Assessment of an implant-skin interface scoring system for external skeletal fixation of dogs.

OBJECTIVE To assess intraobserver repeatability and interobserver and in vivo versus photographic agreement of a scoring system for the implant-skin interface (ISI) of external skeletal fixation (ESF). SAMPLE 42 photographs of ISIs from 18 dogs for interobserver agreement and intraobserver repeatability and 27 photographs of ISIs from 6 dogs for in vivo versus photograph agreement. PROCEDURES An ISI inflammation scoring system was developed. It included scales for 6 metrics (erythema, drainage amount, drainage type, swelling, hair loss or lack of hair regrowth, and granulation tissue). Photographs of the ISI of ESF were obtained by use of a standard protocol and evaluated to determine intraobserver repeatability and interobserver agreement (Cronbach α; 4 raters) of the ISI score. Agreement between in vivo and photographic ISI scores (2 raters) and correlation between median scores across metrics were evaluated. RESULTS 42 photographs met the inclusion criteria. Overall intraclass correlation coefficients ranged from 0.922 to 0.975. Interobserver overall Cronbach α ranged from 0.835 to 0.943. For in vivo versus photographic assessment, 27 ISIs in 6 dogs and their photographs were evaluated. The Cronbach α for both raters ranged from 0.614 to 0.938. Overall, the Cronbach α ranged from 0.725 to 0.932. Mean photographic scores were greater than mean in vivo scores for each metric. Pearson correlation coefficients ranged from 0.221 to 0.923. Erythema, swelling, and granulation were correlated with all other metrics. CONCLUSIONS AND CLINICAL RELEVANCE In this study, an ISI scoring system used in this study had high repeatability and agreement and may therefore be considered for use in clinical situations. Photographic scores were not equivalent to in vivo scores and should not be used interchangeably.

Comparison of measurements obtained by use of an electrogoniometer and a universal plastic goniometer for the assessment of joint motion in dogs.

OBJECTIVE: To compare measurements obtained by use of a universal plastic goniometer (UG) and an electrogoniometer (EG) and from radiographs and to compare joint motion in German Shepherd Dogs and Labrador Retrievers. ANIMALS: 12 healthy adult German Shepherd Dogs and data previously collected from 16 healthy adult Labrador Retrievers. PROCEDURES: German Shepherd Dogs were sedated. One investigator then measured motion of the carpal, cubital (elbow), shoulder, tarsal, stifle, and hip joints of the sedated dogs. Measurements were made in triplicate with a UG and an EG. Radiographs were taken of all joints in maximal flexion and extension. Values were compared between the UG and EG and with values previously determined for joints of 16 Labrador Retrievers. RESULTS: An EG had higher variability than a UG for all dogs. The EG variability appeared to result from the technique for the EG. German Shepherd Dogs had lower values in flexion and extension than did Labrador Retrievers for all joints, except the carpal joints. German Shepherd Dogs had less motion in the tarsal joints, compared with motion for the Labrador Retrievers, but had similar motion in all other joints. CONCLUSIONS AND CLINICAL RELEVANCE: A UG is reliable for obtaining measurements in German Shepherd Dogs. There was higher variability for the EG than for the UG, and an EG cannot be recommended for use.

Assessment of knot security in continuous intradermal wound closures.

BACKGROUND: The traditionally used square knot used for commencement and termination of continuous wound closures is bulky, requiring a minimum of four to six throws to form a secure knot with most suture materials and sizes. This study evaluates the security of self-locking knots, which are significantly smaller in volume than the traditionally applied square knot, for the intradermal closure of standardized wounds in porcine skin. MATERIALS: Porcine skin samples with standardized wounds were closed in one of five patterns with 3/0 PDS suture. Wounds were harvested and tested to failure on a materials testing machine. Load at failure, ultimate elongation, wound stiffness, and mode of failure was determined for each sample. RESULTS: Wound closures incorporating the chain stitch knot performed as well as closures incorporating the conventional square knot for load to failure, elongation, and stiffness. Partial slippage or complete knot failure of 4/40 (10%) of the square knots used in closures was observed. 0/20 (0%) of the chain stitch knots displayed slippage. The half-blood knot performed similarly to the square and chain stitch knot in load to failure, elongation, and stiffness, however, 16/20 (80%) of these knots displayed slippage or complete knot failure. CONCLUSIONS: The chain stitch knot is as secure as the traditionally used square knot when used for termination of a continuous intradermal wound closure. This knot displays characteristics such as smaller knot volume and ease of applications that may make it a superior knot to the square knot in many clinical situations.