ABSTRACT
OBJECTIVE: The adverse effects of intra-abdominal pressure from capnoperitoneum on cardiovascular and pulmonary systems have been well documented, but the effects on portal pressures in dogs with various insufflation pressures is poorly defined. The aim of the present study was to measure the effect of a range of insufflation pressures on the portal pressure, using direct pressure measurements in patients undergoing laparoscopy. STUDY DESIGN: Clinical randomized prospective study. ANIMALS: Nine client-owned dogs undergoing routine laparoscopy. METHODS: Two rounds of direct portal pressure assessments were performed, at insufflation pressures of 0, 6, 10, and 14 mmHg in a predetermined randomized sequence. The data were analyzed for effects of insufflation pressure, hemodynamic alterations, and round. A best-fit exponential model of the relationship between portal pressure and insufflation pressure was created. RESULTS: Portal pressure increased by 38% at 6 mmHg, 95% at 10 mmHg, and 175% at 14 mmHg compared to baseline. Portal pressure increased at an average rate of 7.45% per mmHg of insufflation pressure. Effects of weight, weight/insufflation pressure interaction, and round of insufflation were not statistically significant. No systemic hemodynamic adverse events were observed. CONCLUSION: Portal pressure increased as insufflation pressure increased. There was no clinically significant difference in baseline portal pressure between rounds of insufflation. CLINICAL SIGNIFICANCE: This exponential model of portal pressure supports the use of the minimum insufflation pressure to allow visualization during laparoscopy. The return of portal pressure to baseline following desufflation supports the comparison of portal pressure measurements before and after laparoscopic shunt attenuation.
Subject(s)
Insufflation , Laparoscopy , Animals , Dogs , Laparoscopy/veterinary , Laparoscopy/methods , Insufflation/veterinary , Insufflation/methods , Male , Prospective Studies , Female , Portal Pressure , Pneumoperitoneum, Artificial/veterinary , Pneumoperitoneum, Artificial/methodsABSTRACT
Management of wounds is a commonly performed and essential aspect of small animal veterinary medicine. Appropriate wound management is a difficult art to master, due to the inherent complexity of the clinical scenario, as well as the ever-evolving nature of the field with the constant addition of new products and techniques. This article reviews key concepts that may help the practitioner better understand the natural process of wound healing, factors that delay healing and strategies to help improve the local wound environment to make it more conducive to healing during open wound management. The concept of wound bed preparation is defined before common local wound management strategies, such as wound lavage and debridement, are discussed in more detail. Key aspects of the management of biofilms and appropriate use of antimicrobial agents are also reviewed. Finally, the concept of moist wound healing and its impact in modern wound management is explained before a broad variety of types of wound dressings are reviewed, with a particular focus on active dressings.
La prise en charge des plaies est un aspect courant et essentiel de la médecine vétérinaire pour petits animaux. La gestion appropriée des plaies est un art difficile à maîtriser, en raison de la complexité inhérente du scénario clinique, ainsi que de la nature en constante évolution du domaine avec l'ajout constant de nouveaux produits et techniques. Cet article passe en revue les concepts clés qui peuvent aider le praticien à mieux comprendre le processus naturel de cicatrisation des plaies, les facteurs qui retardent la cicatrisation et les stratégies pour aider à améliorer l'environnement local de la plaie afin de le rendre plus propice à la cicatrisation lors de la gestion des plaies ouvertes. Le concept de préparation du lit de la plaie est défini avant que les stratégies locales courantes de gestion des plaies, telles que le lavage et le débridement de la plaie, ne soient discutées plus en détail. Les principaux aspects de la gestion des biofilms et de l'utilisation appropriée des agents antimicrobiens sont également passés en revue. Enfin, le concept de cicatrisation humide et son impact dans la prise en charge moderne des plaies sont expliqués avant de passer en revue une grande variété de types de pansements, avec un accent particulier sur les pansements actifs.
El manejo de heridas es un aspecto esencial y comúnmente realizado de la medicina veterinaria de pequeños animales. El manejo adecuado de heridas es un arte difícil de dominar, debido a la complejidad inherente del escenario clínico, así como a la naturaleza en constante evolución de este campo con la adición constante de nuevos productos y técnicas. Este artículo revisa los conceptos clave que pueden ayudar al médico a comprender mejor el proceso natural de cicatrización de heridas, los factores que retrasan la cicatrización y las estrategias para ayudar a mejorar el entorno local de la herida para que sea más propicio para la cicatrización durante el tratamiento de heridas abiertas. El concepto de preparación del lecho de la herida se define antes de que se analicen con más detalle las estrategias comunes de tratamiento local de la herida, como el lavado y el debridamiento de la herida. También se revisan aspectos clave del manejo de biopelículas y el uso adecuado de agentes antimicrobianos. Finalmente, se explica el concepto de cicatrización húmeda de heridas y su impacto en el tratamiento moderno de heridas antes de revisar una amplia variedad de tipos de apósitos para heridas, con un enfoque particular en los apósitos activos.
Manejo de feridas é um procedimento essencial comumente realizado na medicina veterinária de pequenos animais. Um manejo de feridas adequado é uma arte difícil de se aperfeiçoar, devido à sua complexidade inerente ao cenário clínico, bem como à natureza em constante evolução da área com a adição contínua de novas técnicas e produtos. Este artigo revisa os conceitos mais importantes que podem ajudar o clínico a compreender melhor o processo natural de cicatrização de feridas, fatores que atrasam e estratégias que melhoram o ambiente local da ferida para torná-la mais predisposta à cicatrização durante o manejo de feridas abertas. O conceito de preparação do leito da ferida deve ser definido antes da discussão mais detalhada das estratégias de manejo mais comuns, como lavagem e debridamento. Aspectos chave do manejo de biofilmes e uso apropriado de antimicrobianos também foram revisados. Finalmente, o conceito de cicatrização úmida de feridas e o seu impacto no manejo de feridas moderno é explicado antes da revisão de diversos tipos de curativos oclusivos, com um foco particular nos curativos ativos.
Subject(s)
Anti-Infective Agents , Wounds and Injuries , Animals , Bandages/veterinary , Biofilms , Debridement/methods , Debridement/veterinary , Wound Healing , Wounds and Injuries/therapy , Wounds and Injuries/veterinaryABSTRACT
The processing of blood samples can be delayed during health assessments of wildlife populations in distant locations. The use of whole blood preservatives may be useful in these situations. However, there is scant information regarding their use in nonmammalian species. This study tested the efficacy of two cell preservatives on whole blood collected from 12 Attwater's prairie chickens (Tympanuchus cupido attwateri). The preservatives used were Streck Cell Preservative© (SCP), a proprietary proteinaceous stabilizer developed for human flow cytology and validated in other mammalian species, and formalin, which is commonplace in histopathology, but its use in whole blood has been limited to fish. Grouped blood samples were treated with heparin, SCP, or formalin and analyzed at 0, 1, 4, and 7 days after collection for packed cell volume (PCV), complete blood count (CBC), and cellular morphology. SCP effectively preserved most cell types in Attwater's prairie chicken blood samples over a period of 7 days, with the exception of monocyte cell counts, which were significantly reduced from day 0. Formalin maintained total white blood cell counts at baseline levels measured by hemocytometer, but irregular staining characteristics prevented accurate analysis of differential counts or cellular morphology. Both preservatives altered PCV compared with the heparin control, but these values remained constant over time, highlighting the need for method-specific reference intervals. The validation of SCP in Attwater's prairie chickens supports its potential for use in other avian species for the collection of accurate hematologic data when the processing of blood samples may be delayed.
