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RESUMEN Introducción: La cobertura de dispositivos ortopédicos expuestos y las infecciones en el hueso con colgajos es un tema controvertido. No existe un consenso claro sobre el tratamiento de esta complicación. En los últimos años se aprecia una tendencia a mantener el material de osteosíntesis y a controlar la infección aportando tejido bien vascularizado en forma de colgajo muscular o fasciocutáneo. Objetivo: Evaluar el éxito reconstructivo con colgajos de defectos de partes blandas en miembros que han precisado de una osteosíntesis, en función de la presencia de infección y el estado de los dispositivos de implante en el momento de la reconstrucción. Métodos: Estudio retrospectivo de una serie de 15 casos con un defecto de partes blandas en las extremidades inferiores secundario a la implantación de dispositivos ortopédicos en el hueso. Todos los casos recibieron cobertura con un colgajo muscular o fasciocutáneo con o sin retirada de los implantes. Se estudió la presencia o ausencia de infección previa a la reconstrucción (signos clínicos, resultado del cultivo microbiológico y exposición del material ortopédico), la retirada o mantenimiento del implante durante la reconstrucción, y la presencia de complicaciones posoperatorias. Se relacionaron estas variables con el éxito reconstructivo posoperatorio. El análisis de las variables se realizó con los estadísticos chi cuadrado, Wilcoxon y U de Mann Whitney, según el tipo de variable, y para una significación de 0,05. Resultados: La frecuencia de éxito reconstructivo fue mayor en aquellos pacientes con cultivo negativo sin exposición de material óseo (p = 0,038). Se encontró menor tasa de complicaciones en los pacientes que presentaban infección antes de la reconstrucción (p = 0,039), y en aquellos con cultivo positivo y exposición del material previos a la cirugía, cuyos implantes habían sido retirados durante la reconstrucción (p = 0,032). Conclusiones: El aporte de tejido bien vascularizado en forma de colgajo permite el mantenimiento del material ortopédico con una frecuencia de éxito de 66,67 %, y resultados favorables de mediano a largo plazo. La exposición y el resultado del cultivo son indicadores predictivos de los resultados de la cirugía(AU)

ABSTRACT Introduction: The covering of exposed orthopedic devices and bone infections with flaps are a controversial issue. There is no clear consensus concerning the treatment of this complication. In recent years, there has been a trend to maintain the osteosynthesis material and to control the infection by providing well vascularized tissue in the form of a muscular or fasciocutaneous flap. Objective: To assess the reconstructive success with flaps of soft tissue defects in limbs that have required osteosynthesis, based on the presence of infection and the status of the implant devices at the time of reconstruction. Methods: Retrospective study of a series of 15 cases with soft tissue defect in the lower limbs after implantation of orthopedic devices to the bone. All the cases were covered with muscle or fasciocutaneous flap, with or without removal of the implants. The presence or absence of infection prior to reconstruction (clinical signs, results of microbiological culture, and exposure of the orthopedic material), removal or maintenance of the implant during reconstruction, and the presence of postoperative complications were studied. These variables were associated with postoperative reconstructive success. The analysis of the variables was performed using the chi-square, as well as Wilcoxon and Mann Whitney U tests, according to the type of variable, and for a significance of 0.05. Results: The frequency of reconstructive success was higher in those patients with negative culture and without exposure of bone material (P=0.038). A lower rate of complications was found in patients with infection before reconstruction (P=0.039), and in those with positive culture and exposure of the material prior to surgery, whose implants had been removed during reconstruction (P=0.032). Conclusions: The provision of well vascularized tissue in the form of flap allows maintenance of the orthopedic material with a success rate of 66.67%, as well as favorable outcomes in the mid to long terms. The results of exposure and culture are predictive indicators of surgery outcomes(AU)

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The purpose of this study was to assess the unilateral prefemoral coelioscopic-assisted approach for ovariosalpingectomy in a d`Orbigny slider (Trachemys dorbigni) using a digital otoscope. Twenty healthy turtles were randomly assigned to one of two groups, for right (GR; n=10) or left (GL; n=10) prefemoral access, for coelioscopic-assisted ovariosalpingectomy. Anesthesia and surgery times, body weight, and ovary/oviduct weight data were recorded. Anesthesia and surgery times did not differ significantly between the groups. Wound closure was the most time-consuming surgical step. Ovary and body weights significantly affected the exposure time of the ipsilateral and contralateral ovaries, respectively. Two intraoperative complications were reported. All the animals recovered uneventfully. The digital otoscope can be safely and effectively used for coelioscopic-assisted single-access, unilateral prefemoral ovariosalpingectomy in d`Orbigny slider.

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Background: Transitional cell carcinoma (TCC) usually affects the trigone region of the bladder and proximal portionof the urethra. TCC in dogs is often complicated by local tumor invasion and obstruction of the urethra, ureters, or both.Urinary obstruction is the cause of death in approximately 60% of dogs with TCC. Radical surgeries are associated withmorbidity and mortality rates. Stents have recently been evaluated for use in dogs with ureteral obstruction resulting froma variety of urinary tract tumors. This report aims to describe bilateral ureteral stent placement for treatment of malignantureteral obstruction and long-term follow-up in a dog.Case: An 11-year-old female spayed Maltese dog with ureteral obstruction secondary to transitional cell carcinoma (TCC)in the bladder trigone. After palliative debulking procedure and diagnostic of TCC in bladder and NSAIDs treatment,recurrence has occurred causing ureteral obstruction and TCC had invaded the abdominal wall. Abdominal wall localtumor resection, trigone mass debulking and bilateral ureteral stent placement was made. A double-pigtail ureteral stentof appropriate length was advanced to bypass the ureteral obstruction. Stent sizes were 3.5 Fr in diameter and from 8 to32 cm in length. The patient underwent surgical resection of the transitional cell carcinoma in the abdominal wall. Thecorrect location of the bilateral ureteral pigtail stent was certified by abdominal radiography. Recovery was uneventfuland the dog was discharged 2 days after surgery. Eleven months after stent placement, the dog developed lumbar vertebrae metastasis, without evidence of recurrent ureteral obstruction. The owners elected euthanasia 517 days after originalpresentation and 337 days after ureteral stent placement. Euthanasia was unrelated to the local tumor obstruction but was...(AU)

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A lamb presented with recurrent prolapse of the descending colon. On clinical examination, intussusception of the descending colon with the prolapse of a segment was verified. The external anal sphincter had a rupture, extending to the lacerated wound in the anus. The lamb underwent colopexy with the two-portal video-assisted incisional technique and was discharged 6 days after the surgical procedure with a satisfactory clinical outcome. There were no recurrences or complications for at least 9 months. Video-assisted colopexy is an alternative treatment for intussusception and recurrent colon prolapse in sheep, even in the presence of an external anal sphincter rupture.

Assuntos

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Background: Transitional cell carcinoma (TCC) usually affects the trigone region of the bladder and proximal portionof the urethra. TCC in dogs is often complicated by local tumor invasion and obstruction of the urethra, ureters, or both.Urinary obstruction is the cause of death in approximately 60% of dogs with TCC. Radical surgeries are associated withmorbidity and mortality rates. Stents have recently been evaluated for use in dogs with ureteral obstruction resulting froma variety of urinary tract tumors. This report aims to describe bilateral ureteral stent placement for treatment of malignantureteral obstruction and long-term follow-up in a dog.Case: An 11-year-old female spayed Maltese dog with ureteral obstruction secondary to transitional cell carcinoma (TCC)in the bladder trigone. After palliative debulking procedure and diagnostic of TCC in bladder and NSAIDs treatment,recurrence has occurred causing ureteral obstruction and TCC had invaded the abdominal wall. Abdominal wall localtumor resection, trigone mass debulking and bilateral ureteral stent placement was made. A double-pigtail ureteral stentof appropriate length was advanced to bypass the ureteral obstruction. Stent sizes were 3.5 Fr in diameter and from 8 to32 cm in length. The patient underwent surgical resection of the transitional cell carcinoma in the abdominal wall. Thecorrect location of the bilateral ureteral pigtail stent was certified by abdominal radiography. Recovery was uneventfuland the dog was discharged 2 days after surgery. Eleven months after stent placement, the dog developed lumbar vertebrae metastasis, without evidence of recurrent ureteral obstruction. The owners elected euthanasia 517 days after originalpresentation and 337 days after ureteral stent placement. Euthanasia was unrelated to the local tumor obstruction but was...

Assuntos