Skin burn by termal nattress - a therapeutic approach

Background: Burns are caused by a direct or indirect action of heat on an organism, compromising the functional integrityof the skin. Hypothermia is a common intercurrence in animals during the transoperative period; thermal mattresses areused to maintain the animal’s body temperature, but inappropriate use can cause the patient’s skin to burn. In humans, burnsare quite common; however, in veterinary medicine, they are infrequent. The aim of this study was to describe a case ofaccidental burn in a canine caused by a thermal mattress, emphasizing wound treatment and analgesia used.Case: A 12-year-old male canine without defined breed weighing 15 kg underwent an emergency exploratory laparotomydue to rupture of a spleen mass and presented with intercurrence hypothermia during the anesthesia procedure, which wascontrolled using a thermal mattress. Ten days after the surgical procedure, he developed a skin lesion with erythema, suffusion, and necrosis, evolving skin displacement along the entire back with a lot of pain which was possibly caused by theuse of a thermal mattress in the transoperative procedure. The intuited analgesic treatment involved the use of numerousand different drugs, including Methadone (0.3 mg/kg, QID, SC), Dipyrone (25 mg/kg, TID, IV), and Ketamine (0.5 mg/kg,TID, SC) (during hospitalization), as well as Tramadol (4 mg/kg, TID, PO) and Dipyrone (25 mg/kg, TID, PO) after medicalrelease as support therapy. For the wound treatment, calcium alginate was initially used daily and subsequently changedfor daily application of dermisana oil. The patient followed up weekly for approximately two months for wound monitoring as well as adjustments to the drug therapy. The would almost completely healed, but the patient showed a significantworsening in the general clinical condition correlated with the neoplasm that he had, and the owner and clinical staff ofthe veterinary hospital opted for euthanasia...

Skin burn by termal nattress - a therapeutic approach

Background: Burns are caused by a direct or indirect action of heat on an organism, compromising the functional integrityof the skin. Hypothermia is a common intercurrence in animals during the transoperative period; thermal mattresses areused to maintain the animals body temperature, but inappropriate use can cause the patients skin to burn. In humans, burnsare quite common; however, in veterinary medicine, they are infrequent. The aim of this study was to describe a case ofaccidental burn in a canine caused by a thermal mattress, emphasizing wound treatment and analgesia used.Case: A 12-year-old male canine without defined breed weighing 15 kg underwent an emergency exploratory laparotomydue to rupture of a spleen mass and presented with intercurrence hypothermia during the anesthesia procedure, which wascontrolled using a thermal mattress. Ten days after the surgical procedure, he developed a skin lesion with erythema, suffusion, and necrosis, evolving skin displacement along the entire back with a lot of pain which was possibly caused by theuse of a thermal mattress in the transoperative procedure. The intuited analgesic treatment involved the use of numerousand different drugs, including Methadone (0.3 mg/kg, QID, SC), Dipyrone (25 mg/kg, TID, IV), and Ketamine (0.5 mg/kg,TID, SC) (during hospitalization), as well as Tramadol (4 mg/kg, TID, PO) and Dipyrone (25 mg/kg, TID, PO) after medicalrelease as support therapy. For the wound treatment, calcium alginate was initially used daily and subsequently changedfor daily application of dermisana oil. The patient followed up weekly for approximately two months for wound monitoring as well as adjustments to the drug therapy. The would almost completely healed, but the patient showed a significantworsening in the general clinical condition correlated with the neoplasm that he had, and the owner and clinical staff ofthe veterinary hospital opted for euthanasia...(AU)

AVALIAÇÃO COMPARATIVA DE DIFERENTES MÉTODOS DE PROTEÇÃO AOS TECIDOS PRÓXIMOS AO JOELHO DURANTE OSTEOTOMIA PARA NIVELAMENTO DO PLATÔ TIBIAL (TPLO). ESTUDO EX-VIVO EM CÃES

Objetivou-se comparar a eficácia de oito diferentes métodos de proteção à artéria poplítea, fíbula e nervos tibial e fibular após osteotomia da TPLO. Foram utilizados 40 cadáveres (80 joelhos) caninos com massa corpórea de 25,9±3,7Kg, distribuídos igualmente em oito grupos experimentais. No primeiro grupo (G1) utilizou-se a compressa cirúrgica, posicionada na face craniolateral da tíbia proximal. No G2 a compressa foi alocada na face caudolateral da tíbia proximal. No G3, a compressa foi aplicada na face craniolateral, porém sendo tracionada até sua visibilização na face caudal da tíbia. O afastador cirúrgico I e II foram utilizados nos grupos G4/G5 e G7\G8, respectivamente. No G4 e G7, o afastador foi utilizado na craniolateral e no G5 e G8, na face caudolateral. No grupo G6, a osteotomia foi realizada de forma parcial na cortical trans e completada, de forma manual, por aplicação de pressão digital. As avaliações foram realizadas por meio de comparação radiográfica pré e pós osteotomia, assim como por meio de dissecação anatômica de forma cega por 4 avaliadores experientes para classificação das possíveis lesões em 3 graus. Encontrou-se uma incidência total de lesões de 20%, sendo 13,8% das lesões grau 2 e 6,2% de lesões grau 3. Das lesões grau 2, 81,8% e 60% das lesões grau 3 foram identificadas quando se utilizou os métodos de proteção. Apesar da maior incidência de lesão quando se utilizou os métodos de proteção, tal diferença não foi significativa (p>5%). Os métodos de proteção que foram utilizados no sentido cranial para caudal foram os que apresentaram piores resultados e o afastador tipo II no sentido caudal para cranial o que menos prejudicou as estruturas avaliadas, porém tal comportamento também não foi significativo. Pelas condições do estudo, conclui-se que o uso dos métodos de proteção adotados não traz benefícios de proteção à artéria poplítea, fíbula e nervos tibial e fibular durante a TPLO.

The propose of the study was to compare the effectiveness of eight different methods of protection of the popliteal artery, fibula, tibial and fibular nerves after TPLO osteotomy. 40 canine corpses (80 knees) with body weight 25,9±3,7Kg were separated in eight experimental groups. In the first group, denominated G1 was used a surgical sponge in the craniolateral aspect of the proximal tibial. In G2 the surgical sponge was allocated in the caudolateral aspect of the proximal tibial. In G3, the surgical sponge was applied in the craniolateral aspect, but it was pushed through caudally to the tibia until it being visible in the operative field. The special retractors I and II developed by the team for this purpose were used in groups G4\G5 and G7\G8, respectively. In G4 and G7, the retractor was used in the craniolateral direction and in G5 and G8, in the caudolateral aspect of the proximal tibial. In G6, the trans cortex osteotomy was partially performed and completed with digital pression. The evaluations were performed through radiographic comparison before and after osteotomy and by dissection of the structures adjacent to the osteotomy line. The images were prepared and sent to 4 evaluators for damage graduation in 3 degrees. A 20% of total incidence of injuries was found with 13,8% of grade 2 injuries and 6,2% of grade 3 injuries. Of grade 2 injuries, 81,8% and 60% of grade 3 injuries were identified when protective methods were used. Despite the higher incidence of injury when protective methods were used, this difference was not significant (p>0,05). The protection methods that were used in the cranial to caudal direction were the ones that showed the worst results and the type II retractor in the caudal to cranial direction was the one which least harmed the evaluated structures, but this behavior was also not significant. Due to the conditions of the study, it is concluded that the use of these methods does not bring benefits to the popliteal artery, fibula and tibial and fibular nerve protection during TPLO.

Feasibility analysis of loop colostomy closure in patients under local anesthesia / Estudo da praticabilidade do fechamento de colostomias em alça em pacientes sob anestesia local

PURPOSE: To verify prospectively the practicability of performing loop colostomy closure under local anesthesia and sedation. METHODS: In this study, 21 patients underwent this operation. Lidocaine 2 percent and bupivacaine 0.5 percent were utilized. Pain was evaluated during the operation, on the first postoperative day and at hospital discharge. Intraoperative events, postoperative complications and the acceptability of this procedure were analyzed. RESULTS: The mean duration of the operation was 133 minutes (range: 85 to 290 minutes). The mean postoperative hospitalization was four days (range: one to twelve days). No patients died. Complications occurred in two patients (9.4 percent): abdominal wall hematoma and operative wound infection. With regard to pain severity, scores of less than or equal to three were indicated in the intraoperative evaluation by 80 percent of the patients (17/21) and on the first postoperative day by 85 percent (18/21). At hospital discharge, 95.2 percent of the patients (20/21) said they were in favor of the local anesthesia technique. CONCLUSION: Loop colostomy closure under local anesthesia and sedation is feasible, safe and acceptable to patients.(AU)

OBJETIVO: Verificar a praticabilidade de se efetuar o fechamento de colostomia em alça sob anestesia local e sedação. MÉTODOS: Neste estudo 21 doentes foram submetidos a esta intervenção cirúrgica. Utilizou-se Lidocaína a 2 por cento e Bupivacaína a 0,5 por cento. Avaliou-se a dor em três períodos: intra-operatório, 1º pós-operatório e alta hospitalar; analisando-se intercorrências intra-operatórias, complicações pós-operatórias e a aceitabilidade desse procedimento. RESULTADOS: O tempo médio operatório correspondeu a 133 minutos, oscilando entre 85 e 290 minutos. O tempo médio de internação pós-operatória teve média de quatro dias, variando de três a doze dias. Não houve letalidade. Em dois doentes (9,4 por cento) ocorreram complicações: hematoma de parede abdominal e infecção de ferida operatória. Quanto a intensidade de dor, escores iguais ou abaixo de três foram indicados na avaliação intra-operatória por 80 por cento (17/21) dos doentes; no 1º pós-operatório por 85 por cento (18/21). Na alta hospitalar 95,2 por cento (20/21) dos doentes mostraram-se favoráveis à técnica sob anestesia local. CONCLUSÃO: Fechamento de colostomia em alça sob anestesia local e sedação é praticável, com segurança e aceitabilidade dos doentes.(AU)

Repercussões respiratórias do pneumoperitônio induzido em suínos

Purpose: To study the respiratory repercussion of differents pneumoperitoneum pressions, with carbon dioxide, induced in pigs. Methods: It was used 14 male Landrance-race pigs, weighing between five and seven kiloragram, with 30 a 45 days of age. The sample was iqually divided in Group A (10mmHg of intra-abdominal during 60 minuts) and Group B (15mmHg of intra-abdominal during 60 minuts). After anesthetic induction, the animals were intubed and kept under monitoring the current volume (CV) and oxigen peripheric saturation (SpO2). Results: It not had statistical difference in CV and SpO2 values before, during and after the induction of pneumoperitoneum. Conclusion: Pneumoperitoneum, at the level of 10 to 15mmHg of intra-abdominal pression, did not cause significance alterations on pigs respiratory standart, during the time period studied.

Objetivo: Estudar, na faixa tida como segura, as repercussões respiratórias de diferentes pressões de pneumoperitônio, com dióxido de carbono, induzido em suínos. Métodos: Foram utilizados 14 suínos machos, da raça Landrace, pesando entre cinco e sete quilos, com 30 a 45 dias de idade. A amostra foi subdividida igualitariamente em Grupo A (pneumoperitônio com 10mmHg durante 60 minutos) e Grupo B (pneumoperitônio com 15mmHg durante 60 minutos). Após a indução anestésica, os animais foram intubados, sendo monitorado o volume corrente (VC) e a saturação periférica de oxigênio (SpO2). Resultados: Não houve diferença estatística nos valores do VC e SpO2 antes, durante e após a indução do pneumoperitônio. Conclusão: O pneumoperitônio, nos níveis pressóricos de 10 a 15mmHg, não causou alteração significativa nos padrões respiratórios de suínos, durante o período de tempo estudado.