin stretching with staples or hypodermic needles resulted in successful wound management with minor side effects on skin histology and circulation.

Surgical management of recurrent cervical sialoceles in four dogs.

Recurrent cervical sialoceles were diagnosed in four dogs associated with inadequate excision of the sublingual gland. Three dogs were managed by resection of the remnants of the sublingual gland via an oral approach. One dog was managed through a ventral approach as identification of the sublingual gland was not possible with the oral approach. The outcome was favourable in all cases and no relapses were detected after a median follow-up time of 10 months.

Naturally Occurring Isohexenylnaphthazarins and Wound Healing: Experimental Study in Dogs

Background: The healing efficacy of isohexenylnaphthazarins (IHN) has been well proved on chronic or contaminated wounds. Objective: To evaluate the wound healing activity of an experimental ointment containing IHN on acute and noncontaminated wounds in dogs. Methods: In each of six beagle dogs, four full-thickness skin defects were created bilaterally: one 2 × 2 cm defect on the lateral aspect of each arm for subjective evaluation, laser Doppler flowmetry (LDF), and planimetry and three 1.5 × 1.5 cm defects on opposite sides of the dorsal midline for histologic evaluation. Wounds on the left were treated with an ointment based on IHN and on the right with another based on petroleum jelly (Vaseline) and beeswax. Results: Wound size decreased significantly in both sides. The significantly increased percentage of epithelialization was higher (p = .0274) in the petroleum jelly–treated wounds on day 20. Tissue perfusion (LDF) increased significantly bilaterally in the center of the wound but only in the IHN-treated side cranial to the wound. Histologically, angiogenesis was significantly higher (p = .0431) on day 5 in the IHN-treated wounds compared with the petroleum jelly–treated wounds. Collagen production increased significantly bilaterally. Conclusion: The IHN-based ointment promoted some of the proliferative processes, but it did not enhance the overall wound healing of acute, surgically created wounds in dogs.

Retained surgical swabs in dogs

WE enjoyed reading the interesting paper ‘Retained surgical swabs in 13 dogs’ by Forster and others (2011), which appeared …

The Effect of a Hydrocolloid Dressing on Second Intention Wound Healing in Cats

The objective of the present study was to evaluate the effect of a hydrocolloid dressing on second intention wound healing in cats. Two full-thickness skin wounds, measuring 2 × 2 cm, were created on both sides of the dorsal midline of 10 cats; bilaterally, one randomly selected wound was bandaged with a hydrocolloid dressing and the second one (control) with a semiocclusive pad. Subjective clinical evaluation of granulation tissue formation, of the quantity and nature of wound exudate, and planimetry were performed on the right-side wounds, and histological examination on the left. No significant differences in subjective clinical evaluation or in planimetry were observed between the hydrocolloid-treated wounds and controls. Most wounds had serous or absence of exudate (41.25% and 25%, respectively), whereas purulent exudate was observed in 7.5% of wounds. Edema was significantly increased in the hydrocolloid-treated wounds compared with controls on day 7 but no significant differences in the other histological variables were observed.

Effects of two occlusive, hydrocolloid dressings on healing of full-thickness skin wounds in cats.

OBJECTIVES To determine the effects of two occlusive, hydrocolloid dressings on second intention wound healing in cats. METHODS Three 2×2 cm full-thickness skin wounds were created on each side of the trunk of 10 cats. Two bilateral wounds were bandaged using different hydrocolloid dressings, namely Hydrocoll and DuoDerm while a semi-occlusive pad (Melolin) was applied to the third bilateral wound (control group). Wound planimetry, subjective evaluation of wound healing, and qualitative bacterial cultures were performed on the right-sided wounds, whereas left-sided wounds were subjected to histological examination. RESULTS Subjective evaluation revealed accelerated (p <0.01) granulation tissue formation in hydrocolloid-treated wounds. The amount of wound exudate was initially greater (p <0.01) in these wounds. Seventeen out of 120 evaluated wounds (14.2%) produced purulent exudate, 11 of which showed Staphylococcus aureus growth. Fewer control wounds (3/17) emitted purulent exudate, but all of them yielded moderate bacterial growth as compared to hydrocolloid-treated wounds (8/17) which had a low incidence of bacterial growth. The only significant difference in histological variables was increased cellular infiltration noted on day 7 in Hydrocoll-treated wounds compared to controls. No significant differences in planimetry variables were found between groups. CLINICAL SIGNIFICANCE Despite the initially increased amount of wound exudate and the low growth of Staphylococcus aureus, hydrocolloid dressings accelerate granulation tissue formation and can hence be suggested for second intention wound healing in cats.