Publications by authors named "Eileen S Hackett"

34 Publications

Outcomes following single, caudally based bilateral versus unilateral frontonasal sinusotomy for treatment of equine paranasal sinus disease.

Vet Med Sci 2021 Aug 17. Epub 2021 Aug 17.

Preclinical Surgical Research Laboratory, Department of Clinical Sciences, Veterinary Teaching Hospital, Translational Medicine Institute, Colorado State University, Fort Collins, Colorado, USA.

Background: Bilateral sinus disease is relatively uncommon in horses, accounting for 3%-4.5% of horses with sinonasal disease, but may require bilateral paranasal surgery for complete resolution. Complications and recurrence following bilateral sinusotomy have not been reported or compared to those following unilateral procedures.

Objective: To describe clinical features and outcomes in horses undergoing standing single, caudally based bilateral frontonasal sinusotomy compared to unilateral frontonasal surgery.

Methods: Records of horses (n = 37) undergoing surgical treatment for sinus disease (five bilateral, 32 unilateral) were retrospectively reviewed (2010-2017) for signalment, presenting complaint, duration of signs preoperatively, diagnostic imaging, treatments administered, duration hospitalization, complications, and owner satisfaction with the procedure. Mann-Whitney testing was used to compare age, duration of hospitalization, and follow-up time in horses undergoing unilateral or bilateral procedures. Fisher's exact testing was used to determine if sex predilection was present for unilateral or bilateral disease. Survival time and time to recurrence were compared by Kaplan-Meier survival curves and log-rank curve comparison testing. Significance was assessed at p < 0.05.

Results: Length of signs prior to admission did not differ between horses with unilateral and bilateral disease (p = 0.09), but there was a tendency for horses with bilateral disease to have clinical signs for longer. Age (p = 0.19) and hospitalization duration (p = 0.53) did not differ between horses undergoing unilateral versus bilateral procedures. Recurrence or failure to resolve signs was reported in 11/32 (34%) of unilateral and 0/5 bilateral cases (p = 0.07).

Conclusions: The bilateral single, caudally based sinusotomy approach may be considered to effectively treat bilateral paranasal sinus disease without concern for increased risk of life-threatening complications or longer hospitalization duration than would be typical for unilateral sinusotomy procedures.
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http://dx.doi.org/10.1002/vms3.607DOI Listing
August 2021

Investigation of neonatal disorders in New World camelids and factors associated with death during and after hospitalization of affected crias.

J Am Vet Med Assoc 2021 Apr;258(8):892-898

Objective: To assess signalment, clinical findings, and treatments for New World camelids (NWCs) hospitalized for evaluation and treatment of neonatal disorders and investigate associations between these factors and death during and after hospitalization.

Animals: 267 NWCs ≤ 30 days of age.

Procedures: Medical records of a veterinary teaching hospital were retrospectively reviewed to identify NWCs admitted for evaluation and treatment of neonatal disorders between 2000 and 2010. Signalment, physical examination data, diagnostic findings, treatments, and outcomes were recorded. Factors were examined for association with death during hospitalization and the overall hazard of death by use of multivariable logistic regression and Cox proportional hazards analysis, respectively.

Results: The sample comprised alpacas (n = 255) and llamas (12). Median age at admission was 3 days, and median hospitalization time was 2 days; 208 of the 267 (77.9%) neonatal NWCs survived to hospital discharge. Factors associated with increased odds of death during hospitalization included prematurity or dysmaturity, hypothermia, sepsis, toxic changes in neutrophils, and undergoing surgery. The odds of death during hospitalization also increased as anion gap increased. After discharge, 151 of 176 (85.8%) animals had follow-up information available (median follow-up time, 2,932 days); 126 (83%) were alive and 25 (17%) had died. Prematurity or dysmaturity, congenital defects, sepsis, oxygen administration, and undergoing surgery as a neonate were associated with an increased hazard of death; the hazard of death also increased as serum chloride concentration at the time of hospitalization increased.

Conclusions And Clinical Relevance: Results suggested the prognosis for survival during and after hospitalization is good for most NWCs hospitalized because of neonatal disorders.
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http://dx.doi.org/10.2460/javma.258.8.892DOI Listing
April 2021

Laparoscopic Ovariectomy in a Domestic Yak.

Case Rep Vet Med 2020 6;2020:8886670. Epub 2020 Nov 6.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.

Owners of a juvenile domestic yak elected bilateral ovariectomy to prevent future reproduction. The yak was noted to be healthy at presentation. Both ovaries were removed using a laparoscopic approach as follows: after induction and maintenance of general inhalant anesthesia, 15 degrees Trendelenburg positioning was required to view the ovaries. Ovariectomy was conducted within a surgical time of 50 minutes. Due to the small ovarian size, portal enlargement was not necessary for removal. Mild hemorrhage from the left ovarian pedicle was controlled with application of a vessel-sealing device. Postoperative complications were not encountered during hospitalization. At 12 months following surgery, the yak was healthy, and the owner was highly satisfied with the procedure. The described approach was successful for performing laparoscopic ovariectomy in a juvenile yak. Positioning for surgery was similar to other small ruminant species. Further case enrollment is needed to optimize the surgical approach and better describe clinical outcomes.
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http://dx.doi.org/10.1155/2020/8886670DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7665910PMC
November 2020

Atypical in a Horse: Implications for Hospital Safety.

Case Rep Vet Med 2020 4;2020:7062408. Epub 2020 Jun 4.

Department of Clinical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523, USA.

A 17-year-old Quarter Horse mare was evaluated for colic of 24-hour duration. Clinical signs and diagnostic evaluation were consistent with duodenitis-proximal jejunitis. The horse's clinical condition deteriorated despite medical treatment and was euthanized. Aerobic culture collected from small intestinal ingesta was positive for subsp. serovar Hadar. sp. is commonly implicated in nosocomial infections in equine veterinary hospitals usually through feces containing the organism. Considering sp. was cultured from the jejunal luminal contents and the large volume of nasogastric reflux that was evacuated in this case, a perceived risk of sp. transmission from infected gastric reflux to other hospitalized cases was realized. Infectious agent biosecurity precautions should be undertaken in horses with nasogastric reflux to prevent hospital-acquired transmission.
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http://dx.doi.org/10.1155/2020/7062408DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292965PMC
June 2020

Evaluation of the Element point-of-care blood gas analyzer for use in horses.

J Vet Emerg Crit Care (San Antonio) 2020 May 18;30(3):279-285. Epub 2020 Mar 18.

Department of Clinical Sciences, Colorado State University, Fort Collins, CO.

Objective: To compare the Element point-of-care (POC) portable blood gas analyzer with a laboratory-based bench-top reference analyzer using whole blood samples obtained from horses presenting to a referral center with various disorders in order to determine agreement between these analyzers.

Design: Prospective clinical study.

Setting: The study was conducted at a university teaching hospital at moderate altitude.

Animals: One hundred paired samples from 80 horses >1 year of age were collected after obtaining informed client consent. Fifty paired samples were from patients admitted for elective procedures and considered to be healthy, and 50 paired samples were emergency admissions and considered to be critically ill.

Measurements And Main Results: Paired whole blood samples were evaluated on both the Element POC and Radiometer ABL 800 FLEX analyzers simultaneously, and results were compared. Pearson correlation coefficients between analyzers were calculated. To assess agreement, scatter and Bland-Altman plots were evaluated, and mean difference and 95% limits of agreement were calculated for each analyte. Correlation was either good (0.8-0.92) or excellent (>0.93) for the majority of analytes. All analytes apart from hemoglobin had acceptable agreement, with ≥80% of individual results within agreement targets. Precision targets were acceptable for most analytes, with partial pressure of carbon dioxide (pCO ) and calcium (Ca ) exceeding precision targets.

Conclusions: The portable Element POC system had acceptable agreement with the ABL 800 FLEX bench-top analyzer currently in use at the study center when evaluating the majority of analytes from equine whole blood samples.
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http://dx.doi.org/10.1111/vec.12950DOI Listing
May 2020

Combined tube cystostomy and urethrotomy for the treatment of urethral obstruction due to urolithiasis in goats.

Vet Surg 2020 Feb 11;49(2):373-379. Epub 2019 Oct 11.

Department of Clinical Sciences, Colorado State University College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado.

Objective: To describe the treatment of goats with urethral obstruction secondary to urolithiasis by combining tube cystostomy and urethrotomy.

Animals: Eight male goats.

Study Design: Short case series.

Methods: Medical records (September 2012-September 2017) of male goats treated for obstruction secondary to urolithiasis with tube cystostomy and urethrotomy were reviewed. Data collected included signalment, history, physical examination findings, diagnostic results, perioperative treatments, operative details, hospitalization duration, intraoperative and postoperative complications, urolith analysis, and time to restoration of urethral patency. Long-term follow-up (>12 months) was obtained by email or telephone interviews of owners or by clinical examination.

Results: Seven of eight goats were castrated males of various of breeds. All goats were tachycardic with urethral pulsation at admission. Uroliths were composed of calcium carbonate in four goats and silica in one goat. All goats regained urethral patency during hospitalization, and all were discharged alive from the hospital. Seven goats were alive at long-term follow-up. Postoperative complications included persistent urethral obstruction requiring a second urethrotomy 2 days postoperatively, premature dislodgement of the bladder catheter and jejunal obstruction secondary to adhesions, and recurrence of obstructive urolithiasis within the proximal perineal urethra requiring a second surgery 8 months later (1 each). Long-term outcome was good, with urethral patency beyond 12 months in six of eight goats.

Conclusion: Combining tube cystostomy and urethrotomy restored urethral patency in goats with urethral obstruction from uroliths. Although none of the complications seemed directly related to the urethrotomy, formation of abdominal adhesions and recurrence of urolithiasis affected long-term outcomes.

Clinical Significance: Uroliths that do not dissolve in acidic urine may be more frequent in some practices. The combined approach of tube cystostomy and urethrotomy appears to successfully restore urethral patency with promising long-term outcomes.
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http://dx.doi.org/10.1111/vsu.13335DOI Listing
February 2020

Prospective randomized investigation of topical anesthesia during unilateral laparoscopic ovariectomy in horses.

Vet Surg 2020 Jun 21;49 Suppl 1:O54-O59. Epub 2019 Jun 21.

Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado.

Objective: To compare pain-related responses in mares receiving topical or injected anesthesia of the ovarian pedicle prior to standing unilateral laparoscopic ovariectomy.

Study Design: Prospective randomized, blinded, placebo-controlled study.

Animals: Fifteen healthy research mares.

Methods: Mares were restrained in stocks and administered sedation. A right or left paralumbar ovariectomy was performed by using a laparoscopic portal and two instrument portals. Mares were divided into two treatment groups, and equal volumes of mepivacaine anesthesia were administered either topically (n = 8) or by injection into the ovarian pedicle (n = 7). Saline controls were simultaneously administered topically (n = 7) or by injection (n = 8), and surgeons were blinded to the treatment group. Ovarian removal was performed with traumatic forceps and a blunt tip vessel sealer and divider. Pain responses were measured by operative visual analog scale (VAS) scoring and perioperative serum cortisol response. Visual analog scale and serum cortisol were compared between groups by using Mann-Whitney testing. Serum cortisol concentrations were evaluated using repeated-measures one-way analysis of variance.

Results: Ovaries were removed in all mares by using the described technique without operative complications. Quantity of sedation required to complete the procedure, operative VAS scores, and perioperative cortisol concentrations did not differ between treatment groups.

Conclusion: Application of topical mepivacaine to the ovary provided intraoperative analgesia similar to injection of the ovarian pedicle when performing unilateral standing laparoscopic ovariectomy in mares.

Clinical Significance: Topical anesthesia application to the ovary could provide an alternative to laparoscopic needle use, reducing the risk of inadvertent trauma to the pedicle or other visceral organs during laparoscopic ovariectomy.
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http://dx.doi.org/10.1111/vsu.13264DOI Listing
June 2020

A retrospective cohort study of racing performance in Quarter Horses undergoing prosthetic laryngoplasty for treatment of recurrent laryngeal neuropathy.

J Am Vet Med Assoc 2019 Feb;254(4):496-500

OBJECTIVE To determine effects of prosthetic laryngoplasty on return to racing, performance index, and career longevity in racing Quarter Horses with recurrent laryngeal neuropathy (RLN) and to evaluate performance variables for horses with RLN undergoing prosthetic laryngoplasty, compared with a control horse population. DESIGN Multicenter, retrospective cohort study. ANIMALS 162 racing Quarter Horses with RLN treated with prosthetic laryngoplasty (case horses) and 324 racing Quarter Horse without RLN (control horses). PROCEDURES Medical and race records of case and control horses examined at 5 referral centers between January 2000 and December 2015 were reviewed retrospectively. Two control horses were matched with each case horse. Return to racing, earnings, number of racing starts, performance index, and career longevity were evaluated. RESULTS The odds of returning to racing did not differ significantly between case and control horses but decreased with increasing age. Neither racing starts nor career longevity were affected by prosthetic laryngoplasty or by RLN grade. In fact, horses undergoing laryngoplasty for treatment of RLN and horses with the lowest RLN grade before surgery had higher performance indices after the surgery, compared with indices for control horses. CONCLUSIONS AND CLINICAL RELEVANCE The faster speeds and shorter distances raced with Quarter Horses could alter how RLN impacts respiratory variables and performance in Quarter Horses, compared with other racehorse breeds. Further study is needed to understand the impacts of RLN and surgical treatments for RLN in racing Quarter Horses.
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http://dx.doi.org/10.2460/javma.254.4.496DOI Listing
February 2019

Laparoscopic ovariohysterectomy in goats.

J Am Vet Med Assoc 2019 Jan;254(2):275-281

OBJECTIVE To describe a minimally invasive 3-portal laparoscopic approach for elective ovariohysterectomy and the outcome of that procedure in a population of goats. DESIGN Descriptive clinical study. ANIMALS 16 healthy client-owned goats. PROCEDURES Food but not water was withheld from all goats for 24 hours before the procedure. Goats were anesthetized and positioned in dorsal recumbency. Three laparoscopic portals were created in the caudoventral portion of the abdomen, and the abdomen was insufflated to a maximum pressure of 10 mm Hg. A blunt-tip vessel sealer and divider device was used to transect the left and right mesovarium and mesometrium and uterus, and the resected tissue was removed from the abdomen. After hemostasis was verified, the portals were closed in a routine manner and anesthesia was discontinued. Goats were discharged from the hospital 24 hours after the procedure, and owners were contacted by telephone or email to obtain short- and long-term follow-up information by use of standardized questions. RESULTS All procedures were performed by a surgeon and assistant surgeon. The procedure was not complex and was easily learned. No intraoperative complications were reported, and only 1 goat required rescue analgesia post-operatively. No other postoperative complications were recorded. Median surgery time was 43 minutes (range, 20 to 65 minutes). All owners were satisfied with the outcome of the procedure, and several perceived that the procedure improved goat behavior. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that laparoscopic ovariohysterectomy was a viable alternative for elective sterilization of female goats.
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http://dx.doi.org/10.2460/javma.254.2.275DOI Listing
January 2019

Clinical features, diagnostic methods, treatments, and outcomes associated with ingested wires in the abdomen of horses: 16 cases (2002-2013).

J Am Vet Med Assoc 2018 Sep;253(6):781-787

OBJECTIVE To describe clinical features, diagnostic methods, treatments, and outcomes associated with ingested wire foreign bodies in the abdomen of horses. DESIGN Retrospective case series. ANIMALS 16 client-owned horses with ingested wire in their abdomens that were evaluated at a veterinary teaching hospital between April 2002 and February 2013. PROCEDURES Data for each case were collected from medical records and owners and then reviewed. Differences in clinicopathologic variables between horses that did (survivors) or did not (nonsurvivors) survive to discharge from the hospital were assessed. RESULTS The median duration of clinical signs prior to admission was 5.5 days (range, 0.5 to 1,095 days). Survivors (n = 4) had significantly lower median WBC count, neutrophil count, and plasma total protein concentration, compared with nonsurvivors (12), and all survivors underwent surgical treatment. Peritoneal fluid analysis revealed suppurative or septic peritonitis in all 8 horses tested. The presence of wire was confirmed by abdominal radiography (n = 6), exploratory laparotomy (2), and necropsy (8). The median length of ingested wire was 6 cm; wire had perforated viscera in 13 horses, 10 of which subsequently developed abdominal abscesses. CONCLUSION AND CLINICAL RELEVANCE Abdominal perforation by wire should be considered a differential diagnosis for horses with peritonitis and abdominal abscesses. Radiography is useful for detection of wire foreign bodies in the abdomens of horses. Given the guarded prognosis for affected horses suggested by results of the present study, early and aggressive treatment, including exploratory laparotomy to retrieve the wire and address perforations, peritonitis, and abscesses, should be considered.
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http://dx.doi.org/10.2460/javma.253.6.781DOI Listing
September 2018

Comparison of two techniques for transpharyngeal endoscopic auditory tube diverticulotomy in the horse.

J Vet Sci 2018 Nov;19(6):835-839

Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80523, USA.

Auditory tube diverticula, also known as guttural pouches, are naturally occurring dilations of the auditory tube in horses that communicate with the nasopharynx through a small ostium. Infection and select other conditions can result in inflammation and narrowing of the nasopharyngeal ostium, which prevents drainage of fluid or egress of air and can lead to persistent infection or guttural pouch tympany. Auditory tube diverticulotomy allows continuous egress from the auditory tube diverticula and is a feature of disease treatment in horses, in which medical treatment alone is not successful. Transpharyngeal endoscopic auditory tube diverticulotomy was performed using a diode laser either at a single dorsal pharyngeal recess location or bilaterally caudal to the nasopharyngeal ostium in 10 horse head specimens. Both methods resulted in clear communication between the nasopharynx and auditory tube diverticula. Diverticulotomy performed in the dorsal pharyngeal recess required less laser energy and activation time and had a shorter surgical duration than diverticulotomy performed caudal to the nasopharyngeal ostium. Further study related to the clinical application of both techniques is warranted.
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http://dx.doi.org/10.4142/jvs.2018.19.6.835DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6265580PMC
November 2018

Duodenoduodenostomy for obstruction of the sigmoid flexure of the duodenum in cattle.

Vet Surg 2018 Jul 15;47(5):623-628. Epub 2018 May 15.

Department of Clinical Sciences, Cornell University, Ithaca, New York.

Objective: To describe clinical findings, surgical treatment, and outcome associated with duodenoduodenostomy for treatment of duodenal obstruction secondary to adhesions associated with the sigmoid flexure of the duodenum.

Study Design: Retrospective study (1996-2016).

Animals: Fourteen Holstein cattle.

Methods: Medical records of cows treated at 3 academic surgical referral centers with duodenoduodenostomy for duodenal obstruction secondary to adhesions associated with the sigmoid flexure of the duodenum were reviewed. Data that were collected included signalment, physical examination results, laboratory results, diagnostic findings, treatments, and survival to discharge. Owners were contacted for follow-up information.

Results: Affected cattle ranged in age from 4 months to 5 years. Electrolyte abnormalities, including severe hypochloremia, were present in all cases. Abnormalities included cranial duodenal distension without concurrent distension of the descending duodenum and palpable focal adhesions in the region of the sigmoid flexure of the duodenum. Duodenoduodenostomy involved a stapled (n = 11) or sutured (n = 3) side-to-side anastomosis between the cranial duodenum and descending duodenum. Thirteen of 14 cattle that were treated with duodenoduodenostomy survived to hospital discharge. Long-term follow-up was available in 8 cows, and 7 of those 8 survived for at least 1 year.

Conclusion: Short- and long-term survival were favorable after duodenoduodenostomy in cattle with adhesions associated with the sigmoid flexure of the duodenum.

Clinical Significance: Duodenoduodenostomy results in acceptable survival and future productivity in cows with obstruction at the sigmoid flexure of the duodenum.
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http://dx.doi.org/10.1111/vsu.12901DOI Listing
July 2018

Vessel sealer and divider instrument temperature during laparoscopic ovariectomy in horses.

Vet Surg 2018 Jun 3;47(S1):O26-O31. Epub 2017 Dec 3.

Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado.

Objective: To determine the temperature of a vessel sealer and divider device during unilateral paralumbar laparoscopic ovariectomy in standing, sedated mares.

Study Design: Prospective study.

Animals: Fifteen healthy research mares.

Methods: Healthy mares with normal ovarian palpation and ultrasonographic appearance were enrolled. Horses were restrained in standing stocks and sedated. A right or left paralumbar ovariectomy was performed with a laparoscopic portal and 2 instrument portals. Ovaries were excised with traumatic forceps and a blunt tip vessel sealer and divider. Temperatures of the vessel sealer and divider were recorded with a thermocouple device adhered to the tip of the instrument. Variables were reported as median and interquartile range (IQR).

Results: Surgical time was 30 minutes (IQR, 25-32) including use of the vessel sealer and the divider for 4.1 minutes (IQR, 3.2-5.8). The tip of the instrument reached temperatures of 77°C (IQR, 72-85) during activation and 64°C (IQR, 61-67) at end cycle. The median increase in end-cycle instrument tip temperature per activation cycle was 2°C (IQR, -1-6). All mares returned to their intended use.

Conclusion: Despite the instrument temperatures observed during unilateral laparoscopic ovariectomy, surgical complications were minimal. The clinical relevance of the increase in instrument tip temperature of the vessel sealer and divider is presently unclear, but surgeons should use the instrument with caution, especially in close proximity to viscera. The increase in temperature observed at the tip of the vessel sealer and divider during unilateral ovariectomy could be associated with morbidity. The clinical relevance of instrument tip heating during other procedures, such as adhesiolysis and intestinal resection, is unknown and should be evaluated.
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http://dx.doi.org/10.1111/vsu.12755DOI Listing
June 2018

Technique-associated outcomes in horses following large colon resection.

Vet Surg 2017 Nov 7;46(8):1061-1067. Epub 2017 Oct 7.

Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado.

Objective: To compare survival and complications in horses undergoing large colon resection with either sutured end-to-end or stapled functional end-to-end anastomoses.

Study Design: Retrospective cohort study.

Animals: Twenty-six client-owned horses with gastrointestinal disease.

Methods: Retrospective data were retrieved from the medical records of 26 horses undergoing colectomy, including 14 horses with sutured end-to-end and 12 horses with stapled functional end-to-end anastomoses, between 2003 and 2016. Records were evaluated for signalment, medical and surgical treatments, and survival to hospital discharge. Long-term follow-up was obtained through owner contact. Continuous variables were compared with Mann-Whitney tests. Fisher's exact testing was used to compare survival to hospital discharge. Survival time was compared by constructing Kaplan-Meier survival curves and performing log-rank curve comparison testing.

Results: Mean age of horses undergoing colectomy was 13 years. Reason for colectomy was prophylaxis (12) or salvage (14). Mean surgical time was 169 minutes. Mean hospitalization time was 9 days, which did not differ with anastomosis type (P = .62). Nine of 12 horses undergoing stapled functional end-to-end anastomosis and 12 of 14 horses undergoing sutured end-to-end anastomosis survived to hospital discharge (P = .63). Survival time did not differ with anastomosis technique (P = .35).

Conclusion: Short- and long-term survival outcomes are not different between sutured end-to-end or stapled functional end-to-end anastomoses in horses undergoing colectomy.
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http://dx.doi.org/10.1111/vsu.12725DOI Listing
November 2017

Evaluation of two methods for topical application of contrast medium to the pharyngeal and laryngeal region of horses.

Am J Vet Res 2017 Sep;78(9):1098-1103

OBJECTIVE To determine the pharyngeal and laryngeal distribution of radiopaque contrast medium administered orally or via nasopharyngeal catheter to standing horses. ANIMALS 5 healthy adult horses. PROCEDURES A crossover study was conducted. Radiopaque contrast medium (12 mL) was administered orally and via nasopharyngeal catheter to each horse. Pharyngeal and laryngeal distribution of contrast medium was determined by examination of radiographs obtained immediately after administration of contrast medium, compared with those obtained before administration. Regional distribution of contrast medium was graded. Endoscopic examination of the nasopharynx, laryngopharynx, and larynx was performed to confirm radiographic results. RESULTS Examination of radiographs obtained after nasopharyngeal administration revealed contrast medium in the nasopharynx (n = 5), oropharynx (2), laryngopharynx (3), and larynx (5) of the 5 horses. Examination of radiographs obtained after oral administration revealed contrast medium in the oropharynx (n = 4) and larynx (1) of the 5 horses. Endoscopic examination confirmed radiographic findings and was found to be sensitive for detection of contrast medium in the laryngopharynx, whereby detection rates were higher for both administration methods. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that medication administered by use of a nasopharyngeal catheter will result in topical distribution within the nasopharynx, including the dorsal surface of the soft palate, and larynx, although distribution should be evaluated in horses with clinical airway disease to confirm these findings. Oral administration did not result in consistently detectable topical laryngeal distribution but could be used for selected conditions (eg, palatitis).
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http://dx.doi.org/10.2460/ajvr.78.9.1098DOI Listing
September 2017

Left paralumbar laparoscopic bilateral ovariectomy in mares.

Vet Surg 2017 May 24;46(4):574-579. Epub 2017 Feb 24.

Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado.

Objective: To develop a novel technique for left paralumbar laparoscopic bilateral ovariectomy in standing, sedated mares.

Study Design: Prospective descriptive clinical study.

Animals: Twelve client-owned mares.

Methods: Healthy mares with normal ovarian palpation and ultrasonographic appearance were enrolled. Horses were restrained in standing stocks and administered a variable rate infusion of sedation. A left paralumbar bilateral ovariectomy was performed with 1 laparoscopic and 3 instrument portals. Access to the right ovary was facilitated by retracting the descending colon and associated mesentery with a fan retractor. Ovaries were removed with traumatic forceps, and a blunt tip vessel sealing device. A laparoscopic portal within the 17th intercostal space provided good visualization of the right ovary and reduced interference between instrumentation. Complications were recorded during hospitalization. In addition, an owner follow-up questionnaire was used to determine complications after discharge from the hospital.

Results: Left paralumbar bilateral ovariectomy was successful in all 12 mares, with a mean surgical time of 76 ± 8 minutes. Postoperative complications occurred in 4/12 (33%) mares and included fever, mild colic, incisional swelling, and azotemia. Complications resolved and mares returned to full activity, with complete owner satisfaction.

Conclusions: Bilateral ovariectomy can be successfully achieved with minimal morbidity in standing mares with normal ovarian ultrasonographic appearance via left paralumbar laparoscopy.
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http://dx.doi.org/10.1111/vsu.12637DOI Listing
May 2017

Repair of an acquired diaphragmatic hernia with surgical mesh in a foal.

Can Vet J 2017 Feb;58(2):145-148

Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA.

A foal born with assisted delivery developed rib fractures and a diaphragmatic hernia. The hernia was repaired using surgical mesh. The filly was healthy 42 months later. Dystocia is a risk factor for rib fractures and traumatic acquired diaphragmatic herniation. Surgical mesh repair is an option for diaphragmatic defects.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5234313PMC
February 2017

Laparoscopic Closure of the Nephrosplenic Space in Horses with Nephrosplenic Colonic Entrapment: Factors Associated with Survival and Colic Recurrence.

Vet Surg 2016 Nov 13;45(S1):O60-O69. Epub 2016 Sep 13.

Department of Clinical Sciences, Colorado State University, Fort Collins, CO.

Objectives: 1) To identify factors associated with short-term survival and time to death after hospital discharge in horses with nephrosplenic entrapment (NSE). 2) To compare the frequency of recurrent colic episodes in horses with and without laparoscopic closure of the nephrosplenic space.

Study Design: Historical cohort with a nested case control.

Animals: Client-owned horses.

Methods: Medical records of horses treated for NSE from January 1, 2002 to June 1, 2014 were reviewed. Data collected included signalment, physical examination parameters, laboratory results, diagnostic findings, and treatments. Factors associated with short-term survival to discharge were analyzed with a multivariable logistic regression model and time to death after hospital discharge was analyzed with a Cox proportional hazards model.

Results: During the study period, 211 horses had 231 NSE events and 192/211 (91%) horses survived to discharge. A positive difference in packed cell volume (PCV at admission - PCV after treatment) was associated with reduced odds of nonsurvival with each increment (OR: 0.899, 95% CI 0.816-0.991, P=.03) while the presence of concurrent alimentary lesions (OR: 8.47, 95% CI 1.42-50.4, P=.02) were significantly associated with increased odds of nonsurvival in the short term. Of 156 horses that survived to discharge for which follow-up was available, 152 (97%) were alive for ≥1 year. Increasing age (incremental years) at hospital admission was significantly associated with death after discharge (hazard ratio 1.078, 95% CI 1.002-1.16, P=.049). Recurrence of NSE was documented in 49/211 (23%) horses. The overall change in colic score indicated a reduction in colic in horses following laparoscopic closure of the nephrosplenic space compared with horses that did not have closure of the nephrosplenic space (P<0.001).

Conclusion: An increase in PCV from admission to after treatment and concurrent abdominal lesions were associated with increased odds of nonsurvival to discharge in horses with NSE. Horses that underwent laparoscopic closure had reduced colic episodes compared with horses without laparoscopic closure.
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http://dx.doi.org/10.1111/vsu.12549DOI Listing
November 2016

Laparoscopic inguinal hernioplasty in a ram.

J Am Vet Med Assoc 2015 May;246(10):1118-21

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.

Case Description: A 4-month-old Hampshire ram underwent open right inguinal herniorrhaphy and unilateral castration following herniation that developed after a kick injury. Seven months later, the ram was reevaluated because of scrotal swelling of 1 month's duration as well as suspected left inguinal hernia.

Clinical Findings: The ram had marked scrotal swelling. Palpation of the left testicle revealed no abnormalities. Ultrasonographic examination revealed heterogenous tissue within the cranial and medial portions of the scrotum with pronounced accumulation of hypoechoic fluid at the scrotal apex. Examination findings indicated left-sided indirect inguinal herniation of omentum.

Treatment And Outcome: To preserve fertility, left inguinal hernioplasty without castration was performed. The ram was anesthetized and placed in dorsal recumbency, and laparoscopic abdominal evaluation revealed omental entrapment within the left inguinal ring. The omentum was removed, and a polypropylene mesh was secured over the internal inguinal ring with an articulating hernia stapler. Following mesh placement, a dorsally based peritoneal flap was elevated and secured over the mesh repair. The ram recovered well from surgery; there was no repeated herniation following the surgical correction, and the ram was able to breed successfully without complication.

Clinical Relevance: Laparoscopic mesh hernioplasty can be successful in rams with inguinal hernias when preservation of fertility is preferred.
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http://dx.doi.org/10.2460/javma.246.10.1118DOI Listing
May 2015

The effect of colloid formulation on colloid osmotic pressure in horses with naturally occurring gastrointestinal disease.

BMC Vet Res 2014 7;10 Suppl 1:S8. Epub 2014 Jul 7.

Background: Naturally occurring gastrointestinal disease is an important cause of acute hypoproteinemia in adult horses and hydroxyethyl starch colloid fluid treatment is a component of supportive care in these cases to improve plasma volume and maintain colloid osmotic pressure (COP). The objectives of the present study were to compare 2 formulations of high molecular weight hydroxyethyl starch and their relative effect on COP, acid-base status, and survival of horses with acute hypoproteinemia secondary to gastrointestinal disease.

Methods: Twenty adult horses, ≥ 1 year of age, were prospectively enrolled, with informed client consent, if they developed acute hypoproteinemia, defined as a plasma total protein <5.0 g/dL or albumin <2.2 g/dL during hospitalization while undergoing treatment for gastrointestinal disease. Horses were randomly assigned to receive a rapid infusion of either 6% hydroxyethyl starch in 0.9% saline or 6% hydroxyethyl starch in lactated ringers solution at a dose of 10 ml/kg. Venous blood gas analysis, COP, and PCV were evaluated before and after colloid administration.

Results: For both groups, average COP prior to treatment was 11.0 mmHg (9.7 - 12.2 mmHg) and post colloid treatment was 13.2 mmHg (12.0 -14.7 mmHg) [Normal range 18 - 22 mmHg]. COP was significantly increased with colloid treatment (p<0.001) but this increase was not significantly different between treatment groups. Venous pH did not change significantly with treatment. Twelve horses survived to hospital discharge and survival did not differ significantly between treatment groups.

Conclusions: Post-treatment COP improved approximately 20% regardless of the formulation used, however, values did not reach the normal range of COP observed in healthy horses. Acid-base parameters were not significantly impacted by either treatment. Further study is needed to determine how these two products compare with regards to other outcome measures. Evaluation of the relative effects of colloid formulation in horses with clinical disease is a future area of interest.
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http://dx.doi.org/10.1186/1746-6148-10-S1-S8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4123155PMC
May 2015

Evaluation of plasma muscle enzyme activity as an indicator of lesion characteristics and prognosis in horses undergoing celiotomy for acute gastrointestinal pain.

BMC Vet Res 2014 7;10 Suppl 1:S7. Epub 2014 Jul 7.

Background: In horses undergoing celiotomy for acute gastrointestinal pain, identification of variables correlating with lesion severity and location, and survival provide veterinarians and owners with information that aids in making informed decisions regarding appropriate treatment. Muscle enzyme activity is often increased in horses undergoing celiotomy for acute gastrointestinal pain and it is not known if muscle enzyme activity increase is specific to lesion type or impacts prognosis for survival. The objective of this study was to evaluate the relationship of pre-operative increase in muscle enzyme activities with intestinal lesion characteristics, specifically lesion location (large versus small intestine) and whether it was strangulating versus nonstrangulating, and case survival in horses undergoing celiotomy for acute gastrointestinal pain.

Methods: Records of 241 horses undergoing exploratory laparotomy for colic were reviewed retrospectively. Evaluation of preoperative plasma aspartate aminotransferase (AST), creatine kinase (CK), sorbitol dehydrogenase (SDH), and gamma-glutamyltransferase (GGT) activities, fibrinogen and glucose concentrations, and hematocrit (HCT) and their association with gastrointestinal lesion characteristics and survival was performed.

Results: Pre-operative increase in plasma CK and AST activity, and HCT and decrease in plasma bilirubin concentration were significantly associated with presence of lesions resulting in intestinal ischemia. Increase in plasma CK activity and HCT were significantly associated with a decreased probability of survival to hospital discharge. Plasma GGT and SDH activity, and glucose and fibrinogen concentration were not significantly associated with survival or severity of disease in multivariate analysis.

Conclusions: Plasma muscle enzyme activity may be useful as a prognostic indicator in equine colic cases. Given that increases in plasma CK and AST activity were significantly associated with nonsurvival and the presence of intestinal ischemia, preoperative increase in these enzyme activities could assist in identification of disease severity and prognosis of horses undergoing celiotomy for acute gastrointestinal pain. Further study is indicated to elucidate the etiology of increased muscle enzyme activity in horses with surgical colic disease observed in this preliminary study.
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http://dx.doi.org/10.1186/1746-6148-10-S1-S7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4122891PMC
May 2015

Colonic gastrointestinal stromal tumor resulting in recurrent colic and hematochezia in a warmblood gelding.

Can Vet J 2014 May;55(5):471-4

Colorado State University, Department of Clinical Sciences, 300 West Drake Road, Fort Collins, Colorado 80523, USA (Malberg, Hackett); North Dakota State University, Veterinary Diagnostic Laboratory, Dept. 7691, PO Box 6050, Fargo, North Dakota 58108, USA (Webb).

A 14-year-old Trakehner gelding was evaluated for recurrent colic, with episodes occurring over 1 year. Signs were consistent with intermittent ascending colon obstruction and hematochezia. Necropsy examination revealed an ulcerated mass extending into the lumen of the right dorsal ascending colon. Gross and histologic appearance and immunoreactivity to c-kit (CD117), desmin, vimentin, and smooth muscle actin, were consistent with a diagnosis of gastrointestinal stromal tumor.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3992309PMC
May 2014

Current treatment of ascending colon volvulus in horses: a survey of ACVS Diplomates.

Vet Surg 2015 Apr 14;44(3):398-401. Epub 2014 Apr 14.

Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado.

Objective: To report the results of a survey of opinions on current treatments and estimated outcomes of ascending colon volvulus in horses.

Study Design: Web-based survey.

Sample Population: American College of Veterinary Surgeons (ACVS) Diplomates (n = 151) who perform gastrointestinal surgery in horses.

Methods: ACVS Diplomates with credentials in the large animal specialty obtained by examination in 2010 or earlier (n = 410) were solicited by e-mail to complete a web-based survey designed to determine ascending colon volvulus treatment preferences and outcomes.

Results: Responses were obtained from 162 ACVS Diplomates, of which 151 currently performed gastrointestinal surgery in horses. Horses surgically treated with ascending colon volvulus accounted for ≤ 20 cases/year and primary treatment was most often anatomic reduction with or without pelvic flexure enterotomy. Median estimated survival rate was 70% and surgical treatments were not associated with estimated survival (P = .27). Diplomates identified early surgical correction as the single most important factor impacting survival of horses surgically treated for ascending colon volvulus.

Conclusions: Reported survival rates for horses with ascending colon volvulus were good. Respondents indicated this might be due in part to early surgical treatment. Survey investigations can provide preliminary data for future prospective studies and facilitate a consensus among Diplomates in treatment of surgical disease.
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http://dx.doi.org/10.1111/j.1532-950X.2014.12195.xDOI Listing
April 2015

Evaluation of antioxidant capacity and inflammatory cytokine gene expression in horses fed silibinin complexed with phospholipid.

Am J Vet Res 2013 Oct;74(10):1333-9

Department of Clinical Sciences, College of Veterinary Medicine and Biological Sciences, Colorado State University, Fort Collins, CO. 80523.

Objective: To evaluate antioxidant capacity and inflammatory cytokine gene expression in horses fed silibinin complexed with phospholipid.

Animals: 5 healthy horses.

Procedures: Horses consumed increasing orally administered doses of silibinin phospholipid during 4 nonconsecutive weeks (0 mg/kg, 6.5 mg/kg, 13 mg/kg, and 26 mg/kg of body weight, twice daily for 7 days each week). Dose-related changes in plasma antioxidant capacity, peripheral blood cell glutathione concentration and antioxidant enzyme activities, and blood cytokine gene expression were evaluated.

Results: Plasma antioxidant capacity increased throughout the study period with increasing dose. Red blood cell nicotinamide adenine dinucleotide phosphate:quinone oxidoreductase I activity decreased significantly with increasing doses of silibinin phospholipid. No significant differences were identified in glutathione peroxidase activity, reduced glutathione or oxidized glutathione concentrations, or expression of tumor necrosis factor α, interleukin-1, or interleukin-2.

Conclusions And Clinical Relevance: Minor alterations in antioxidant capacity of healthy horses that consumed silibinin phospholipid occurred and suggest that further study in horses with liver disease is indicated.
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http://dx.doi.org/10.2460/ajvr.74.10.1333DOI Listing
October 2013

Pharmacokinetics and safety of silibinin in horses.

Am J Vet Res 2013 Oct;74(10):1327-32

Department of Clinical Sciences, College of Veterinary Medicine and Biological Sciences, Colorado State University, Fort Collins, CO, 80523.

Objective: To determine the oral bioavailability, single and multidose pharmacokinetics, and safety of silibinin, a milk thistle derivative, in healthy horses.

Animals: 9 healthy horses.

Procedures: Horses were initially administered silibinin IV and silibinin phospholipid orally in feed and via nasogastric tube. Five horses then consumed increasing orally administered doses of silibinin phospholipid during 4 nonconsecutive weeks (0 mg/kg, 6.5 mg/kg, 13 mg/kg, and 26 mg/kg of body weight, twice daily for 7 days each week).

Results: Bioavailability of orally administered silibinin phospholipid was 0.6% PO in feed and 2.9% via nasogastric tube. During the multidose phase, silibinin had nonlinear pharmacokinetics. Despite this, silibinin did not accumulate when given twice daily for 7 days at the evaluated doses. Dose-limiting toxicosis was not observed.

Conclusions And Clinical Relevance: Silibinin phospholipid was safe, although poorly bio-available, in horses. Further study is indicated in horses with hepatic disease.
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http://dx.doi.org/10.2460/ajvr.74.10.1327DOI Listing
October 2013

Alterations of drug metabolism in critically ill animals.

Vet Clin North Am Small Anim Pract 2011 Jul 23;41(4):805-15, vii. Epub 2011 May 23.

Department of Clinical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523, USA.

Critically ill animals are by nature a diverse group with multiple presenting complaints and differing levels of organ function. Pharmacokinetics and pharmacodynamics of administered compounds are affected both by the disease processes and by the interventions of the treating veterinarian. Polypharmacy is not an exception but a rule within this caseload. Basic principles of pharmacology allow for safe and effective administration of pharmaceuticals, especially in the critically ill. Future research evaluating the pharmacokinetics and pharmacodynamics of drugs important in the management of critically ill animals is imperative, and will allow evidence-based dose modification.
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http://dx.doi.org/10.1016/j.cvsm.2011.03.019DOI Listing
July 2011

Pulmonary gas exchange and plasma lactate in horses with gastrointestinal disease undergoing emergency exploratory laparotomy: a comparison with an elective surgery horse population.

Vet Surg 2011 Jul 3;40(5):601-9. Epub 2011 May 3.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.

Objective: To characterize pulmonary gas exchange and arterial lactate in horses with gastrointestinal disease undergoing anesthesia, compared with elective surgical horses, and to correlate these variables with postoperative complications and mortality.

Study Design: Prospective clinical study.

Animals: Horses undergoing emergency laparotomy for acute intestinal disease (n = 50) and healthy horses undergoing elective surgery in dorsal recumbency (n = 20).

Methods: Arterial blood gas analysis was performed at predetermined intervals on horses undergoing a standardized anesthetic protocol. Alveolar-arterial oxygen gradient was calculated. Predictive factors for postoperative complications and death in colic horses were determined.

Results: Arterial oxygen tension (P(a) O(2)) varied widely among horses in both groups. P(a) O(2) significantly increased in the colic group after exteriorization of the ascending colon. P(a) O(2) and alveolar-arterial oxygen gradient were not significantly different between groups, and neither were correlated with horse outcome. Arterial lactate in recovery ≥ 5 mmol/L was associated with a 2.25 times greater relative risk of complications and lactate ≥ 7 mmol/L was associated with a 10.5 times higher relative risk of death.

Conclusion: Colic horses in this population were not more likely to be hypoxemic than elective horses, nor was gas exchange impaired to a greater degree in colic horses relative to controls. Arterial lactate sampled immediately after anesthetic recovery was predictive for postoperative complications and death.
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http://dx.doi.org/10.1111/j.1532-950X.2011.00840.xDOI Listing
July 2011

A Warmblood gelding with a deep neck laceration.

Compend Contin Educ Vet 2011 Jan;33(1):E4

Colorado State University, USA.

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January 2011

Inadvertent transvaginal administration of sodium phosphate enemas in 2 alpaca crias.

J Vet Emerg Crit Care (San Antonio) 2010 Dec;20(6):623-7

Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80523, USA.

Objective: To describe the clinical presentation and resultant metabolic disturbances following retroperitoneal administration of hyperphosphate enemas in alpaca crias.

Case Or Series Summary: Two crias presented to the Colorado State University Veterinary Teaching Hospital after inadvertent transvaginal retroperitoneal hyperphosphate enema administration. The first cria developed an acute onset of neurologic signs, severe hypernatremia, and died soon after presentation. The second cria developed severe hyperphosphatemia, hypocalcemia, and acidemia. The metabolic derangements normalized within 24 hours of intensive treatment with calcium supplementation and IV crystalloid fluid diuresis. The cria was discharged after 1 week in the hospital.

New Or Unique Information Provided: This report provides a description of electrolyte disturbances secondary to inadvertent transvaginal retroperitoneal administration of hyperphosphate enemas in 2 crias and attendant clinical signs of these disturbances. Management of hyperphosphatemia and hypocalcemia in 1 cria via aggressive fluid therapy with calcium supplementation led to a rapid and sustained normalization of phosphorus, calcium, and acid-base balance.
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http://dx.doi.org/10.1111/j.1476-4431.2010.00583.xDOI Listing
December 2010

Evaluation of porcine hydrated dermis augmented repair in a fascial defect model.

J Biomed Mater Res B Appl Biomater 2011 Jan;96(1):134-8

Small Ruminant Comparative Orthopaedic Laboratory, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA.

Surgical mesh composed of extracellular matrix promotes healing of difficult soft tissue and orthopedic repairs in preclinical and clinical trials. In this study, a novel extracellular matrix prepared from porcine hydrated dermis was evaluated in an in vivo fascial defect model in sheep. Fascial defects were created, and then acutely repaired with surgical mesh. Healed surgical sites were evaluated grossly, histologically, and biomechanically at 6 and 12 weeks. Porcine hydrated dermis extracellular matrix performed favorably compared to negative control empty defects and native fascia, with minimal gross adhesion, low histologic inflammatory scores, and significantly greater tensile strength of the healing surgical site when compared with native fascia.
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http://dx.doi.org/10.1002/jbm.b.31751DOI Listing
January 2011
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