Postoperative wound assessment in cattle: How reliable is the back hand palpation?

BACKGROUND: As part of clinical wound assessment in bovine surgery, discrepancies in skin temperature are evaluated by placing the back of the hand on the area to be examined. Generally, an increased skin temperature at the wound site for a prolonged period is considered as an indicator of impaired wound healing. The aim of this study was to verify the reliability of palpation under bovine practice conditions using laparotomy as an example. Fourteen cows (German Holstein) with a left displacement of the abomasum (LDA) without other severe concurrent diseases were examined preoperatively and once daily for ten days after surgery. The skin temperature of the wound site in the right flank was assessed by palpation, followed by thermographic evaluation using an infrared camera after a 45-min acclimatisation period, under standardised conditions in a closed examination room daily for 10 days. RESULTS: All the incisions healed without clinical detectable perturbances. The ambient temperature range during the study period was 7.8 - 24.1 °C. Two groups were retrospectively defined according to the ambient temperature: high ambient temperature (HT group; median: 20.2 °C 25/75 quartile: 18.5 °C / 21.7 °C; n = 6) and low ambient temperature (LT group; 10.8 °C; 9.4 °C / 12.8 °C; n = 8). The temperature differences (Δϑ) between the mean skin temperature of the wound site and a defined reference area cranial to the wound were assessed. A significant negative correlation was found between the ambient temperature (ϑAmb) and Δϑ (r=-0.51; P < 0.001). The Δϑ was postoperatively higher in the cows in the LT group (median of the individual animals 0.8-2.5 °C) than in the HT group (0.1-0.5 °C; P < 0.05). In contrast to the thermographic findings, manual palpation rarely detected local hyperthermia (> 1 °C) at the wound site (sensitivity 0.20; specificity 0.96). CONCLUSIONS: The infrared thermography provides a more reliable assessment of temperature changes at the wound site in comparison to manual palpation. The ambient temperature markedly affects the extent of local hyperthermia at the wound site.

[Six years later - long-term follow-up after rare injury in childhood]. / 6 Jahre später ­ Langzeitnachuntersuchung nach seltener Verletzung im Kindesalter.

The present case shows the long-term follow-up of a rare injury due to blunt abdominal trauma in childhood. The patient suffered from a traumatic transsection to the A. iliaca communis, which was restored by the combination of a direct suture with a venous autologous patch. A six-year follow-up when the boy was mature with a height of180 cm showed an unremarkable MRI angiography without any sign of stenosis. Due to the limited number of experiences with this rare injury reported in the literature, there is a lack of consensus on the suture technique and use of patches or grafts. The demonstrated technique supplies a possible treatment for this rare injury to infantine arteries.

Actinobacillus pleuropneumoniae challenge in swine: diagnostic of lung alterations by infrared thermography.

BACKGROUND: Actinobacillus pleuropneumoniae (A.pp.) is the causative agent of porcine pleuropneumonia leading to high economic losses in the pig industry. Infrared thermography (IRT) of the thorax might offer a new method to select swine with lung alterations for further diagnostics. In this study 50 german landrace pigs were infected with A.pp. in an established model for respiratory tract disease, while 10 healthy pigs served as control animals. To avoid drift errors during IR measurements absolute skin temperatures and temperature differences between a thoracal and an abdominal region were assessed for its diagnostic validity. RESULTS: IRT findings during the course of experimental A.pp.-infection were verified by computed tomography (CT) before and on days 4 and 21 after infection. Significant correlations were found between clinical scores, CT score and lung lesion score. Ambient temperature, body temperature and abdominal surface temperature were factors influencing the skin surface temperature of the thorax. On day 4 but not on day 21 after infection the right thoracal temperature was significantly higher and the difference between a thoracal region in the height of the left 10th vertebra and an abdominal region was significantly lower in infected pigs than in control pigs. At a cut off of 28°C of right thoracal temperature the specificity of the method was 100% (CI 95%: 69-100%) and the sensitivity 66% (CI 95%: 51-79%). At a cut off of 2°C temperature difference between thoracal and abdominal region on the left body site the specificity of the method was 100% (CI 95%: 69-100%) and the sensitivity 32% (CI 95%: 19-47%) with all control pigs detected negative. Orientation for lung biopsy by IRT resulted in 100% specificity and sensitivity (CI 95%: 69-100%) of bacteriological examination of tissue samples during the acute stage of infection. CONCLUSION: IRT might be a valuable tool for the detection of inflammatory lung alterations in pigs, especially during the acute stage of infection and if ambient temperatures are constant during individual measurements. External and internal factors interfere with this method, so that its application in the field might be restricted to a selection of pigs for further diagnostic with adequate specificity.

Difference method for analysing infrared images in pigs with elevated body temperatures.

Infrared imaging proves to be a quick and simple method for measuring temperature distribution on the pig's head. The study showed that infrared imaging and analysis with a difference ROI (region of interest) method may be used for early detection of elevated body temperature in pigs (> 39.5°C). A high specificity of approx. 85% and a high sensitivity of 86% existed. The only prerequisite is that there are at least 2 anatomical regions which can be recognised as reproducible in the IR image. Noise suppression is guaranteed by averaging the temperature value within both of these ROI. The subsequent difference imaging extensively reduces the off-set error which varies in every thermal IR-image.

[Influence of exercise on horses' limb volume, measured by an optoelectronic device]. / Experimentelle Untersuchung zum Einfluss definierter Bewegung auf das Volumen der Pferdeextremität anhand optoelektronischer Messungen.

This study tested for the first time an optoelectronic device (Perometer*) measuring limb volume of horses. An analysis of its application was performed regarding the influence of different types of physical exercise on the volume of the extremities. 40 horses were divided into four groups often horses, each group being exposed to exercise, differing in kind and duration of lunging, horse-ridden and riderless. The volume measurement was performed by determining the inactive value (I) after a twelfe-hour standing period, the load value (II) immediately after exercise and recovery value (III) one hour after exercise. The results showed a highly significant decrease in limb volume of 5.7% between values (I) and (II), as well as a highly significant increase of 68% between (II) and (III). The volume changes observed in male horses were significantly higher than in female horses. Volume changes in horse-ridden groups were higher than riderless ones, but not significant. There were fewer leg volume changes at low ambient temperatures (1-12 degrees C) compared to high temperatures (23-31 degrees C), but these were not statistically significant. Well-trained horses showed lower volume changes than less trained horses (not statistically significant). The Perometer is a fast and reliable tool for measuring limb volume of horses. The ICC (Interclass Correlation Coefficient) calculated a high measurement reproducibility of 0.996. A variance analysis showed no significant differences between the three repeated leg measurements. Thus, the Perometer can be used for monitoring and quantifying edema and documenting limb volume changes resulting from training, wearing compression stockings or bandages, manual lymph drainage.

[Comparison of different methods to quantify the volume of horse limbs]. / Vergleich verschiedener Methoden zur Volumenmessung am Pferdebein.

Measuring the leg volume of horses is useful for diagnostic and treatment of different diseases in relation to swollen legs. In the present study different methods to quantify the limb volume are compared, the water displacement method, an optoelectronic 2-dimensional body scanner, the so-called perometer and calculation of volume by applying the disc model. As reference method the golden standard of human medicine - the water displacement method was used. We took volume measurements from different tall horses in a defined section of the forelegs between the coronary band and the carpal joint. All applied methods are easily reproducible. The optoelectronic method has a higher intra-class correlation coefficient (ICC) of 0.90 than the water displacement method (ICC = 0.84). Pairwise comparison delivers strong linear relationship with coefficients of correlation > or = 0.972 and comparing the absolute values delivers coefficients of concordance > or = 0.962. In comparison to the water displacement method, the volumes taken by the disc model using a measuring tape tend to underestimate the volume by approximately 8%. The volume taken by the perometer agrees well in the range of measuring accuracy (-0.6 +/- 4.4%), but tends to slightly overestimate the volume (0.6%). Due to the linear relationship, the different methods are easily interchangeable using a conversion factor. The only methods applicable in clinical practice are the disc model and the perometer. The water displacement method is strongly limited due to its lacke of acceptance by horses. In comparison with all the above-mentioned methods the results taken by the disc model are the least accurate. However, when viewed in comparison their reliability is in many applications satisfying. The best method to quantify the limb volume of a horse is the contactless optoelectronic measurement by the perometer. This is quite expensive, but it is found to be acceptable to horses and established results that are nearly one to one when compared to the golden standard. The examiner gets much more information (volume-time diagrams) due to different options and not only the pure result of volume.