Grafting with double-layered polypropylene mesh for gap healing of mid-metacarpal superficial digital flexor tendon in Equus asinus : clinical and pathological evaluations
AbstractTendon injury is one of the most common causes of wastage in equine. The superficial digital flexor tendon (SDFT) gets affected the most, especially in the mid-metacarpal region. Several studies have focused on the grafting of severed SDFT, but no ideal grafting material has been approved for clinical application. The present study aimed to evaluate the grafting of the mid-metacarpal SDFT in donkeys with a double-layered polypropylene mesh clinically, ultrasonically, macro/microscopically. Clinically healthy adult donkeys (n = 24) were divided randomly and equally into two groups: control (C) and study (S) groups. Tenotomy was performed on all animals by excising a full-thickness segment from the mid-metacarpal SDFT. In the C group, a suture tenorrhaphy was performed. While in the S group, SDFT was grafted with the double-layered polypropylene mesh. The S group showed faster clinical improvements, and earlier appearance of normal newly formed tendinous tissue ultrasonically compared with the C group. Macroscopically, the grafted tendons showed a rapid restoration of normal color and consistency. Moreover, the y had minimal peri-tendinous adhesions compared with the non-grafted tendons. Microscopically, the grafted tendons showed earlier vascularization and more mature collagen fibers compared with the non-grafted tendons. In the present study, we have succeeded to graft the gap of the mid-metacarpal SDFT of a donkey using the double-layered polypropylene...
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Publication date: Available online 15 July 2019Source: Operations Research for Health CareAuthor(s): Maarten Otten, Aleida Braaksma, Richard J. BoucherieAbstractEarly or tardy surgeries are frustrating for both patients and personnel, and cause inefficient use of resources at the operating rooms. The stochastic Earliness/Tardiness (E/T) scheduling problem addresses this by minimizing the total expected deviation of the surgery completion times from the planned completion times. We introduce the concept of E/T-concavity as a property of a probability distribution if the E/T costs are concave as a function of the standard de...