Evaluation of the in vitro performance of the double forwarder knot, compared to square and surgeon's knots using large gauge suture.

OBJECTIVE: The aim of the study was to evaluate the strength and size of the double forwarder (DF) knot in 2 and 3 USP polyglactin 910 when used to form a ligature and to compare the knot holding capacity (KHC), size and weight of the DF knot to surgeon's (SU) and square (SQ) knots with varying numbers of throws. STUDY DESIGN: Laboratory study. STUDY POPULATION: Knotted suture. METHODS: Knots were tied using 2 and 3 USP polyglactin 910 and tested on a universal testing machine under linear tension. Mode of failure and (KHC) were recorded. Knot volume and weight were determined by digital micrometer and balance. KHC, size, and weight between knot type, number of throws, and suture type and size were compared using ANOVA testing, with p < .05 as significant. RESULTS: In both suture types, DF knots had a higher KHC than SQ/SU knots (p < .004), with the exception of SU knots with 6-8 throws in 3 USP polyglactin 910 (p > .42). All DF knots failed by suture breakage at the knot, as did all SQ/SU knots with >6 throws. DF knots in 2 and 3 USP polyglactin 910 were larger and heavier than SQ and SU knots when the same number of throws was applied (p < .003). CONCLUSION: Self-locking DF knots provided increased strength compared to SU/SQ in large gauge suture but only when fewer than six throws are applied to SU/SQ knots. CLINICAL RELEVANCE: The new DF knot could be an alternative for a secure ligature.

Ex vivo evaluation of a novel suture loop method for equine intestinal biopsies.

OBJECTIVE: To compare a novel suture loop method for intestinal biopsies (SLB) with a two-layer, hand-sutured biopsy (HSB) technique in equine small and large intestines. STUDY DESIGN: Experimental, randomized, ex vivo study. ANIMALS: Eight healthy adult horses. METHODS: The duodenum, aboral jejunum, and ventral and dorsal large colon were harvested after euthanasia and divided into three sections each. The sections were randomized to SLB, HSB, or control (C, no biopsy) groups. Tissue samples were excised after placement of a suture loop formed by a 4S Roeder knot and oversewn with a Cushing pattern using barbed suture (SLB), or a simple continuous pattern oversewn with a Cushing pattern (HSB). Intraluminal diameter was assessed with contrast radiographs; bursting pressure and wall tension were determined using a solid-state sensor after instillation of fluid. Tissue samples were evaluated by a board-certified pathologist. RESULTS: Tissue samples were full thickness with similar depth and quality (p > .3). Changes in intraluminal diameter did not differ between methods (p > .16). The bursting pressures were higher for controls than biopsied sections (p < .009) but were not different between biopsy methods (p = .998). Bursting wall tension was higher for controls (p < .02) and was similar for both biopsy methods (p = .852). CONCLUSION: The SLB was equivalent to HSB in strength and effect on intraluminal diameter. The HSB samples were larger and more likely to contain mucosa/villi for histologic diagnosis. CLINICAL SIGNIFICANCE: The SLB method can be adapted for laparoscopic surgery to obtain both small and large intestinal biopsies. Further investigation is needed before clinical use.

Effects of methionine, leucine, and insulin on circulating concentrations and mammary extraction of energy substrates and amino acids in lactating dairy cows.

The aim of this experiment was to test whether insulin potentiates the effects of two abomasally infused amino acids (AA), leucine and methionine (LM), on mammary extraction efficiency of energetic and nitrogenous nutrients. Six lactating Holstein cows (155 ± 9 DIM) were ruminally-cannulated and had the right carotid artery subcutaneously transposed. Cows were fed a 20% metabolizable protein-restricted diet and abomasally infused with water (8 L/d) or AA (Met 26 g/d, Leu 70 g/d) for 8 h/d, for 7 days. On the last day of each period, cows were intravenously infused with saline (0.9% NaCl, 110 mL/h) or subjected to 8 h hyperinsulinemic clamp (IC) alongside abomasal infusions. For IC, insulin was infused at 1 µg/kg/h. Normoglycemia was maintained by varying glucose (50% w/v in water) infusion rate based on coccygeal vein glucose concentration. Carotid arterial and subcutaneous abdominal (mammary) vein blood samples were collected at 0, 1, 2, 4, and 6 h from the start of infusions. Milk weights and samples for baseline measurements of production were taken on day 5 PM, day 6 AM and PM, and day 7 AM of the experimental period. A final milk weight and sample was taken immediately after abomasal and intravenous infusions on day 7 PM for assessing the interaction between insulin and the infused AA. The experiment had an incompletely replicated Latin square design with a 2 × 2 factorial arrangement of treatments (abomasal and intravenous infusion). Baseline milk production when cows were only receiving abomasal infusions was largely unaffected by LM, but milk protein yield tended to be decreased. On day 7, LM tended to positively increase milk fat and de novo fatty acid content, and IC tended to decrease milk protein content. Both milk urea nitrogen and plasma urea nitrogen were decreased by IC. Circulating AA concentrations in plasma were decreased by both LM and IC, but mammary extraction efficiency was affected by neither. Infusion of LM had no effect on any energy metabolite analyzed. Circulating non-esterified fatty acid concentration was decreased by IC, with no effect on mammary extraction efficiency. Mammary extraction efficiency of both acetate and ß-hydroxybutyrate were decreased by IC. Overall, while both circulating concentrations of energy metabolites and amino acids were decreased in response to treatments, this was not due to improved mammary extraction efficiency.

Evaluation of the effects of medial saphenous venous pressures as an indirect method of measurement of intra-abdominal pressures in the horse.

OBJECTIVE: To evaluate the effect of changes in intra-abdominal pressure (IAP) on medial saphenous venous pressure (MSVP) and hemodynamics in normal horses. DESIGN: Experimental, in-vivo study. SETTING: University Teaching Hospital. ANIMALS: Convenience sample of 7 mixed breed horses; 5 geldings, and 2 mares. INTERVENTIONS: Pneumoperitoneum was induced in horses under standing sedation with carbon dioxide gas using a laparoscopic insufflator for a total of 60 minutes to simulate clinical elevation in IAP. Pressure was increased stepwise to 20 mm Hg over 30 minutes, and maintained at that pressure for 30 minutes to evaluate the effect of sustained intra-abdominal hypertension. The MSVP and vital parameters were recorded, along with direct arterial blood pressure from the transverse facial artery. MEASUREMENTS AND MAIN RESULTS: As IAP increased, MSVP increased in a stepwise manner, in concert with changes in IAP. The consistency in measurement between MSVP and IAP was high (intraclass correlation coefficient = 0.92; P < 0.001) and repeated measures correlation was excellent (r = 0.98; P < 0.001). Heart rate was unchanged over the course of the experiment (P = 0.09), however, respiratory rate increased with increasing IAP (P < 0.001). Arterial blood pressure also increased with insufflation (P < 0.001), with a significant difference at an IAP of 15 mm Hg (P = 0.04). CONCLUSIONS: This report provides preliminary data demonstrating a strong correlation between equine MSVP and changes in IAP, similar to that observed in other species. Further investigations are needed to evaluate this relationship, and to confirm these results in clinical patients.

Evaluation of the effects of intraabdominal hypertension on equine central venous pressure.

OBJECTIVE: To evaluate the effect of changes in intraabdominal pressure (IAP) on central venous pressure (CVP) in normal horses. DESIGN: Experimental, in vivo study. SETTING: University Teaching Hospital. ANIMALS: Convenience sample of 7 mixed breed horses-5 geldings and 2 mares. INTERVENTIONS: Pneumoperitoneum was induced in horses under standing sedation with carbon dioxide gas using a laparoscopic insufflator for a total of 60 minutes to simulate clinical elevation in IAP. Pressure was increased stepwise to 20 mm Hg over 30 minutes, and maintained at that pressure for 30 minutes to evaluate the effect of sustained intraabdominal hypertension. CVP was obtained from the cranial vena cava, concurrent with pressure obtained from the peritoneal cavity. MEASUREMENTS AND MAIN RESULTS: CVP increased as IAP increased up to 12 mm Hg, and declined as IAP increased further. The changes in CVP over time were significantly different (P < 0.03). Repeated measures correlation was positive, and highest, for mean CVP as IAP increased from 0 to 12 mm Hg (r = .70; 95% CI, .43-.85; P < 0.0001). Correlation of mean CVP with insufflation pressure became negative as IAP increased further from 15 to 20 mm Hg (r = -.47; 95% CI, -.66 to -.21; P = 0.0006). CONCLUSIONS: This report provides preliminary data demonstrating a biphasic trend in equine CVP caused by changes in IAP, similar to that observed in other species. Further investigations are needed to evaluate this trend and to confirm these results in clinical patients.

Transposition of the common carotid artery in standing cattle.

OBJECTIVE: To describe a method for permanent transposition of the common carotid artery (CCA) in standing cattle. STUDY DESIGN: Experimental study. ANIMALS: Eight healthy, adult, lactating Holstein-Friesian cows. METHODS: Cows were restrained with the head and neck extended by using halters, head catch, and squeeze chute. Surgery was performed under local anesthesia and intravenous sedation. The right CCA was approached through a skin incision dorsal and parallel to the jugular vein. The skin incision was extended through the brachiocephalicus and longus capitus muscles. When the vessel was present, ligation of accessory vessels of the CCA and internal jugular vein was performed to facilitate exposure. The artery was sharply dissected from the carotid sheath and elevated by using Penrose drains. The muscles were closed in two layers, leaving the artery in a subcutaneous position. The incision was protected with a tie-over bandage for 1 week. Sampling from the CCA was initiated approximately 6 weeks after surgery. RESULTS: The CCA was successfully transposed and used for repeated arterial blood sampling in all eight cows. No cows had intraoperative complications or evidence of surgical site infection. One cow had a postoperative suture reaction at the site of a suture used for maintaining the tie-over bandage. All arteries remained patent for use in subsequent studies. CONCLUSION: Permanent translocation of the CCA was successful in all cows in this study and consistently allowed serial arterial blood sampling. CLINICAL SIGNIFICANCE: Common carotid artery translocation is possible without general anesthesia in adult cattle and is useful in studies requiring serial sampling of arterial blood.

Evaluation of a Chinese herbal supplement on equine squamous gastric disease and gastric fluid pH in mares.

BACKGROUND: Wei Le San (WLS) is a Chinese herbal formula comprised of 9 herbs selected for their putative anti-inflammatory effects. OBJECTIVES: To evaluate the effects of WLS administration in horses with nonglandular gastric ulcers. ANIMALS: Ten mixed breed mares (aged 7-21 years, 401-567 kg body weight). METHODS: Experimental design was a blinded, prospective, 2-period crossover study. All horses received a placebo (25 mL dextrose-based syrup; n = 10) and the treatment (WLS, 5 g in 25 mL dextrose-based syrup; n = 10), administered twice daily. Horses underwent a 1-week, alternating feed-deprivation period to induce or worsen existing ulcers; treatment began on day 7. Gastroscopic examination was performed on d0, d6, and d35, with gastric fluid pH obtained on d6 and d35. Gastric ulcer scores assigned by 3 masked observers were averaged for each examination. RESULTS: Ulcer number scores for horses treated with WLS (median = 0; range, 0-4) was not different from the untreated controls (median = 0.5; range, 0-4; P = .81) by the end of the treatment period. Ulcer severity score for treated horses (median = 0; range, 0-1) was also unchanged compared to the control group (median = 0.5; range, 0-1; P = .85). Gastric pH was not altered by either treatment, with a median of 2.1 (range, 1.9-4.1) for the horses treated with WLS and 2.8 (range, 1.6-7.2) in the untreated controls (P = .46). CONCLUSIONS AND CLINICAL IMPORTANCE: The experimental model used to induce gastric ulceration was unable to discern a difference between the herbal supplement and the placebo in normal horses.

Evaluation of phenylephrine and exercise with or without trocarization for treatment of suspected nephrosplenic entrapment in horses.

OBJECTIVE To report the outcomes of horses with suspected nephrosplenic entrapment (NSE) of the large colon treated by IV phenylephrine administration and exercise with and without trocarization (ie, medical management). DESIGN Retrospective, observational study. ANIMALS 134 horses. PROCEDURES Electronic medical records were searched to identify horses that underwent medical management for suspected NSE at a veterinary teaching hospital between 1995 and 2014. Demographic information, physical and ultrasonographic examination findings, treatment information (including the number of times the treatment was performed and patient response), surgical findings if applicable, complications, and patient outcome were recorded. Descriptive statistics were reported. RESULTS 72 horses had suspected NSE that resolved with medical treatment; 59 of 62 horses underwent laparotomy when medical management failed, and 3 were euthanized without surgery. Twenty-five of the 59 horses had confirmed NSE that was surgically corrected, and 34 had lesions other than or in addition to NSE. All horses that had surgically corrected NSE and 18 of 34 horses that had other lesions survived to hospital discharge. The odds of resolution of NSE with medical management were greater for horses that underwent ≤ 2 (vs > 2) treatments. The treatment success rate for horses that underwent trocarization was not greater than that for horses that did not have the procedure. CONCLUSIONS AND CLINICAL RELEVANCE Suspected NSE resolved with the described medical management for most horses. However, results indicated the potential for misdiagnosis was high. Timely surgical intervention is recommended for horses that fail to respond to medical treatment.

In vitro evaluation of the knot-holding capacity and security, weight, and volume of forwarder knots tied with size-3 polyglactin 910 suture exposed to air, balanced electrolyte solution, or equine abdominal fat.

OBJECTIVE: To evaluate the effect of exposure to a balanced electrolyte solution (BES), or equine abdominal fat on the knot-holding capacity (KHC), relative knot security (RKS), weight, and volume of forwarder knots versus surgeon's knots. SAMPLE: 315 knots tied and tested in vitro. PROCEDURES: United States Pharmacopeia size-3 polyglactin 910 suture exposed to air (dry [control]), equine abdominal fat (fat-exposed), or BES (BES-exposed) was used to tie forwarder knots with 2, 3, and 4 throws and surgeon's knots with 5, 6, 7, and 8 throws. A universal materials testing machine was used to test the tensile strength of suture and knots to failure, and the KHC, RKS, weight, and volume of knots were determined. RESULTS: Forwarder knots had significantly higher KHC and RKS and lower volume, compared with surgeons' knots. Forwarder knots tied with fat-exposed suture had greater weight, but not volume, than did forwarder knots tied with dry or BES-exposed suture with the same number of throws. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that forwarder knots were superior to surgeon's knots when configured as start knots intended for continuous lines of suture. Exposure to media did not negatively affect mechanical or physical properties of forwarder knots and may improve specific biomechanical functions, including KHC and RKS.

Bursting strength of surgeon's and self-locking knots for closure of ventral midline celiotomy in horses.

OBJECTIVE: To compare the bursting strength and failure mode of ventral midline celiotomy closed with a simple continuous suture pattern with 1 of 2 knot combinations, a novel self-locking knot combination of a forwarder start with an Aberdeen end knot (F-A) and a traditional combination of a surgeon's start with a surgeon's end knot (S-S). STUDY DESIGN: Ex vivo experimental. SAMPLE POPULATION: Equine cadavers (n = 14). METHODS: A 20-cm ventral midline celiotomy was created in 14 equine cadavers. Horses were assigned to celiotomy closure with an F-A or S-S knot combination. Prior to closure, a 200-L inflatable bladder was placed in the abdomen and then insufflated until failure of the celiotomy closure. The horses' signalment, weight, breed, and age, as well as knot combination type, mode of failure, closure time, and bursting strength (mm Hg) were recorded. RESULTS: The median bursting strength was significantly greater when incisions were closed with the F-A knot combination (388 mm Hg) compared with the S-S knot combination (290 mm Hg) (P = .035). Most incisions failed along the fascia when closed with F-A combinations and at the knot when closed with S-S combinations. CONCLUSION: The bursting strength of ventral midline incisions in equine cadavers was increased by an average of 25% when closed with the self-locking F-A knot combination. CLINICAL SIGNIFICANCE: Closing ventral midline celiotomies with an F-A knot combination may provide a more secure closure than the traditional S-S knot combination. Additional in vivo investigation is required prior to recommending this closure in clinical cases.

In vitro evaluation of square and surgeon's knots in large gauge suture.

OBJECTIVE: To investigate the strength and size of surgeon's and square knots for starting and ending continuous suture lines using large gauge suture. STUDY DESIGN: In vitro mechanical study. STUDY POPULATION: Knotted suture. METHODS: Surgeon's and square knots were tested using 2 and 3 USP polyglactin 910 and 2 USP polydioxanone under linear tension on a universal testing machine. Failure mode and knot holding capacity (KHC) were recorded, and relative knot security (RKS) was calculated as a percentage of KHC. Comparisons were made between number of throws, suture size, suture type, and knot types. Knot volume and weight were assessed by a digital micrometer and balance, respectively. RESULTS: There were no significant differences in KHC (P = .295), RKS (P = .307), volume (P = .128), or weight (P = .310) between square and surgeon's knots at the start or end of suture lines with the same number of throws and suture type. A minimum of 6 throws were required for start knots and 7 throws at end knots to prevent unraveling. Knots tied with 3 polyglactin 910 were strongest (P < .001) and 2 polyglactin 910 produced knots with higher KHC and RKS than 2 polydioxanone (P < .001). CONCLUSION: No consistent differences were detected between knots types tied with the same suture material; however, number of throws affected KHC and RKS up to 6 throws in start or 7 throws in end knots. The configuration of square and surgeon's knots performed at the end of a continuous line alters their KHC, supporting the use of additional throws for knot security.

Effect of fluid media on the mechanical properties of continuous pattern-ending surgeon's, square, and Aberdeen knots in vitro.

OBJECTIVE: To investigate the knot holding capacity (KHC) of pattern-ending square, surgeon's and Aberdeen knots each tied in 4 throw combinations using large gauge suture after exposure to media commonly found in equine abdominal surgery. STUDY DESIGN: In vitro mechanical study. SAMPLE POPULATION: Knotted suture strands (n = 10/group). METHODS: Strands of 2 polydioxanone or 3 polyglactin 910 were exposed to 1 of 4 media for 15 minutes. Control suture strands remained dry. Media used included balanced electrolyte solution, 1% sodium carboxymethylcellulose, equine serum, or equine fat. Pattern-ending knots for the 3 knot configurations were loaded to failure in a linear fashion on a materials testing machine to determine KHC. RESULTS: Surgeon's knots tied using media-exposed 3 polyglactin 910 had a significantly higher KHC than the same dry knots with 5 and 6 throws. Square knots tied using media-exposed to 3 polyglactin 910 had a significantly higher KHC than the same dry knots at 5 throws. Aberdeen knots tied with either media-exposed 2 polydioxanone or 3 polyglactin 910 had a significantly higher KHC than their equivalent dry knots. Aberdeen knots had a superior KHC, while requiring less suture than both surgeon's and square knots. CONCLUSION: Media exposure either had no effect on KHC or significantly improved the KHC of all knots investigated. Based on KHC and knot volume, Aberdeen knots tied using media-exposed 3 polyglactin 910 with 3 throws and 1 turn are recommended to end a continuous suture pattern.

In Vitro Evaluation of the Size, Knot Holding Capacity, and Knot Security of the Forwarder Knot Compared to Square and Surgeon's Knots Using Large Gauge Suture.

OBJECTIVE: To investigate the strength, size, and holding capacity of the self-locking forwarder knot compared to surgeon's and square knots using large gauge suture. STUDY DESIGN: In vitro mechanical study. STUDY POPULATION: Knotted suture. METHODS: Forwarder, surgeon's, and square knots were tested on a universal testing machine under linear tension using 2 and 3 USP polyglactin 910 and 2 USP polydioxanone. Knot holding capacity (KHC) and mode of failure were recorded and relative knot security (RKS) was calculated as a percentage of KHC. Knot volume and weight were assessed by digital micrometer and balance, respectively. ANOVA and post hoc testing were used tocompare strength between number of throws, suture, suture size, and knot type. P<.05 was considered significant. RESULTS: Forwarder knots had a higher KHC and RKS than surgeon's or square knots for all suture types and number of throws. No forwarder knots unraveled, but a proportion of square and surgeon's knots with <6 throws did unravel. Forwarder knots had a smaller volume and weight than surgeon's and square knots with equal number of throws. The forwarder knot of 4 throws using 3 USP polyglactin 910 had the highest KHC, RKS, and the smallest size and weight. CONCLUSION: Forwarder knots may be an alternative for commencing continuous patterns in large gauge suture, without sacrificing knot integrity, but further in vivo and ex vivo testing is required to assess the effects of this sliding knot on tissue perfusion before clinical application.

In Vitro Evaluation of the Aberdeen Knot for Continuous Suture Patterns with Large Gauge Suture.

OBJECTIVE: To evaluate the strength, size, and holding capacity of the Aberdeen knot compared to surgeon's and square knots using large gauge suture. STUDY DESIGN: In vitro mechanical study. STUDY POPULATION: Knotted suture. METHODS: Aberdeen, surgeon's, and square knots were tested using 2 and 3 USP polyglactin 910 and 2 USP polydioxanone under linear tension on a universal testing machine. Mode of failure and knot holding capacity (KHC) were recorded and relative knot security (RKS) was calculated as a percentage of KHC. Knot volume and weight were quantified by a digital micrometer and balance, respectively. Strength between number of throws, suture, suture size, and knot type were compared by ANOVA and post hoc testing. P≤.05 was considered significant. RESULTS: Aberdeen knots had higher KHC and RKS than surgeon's or square knots for all suture types and number of throws (P<.001). For all suture materials, none of the Aberdeen knots unraveled, but a portion of square and surgeon's knots with <7 throws did unravel (P=.101). Aberdeen knots had a smaller volume and weight than both surgeon's and square knots with equal numbers of throws (P<.001). The knot with the combined highest RKS and smallest size and weight was an Aberdeen knot with 4 throws using 3 USP polyglactin 910. CONCLUSION: The Aberdeen knots were stronger, more secure, and smaller than surgeon's and square knots for ending a continuous suture pattern. Clinically, the Aberdeen knot may be a useful alternative for completion of continuous patterns using large gauge suture, without sacrificing knot integrity.

Meta-Analysis of the Effects of Adhesion Barriers on Adhesion Formation in the Horse.

OBJECTIVE: To determine the efficacy of adhesion barriers in horses using quantitative statistical analysis. STUDY DESIGN: Meta-analytical review. METHODS: A search using PubMed/MEDLINE and Google Scholar was performed, followed by secondary searches of veterinary trade journals, bibliographies of relevant articles, manufacturer websites, and technical reference guides. Randomized experimental trials in healthy horses were considered that included both a treatment and control group. The endpoint required was euthanasia or laparoscopy to identify adhesion formation. A meta-analysis was performed using a random effects model, with the effect size calculated as an odds ratio (OR) with 95% confidence intervals (CI). Statistical significance was set at P<.05. RESULTS: Out of 354 peer reviewed publications that met the search criteria, a total of 9 relevant studies were identified and investigated the use of sodium carboxymethylcellulose (CMC) solutions, sodium hyaluronate/carboxymethylcellulose (HA/CMC) membranes, hyaluronate (HA), and fucoidan solutions. The odds of adhesions in horses treated with an adhesion barrier were significantly lower than untreated controls (OR=0.102; 95% CI [0.041, 0.254]; P<.001). When analyzed as subsets for each type of barrier, horses treated with HA/CMC membranes and CMC solutions had significant OR for fewer adhesions (OR=0.061; 95% CI [0.013, 0.292]; OR=0.119; 95% CI [0.034, 0.415], respectively; P<.001). CONCLUSION: The meta-analysis demonstrated adhesion barriers provide a positive effect on the odds of adhesion formation. These results are tempered by the limitations of the study, including the small sample size and a bias towards publication of studies with only positive findings.

Formalizing the definition of meta-analysis in Molecular Ecology.

Meta-analysis, the statistical synthesis of pertinent literature to develop evidence-based conclusions, is relatively new to the field of molecular ecology, with the first meta-analysis published in the journal Molecular Ecology in 2003 (Slate & Phua 2003). The goal of this article is to formalize the definition of meta-analysis for the authors, editors, reviewers and readers of Molecular Ecology by completing a review of the meta-analyses previously published in this journal. We also provide a brief overview of the many components required for meta-analysis with a more specific discussion of the issues related to the field of molecular ecology, including the use and statistical considerations of Wright's FST and its related analogues as effect sizes in meta-analysis. We performed a literature review to identify articles published as 'meta-analyses' in Molecular Ecology, which were then evaluated by at least two reviewers. We specifically targeted Molecular Ecology publications because as a flagship journal in this field, meta-analyses published in Molecular Ecology have the potential to set the standard for meta-analyses in other journals. We found that while many of these reviewed articles were strong meta-analyses, others failed to follow standard meta-analytical techniques. One of these unsatisfactory meta-analyses was in fact a secondary analysis. Other studies attempted meta-analyses but lacked the fundamental statistics that are considered necessary for an effective and powerful meta-analysis. By drawing attention to the inconsistency of studies labelled as meta-analyses, we emphasize the importance of understanding the components of traditional meta-analyses to fully embrace the strengths of quantitative data synthesis in the field of molecular ecology.

Ex-Vivo Evaluation of a Modified Teno Fix(®) Device Repair Pattern Versus a 3-Loop Pulley for Repair of Equine Flexor Tendons.

OBJECTIVE: To compare the load to ultimate failure, load to a 2 mm gap, mode of failure, and gap at failure (mm) of the Teno Fix(®) (TF) to the 3-loop pulley (3LP) for repair of equine tendon lacerations. The use of 4TF devices versus 5TF devices on load to ultimate failure and load to a 2 mm gap was also compared. STUDY DESIGN: Ex vivo biomechanical study; unbalanced incomplete block (horse) design. SAMPLES: Cadaveric equine forelimb superficial digital flexor tendon (n = 20 paired tendons). METHODS: Ten tendon pairs were selected randomly and repaired with a 3LP and 4TF pattern, and 10 tendon pairs repaired with a 3LP and 5TF pattern. Load to ultimate failure, load to a 2 mm gap, mode of failure, and gap at failure were obtained using materials testing. RESULTS: The 3LP had a significantly greater ultimate load to failure (P < .001, respectively) and a significantly higher load to a 2 mm gap than both TF repairs (P < .001, respectively). The most frequent mode of failure was suture pull-out for the 3LP and anchor pull-out for the TF. Gap at failure was significantly larger in the 3LP than both TF repairs (P < .001). The ultimate load to failure was significantly higher for the 5TF than the 4TF (P = .004) but there was no significant difference in load to a 2 mm gap, or gap at failure between both TF repairs (P = .11, P = .15, respectively). CONCLUSIONS: Neither TF repair was stronger than the 3LP in load to ultimate failure and load to a 2 mm gap. Addition of a fifth TF device significantly increased the load to ultimate failure but did effect the load to a 2 mm gap over the 4TF.

Trauma and wound management: gunshot wounds in horses.

Bullet wounds in horses can cause a wide array of injuries, determined by the type of projectile, the energy of the bullet on entry, and the type of tissue the bullet encounters. Treatment includes identification of all structures involved, debridement of the permanent cavity, and establishing adequate drainage. Bullet wounds should be treated as contaminated, and broad-spectrum antibiotics, including those with an anaerobic spectrum, are indicated. Although musculoskeletal injuries resulting from gunshots are most common in horses, they carry a good prognosis for survival and return to function.

Biomechanical testing of a novel tendon implant device for the repair of equine flexor tendon lacerations.

OBJECTIVE: To compare in vitro strength and failure characteristics of a tendon implant against a 3 loop pulley suture pattern for equine superficial digital flexor tendon (SDFT) laceration repair. STUDY DESIGN: Experimental. STUDY POPULATION: Cadaveric equine forelimb SDFT (n = 16). METHODS: One tendon of each of 8 pair of SDFT was randomly selected for repair with either the 3-loop pulley (3LP) suture pattern using 2 polydioxanone or with 4 stainless steel suture and anchor implants (SA). Ultimate load to failure, mode of failure, gap at failure, and load to 2 mm gap were obtained using a materials testing system synchronized with a high-speed camera. Statistical evaluation was made using Student's t-test; significance was set at P ≤ .05. RESULTS: The 3LP failed at a significantly (P = .0001) greater load (363.5 ± 83.7 N) than SA (132.4 ± 26.8 N), but the load to a 2 mm gap (3LP = 164.9 ± 67.7 N, SA = 114.5 ± 21.5 N) was not significantly different (P = .09). Failure mode was by suture pull out and anchor pull out respectively. The gap at failure was significantly larger in the 3LP than in SA repair (P = .000005). CONCLUSIONS: Both the SA repair and the 3LP resisted similar tension to 2 mm gap. However, the ultimate load to failure of the SA repair was only 36% that of the 3LP repair.

Surgical technique and short-term outcome for experimental laparoscopic closure of the epiploic foramen in 6 horses.

OBJECTIVE: To describe a laparoscopic technique for, and short-term outcome after, closure of the epiploic foramen (EF) in horses. STUDY DESIGN: Descriptive, experimental study. ANIMALS: Healthy, adult horses (n = 6). METHODS: Laparoscopic portals to approach the EF were identified in standing horses. Under laparoscopic observation, the gastropancreatic fold and right lobe of the pancreas were grasped with Babcock forceps and secured to the caudate hepatic lobe using helical titanium coils to obliterate the EF. Surgical procedure time and intra- and postoperative complications were recorded. Serial analysis of select serum enzymes was used as an indication of involvement of the pancreas and liver. Closure was reevaluated at 4 weeks using repeat laparoscopy, and necropsy was performed immediately after. RESULTS: At initial surgery, EF closure was successful in all 6 horses; median surgical time was 40.5 minutes (range, 22-110 minutes). Serum gamma-glutamyl transferase (GGT) and sorbitol dehydrogenase (SDH) were not significantly altered by the surgical procedure; however, aspartate aminotransferase (AST) and amylase (AMY) were transiently increased. At repeat laparoscopic reevaluation, closure was complete in 5 horses, with partial closure of the EF observed in 1 horse. No complications related to the procedure were noted during or after surgery in any horse. CONCLUSIONS: EF closure in the standing horse can be accomplished without complications to the surrounding organs and vessels.