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Biomedical subjects

R C Straw

Publications and source records attributed to R C Straw.

At least 55 records · Page 3Linked to original sources

The Kirschner-Ehmer splint in small animal orthopedics.

The Kirschner-Ehmer splint can be used to treat open, infected or highly comminuted fractures, gunshot fractures, nonunions, delayed unions, mandibular fractures and angular deformities in association with osteotomy, as well as to immobilize joints and as an adjunct to other fixation devices. After the fracture is reduced, 2-4 percutaneous pins are inserted with a Jacobs hand chuck through one or both cortices at 45-60 degrees to the longitudinal axis of the bone and attached to a connecting bar with clamps. Complications are minimized by not inserting the pin through large muscle masses, the fracture hematoma, large blood vessels or the incision line, avoiding encroachment of soft tissue with the clamps, and restricting the animal's activity during healing.

Animals↗

Scalpel blade contamination with skin bacteria during orthopedic and neurosurgical procedures in dogs.

Skin incision and internal incision scalpel blades used during 40 clean canine orthopedic or neurologic operations were cultured. A biopsy of skin was taken from the incision edge and cultured aerobically and anaerobically. Culture of five skin blades, eight skin biopsies, and nine deep dissection blades resulted in bacterial growth. Results indicate that the skin blade does not add significantly to bacterial inoculum contaminating clean wounds.

Animals↗

Use of a vascular skeletal muscle graft for canine esophageal reconstruction.

A technique for reconstruction of the thoracic esophagus was evaluated in 13 dogs. A 9 x 10 cm section of transversus abdominis muscle was harvested, fashioned into a tubular graft, and vascularized via the greater omentum. The vascularized tube was advanced into the caudal thorax through the diaphragm at a second surgery 20 to 44 days after harvesting the section of the transversus abdominis muscle. A 5 cm section of caudal thoracic esophagus was replaced with the vascular tubular graft. One dog died because of incarceration of the intestine within the tube and two dogs were euthanized because of infected tubes. One dog died due to an anesthetic complication, one dog had a diaphragmatic hernia and died, and one dog died from pyothorax. Leakage of luminal contents at the anastomoses did not occur in any dog. Seven dogs survived both surgeries but showed deglutitory difficulty 6 days postoperatively due to the grafted esophageal segments becoming severely strictured in each case. Angiography demonstrated vascularization of the full thickness of the graft in each of the seven dogs. An unacceptably high incidence of infection and stricture formation made this technique unsuitable for clinical use.

Anastomosis, Surgical↗

Partial or total hemipelvectomy in the management of sarcomas in nine dogs and two cats.

The functional results of partial or total hemipelvectomy in seven dogs and two cats with sarcomas involving the pelvis were excellent, and the cosmetic outcome was acceptable to all owners. Tumors in two dogs were inoperable. Locally recurrent cancer occurred in two animals and metastases occurred in three animals. Three dogs survived longer than 2.5 years and the overall and disease-free survival at 12 months was 62%. It appears that osteosarcoma of the pelvis is at least as aggressive as osteosarcoma of limbs and, unless effective adjuvant therapy is used, poorer survival results are likely in dogs with osteosarcoma than with other sarcomas of the pelvis. Hemipelvectomy is an aggressive surgical procedure that can be used successfully in selected dogs and cats with cancer involving the pelvis.

Animals↗

Resection of pulmonary metastases in canine osteosarcoma: 36 cases (1983-1992).

Thirty-six dogs underwent pulmonary metastatectomy for osteosarcoma. All patients had been treated for histologically confirmed osteosarcoma of the appendicular skeleton. Treatment for the primary tumor consisted of amputation or a limb sparing procedure in conjunction with adjuvant chemotherapy, local radiation therapy, or both. Significant factors in determining prognosis included the disease-free interval (DFI) between treatment of the primary tumor and development of pulmonary metastases and the number of metastatic nodules present at surgery. Dogs that developed pulmonary metastases 300 days or more after diagnosis of the primary tumor had a median DFI of 128 days after metastatectomy. Dogs that developed pulmonary metastases fewer than 300 days after diagnosis had a median DFI of 58 days. Dogs with one or two metastatic nodules removed had a median DFI of 95 days, whereas dogs with three or more nodules removed had a median DFI of 53 days. The results of this study indicate that prognostic variables exist for dogs with metastatic pulmonary osteosarcoma and can help predict survival after metastatectomy. These variables are similar to the prognostic variables that have been determined for human patients undergoing pulmonary metastatectomy because of osteosarcoma. Though a controversial procedure, pulmonary metastatectomy seems to be a valid treatment option for selected dogs with metastatic pulmonary osteosarcoma.

Animals↗

Combined resection of the nasal planum and premaxilla in three dogs.

Surgical techniques for removal of tumors that affect the nasal planum or the premaxilla have been described. For extensively invasive malignancies, these techniques may be inadequate if used alone to achieve wide surgical margins. An operative technique that combines resection of the nasal planum and premaxilla has been developed for extensive malignant tumors of the nasal planum or premaxilla. This technique was used in three dogs and resulted in an acceptable cosmetic appearance and good function and tumor control. Complications after surgery included minor bleeding and partial dehiscence of the suture lines in two dogs and stenosis of the nasal orifice in one dog.

Animals↗

Total and partial orbitectomy for the treatment of periorbital tumors in 24 dogs and 6 cats: a retrospective study.

Total or partial orbitectomy were used to treat 24 dogs and six cats with invasive periorbital tumors. The surgical procedure and clinical results were evaluated in this retrospective study. The most common types of tumors treated in this series of patients were multilobular osteochondrosarcoma and squamous cell carcinoma. Two patients died of cardiopulmonary arrest within 24 hours after surgery. One patient developed neurological signs after total orbitectomy that resolved with conservative therapy. Minor complications, which included infection, strabismus, and conjunctivitis, occurred in seven patients. Regrowth of tumor in the periorbital region occurred in 11 patients (36.7%). Tumor resection by orbitectomy provided local disease-free interval of more than 1 year in more than 50% of patients. Survival rate for the first year was 70.4% in this series of patients as determined by life table analysis. Orbitectomy requires detailed knowledge of regional anatomy and experience with performing a combination of surgical procedures. Preoperative diagnostic tests should include imaging techniques to define the extent of the disease. When performed properly, orbitectomy is a valuable procedure that can be used to effectively treat invasive tumors of the orbit.

Animals↗

Limb salvage surgery for osteosarcoma of the proximal humerus: outcome in 17 dogs.

OBJECTIVE: To describe function and identify factors that affect outcome in dogs undergoing limb salvage surgery for osteosarcoma (OS) of the proximal humerus. STUDY DESIGN: A retrospective study of dogs in which OS of the proximal humerus was treated with limb salvage surgery. ANIMALS: 17 client-owned dogs. METHODS: Records were analyzed for functional outcome, recurrence, metastasis, and survival. RESULTS: Outcome was good to excellent in 12% of dogs. Recurrence, metastasis, and survival were significantly affected by completeness of surgical margins. Double plating of the distal allograft-host junction significantly reduced frequency of biomechanical failure. CONCLUSIONS: Limb salvage surgery for OS of the proximal humerus did not result in acceptable function and was fraught with postoperative complications. Outcome was significantly affected by completeness of surgical margins. CLINICAL RELEVANCE: Limb salvage surgery for OS of the proximal humerus in dogs cannot be recommended until improvement in functional outcome and reduction in postoperative complications can be achieved. The dependence of outcome on completeness of surgical margins supports aggressive en bloc resection and marking and evaluating surgical margins.

Amputation, Surgical↗

Transposition of first digital pad for reconstruction of a palmar antebrachial soft tissue defect in a cat.

An 8-year-old female neutered Siamese cat was presented with a recent history of incomplete excision of an apocrine gland adenocarcinoma from the palmar aspect of the right antebrachium, just proximal to the carpal joint. There was no evidence of metastasis. Wide surgical excision of the previous surgery site was performed resulting in a soft tissue defect. Partial reconstruction was achieved using digital pad transposition of the first digit (dewclaw), forming a local axial pattern flap that was transposed into the adjacent defect. The remaining defect was closed by primary apposition. The skin flap healed successfully. Some breakdown of the skin closed by primary apposition necessitated open wound management. The cosmetic and functional result of the first digital pad transposition was considered excellent, rendering it a useful means to reconstruct soft tissue defects in the carpal region.

Adenocarcinoma↗

Amputation and cisplatin for treatment of canine osteosarcoma.

Seventy-one dogs with histologically confirmed appendicular osteosarcoma were evaluated. Seventeen dogs were treated with amputation and two postoperative [corrected] doses of IV cisplatin given 21 days apart (group 1). Nineteen dogs were treated with IV cisplatin 21 days before amputation, with a second dose given immediately after amputation (group 2). Thirty-five dogs were treated by amputation of the affected limb with no chemotherapy (group 3). The median disease-free interval for group 1 was 226 days, and 177 days for group 2. This was not significantly different. The median survival time was 262 days for group 1, 282 days for group 2 and 119 days for group 3. Group 1 and 2 dogs had survival times that were significantly longer than for dogs in group 3. Two IV courses of cisplatin given before or after amputation appears to improve the survival of dogs with osteosarcoma.

Amputation, Surgical↗

Amputation and carboplatin for treatment of dogs with osteosarcoma: 48 cases (1991 to 1993).

Forty-eight dogs with histologically confirmed appendicular osteosarcoma (OSA) entered a prospective clinical trial evaluating treatment with amputation and up to 4 doses of carboplatin given every 21 days. The median disease-free interval (DFI) was 257 days, with 31.2% of the dogs disease-free at 1 year. The median survival time was 321 days, with 35.4% of the dogs alive at 1 year. Dogs with proximal humeral OSA had shorter DFI (P = .016) and survival (P = .037) times than dogs with OSA at other locations. Dogs with lower body weights ( < 40 kg) had longer DFI (P = .0056) and survival (P = .007) times than larger dogs. Survival times for dogs that received carboplatin were statistically longer than those previously reported for amputation alone (P < .001). DFI and survival times are similar to those previously reported for 2 to 4 doses of cisplatin. Carboplatin appears to be a well-tolerated chemotherapeutic drug that can be given safely every 21 days at a dose of 300 mg/m2. Neutropenia was the dose-limiting toxicity in this study.

Amputation, Surgical↗

Primary rib tumors in 54 dogs.

Fifty-four dogs with primary tumors of the rib were evaluated. Thirty-four dogs had osteosarcomas, 15 dogs had chondrosarcomas, three dogs had hemangiosarcomas, and two dogs had fibrosarcomas. Forty-nine dogs had en bloc excision. Within the osteosarcoma group, nine animals received postoperative adjuvant chemotherapy. These animals had significantly longer median disease-free intervals (225 days) and median survival times (240 days) than dogs with osteosarcoma treated by surgery alone (median disease-free interval, 60 days; median survival, 90 days). Chondrosarcoma had a better prognosis (median disease-free interval, 1,080 days; median survival, 1,080 days) than osteosarcoma, hemangiosarcoma, or fibrosarcoma of the rib. Age, weight, sex, number of ribs resected, tumor volume, and total cisplatin dose did not influence survival nor disease-free interval.

Animals↗

Primary osteosarcoma distal to the antebrachiocarpal and tarsocrural joints in nine dogs (1980-1992).

The medical records of nine dogs with primary osteosarcoma distal to the antebrachiocarpal or tarsocrural joint were reviewed. Eight of the nine dogs were treated with surgical removal of the primary tumor; seven received adjuvant chemotherapy; and one dog was treated with chemotherapy alone. Median survival of dogs in this series was 466 days. Six of the nine dogs died of causes attributable to osteosarcoma, and both skeletal and pulmonary metastases occurred. Survival of dogs with osteosarcoma distal to the antebrachiocarpal or tarsocrural joint was somewhat longer than survival of dogs with osteosarcoma of more common appendicular sites. However, these are aggressive tumors with a high potential for metastasis.

Animals↗

Canine mandibular osteosarcoma: 51 cases (1980-1992).

Fifty-one dogs treated for mandibular osteosarcomas (OSs) were studied retrospectively. Treatments were partial mandibulectomy (n = 32); partial mandibulectomy and chemotherapy (n = 10); partial mandibulectomy and radiation therapy (n = 3); partial mandibulectomy, radiation therapy, and chemotherapy (n = 4); and radiation therapy alone (n = 2). The overall one-year survival rate was 59.3%. Dogs treated with surgery alone had a one-year survival rate of 71%, which is higher than the one-year survival rate for dogs with appendicular OSs treated with surgery alone (p of 0.001 or less; hazard ratio of 0.29). There was no apparent effect of various treatment modalities, nor institution where treatment was given, nor histological type. Histological score and, to a lesser extent, histological grade were predictive of survival outcome.

Animals↗

Feline cutaneous squamous cell carcinoma of the nasal planum and the pinnae: 61 cases.

Cutaneous squamous cell carcinoma is a common tumor in cats and frequently occurs on the nasal planum and the pinnae. The medical records of 61 cats were reviewed for this retrospective study. Typical presentation was an older (median age, 12 years) cat with an erythematous, crusty, and erosive lesion. Methods of treatment included surgery, radiation, and cryotherapy. Disease-free interval and survival time were calculated for each case and grouped according to lesion location and treatment type. All treatments were found to be effective, with surgery resulting in the longest disease-free interval (median, 594 days).

Animals↗

Digital pad transposition for replacement of the metacarpal or metatarsal pad in dogs.

A technique for digital pad transposition is described and illustrated. This technique has application for use in cases of metacarpal or metatarsal pad neoplasia or severe trauma. The transposed digital pad will provide a weight-bearing surface of heavy, keratinized epidermis in cases where the normal metacarpal or metatarsal footpad has been removed. The use of the technique in four clinical cases of footpad neoplasia also is reported.

Animals↗

Multilobular osteochondrosarcoma in 39 dogs: 1979-1993.

Thirty-nine, older, large-breed dogs with multilobular osteochondrosarcoma (MLO) each presented primarily with a fixed mass involving the flat bones of the skull. Twenty-five dogs were treated with surgical resection alone, nine were treated with adjuvant therapy, and five were not treated. Forty-seven percent of dogs treated had local tumor recurrence, and 56% had metastasis. Median time to recurrence, median time to metastasis, and median survival time were 797, 542, and 797 days, respectively. Histological grade, surgical margins, and tumor location affected outcome. Long-term remission can be obtained with aggressive treatment of MLO, although it is locally invasive and moderately metastatic.

Animals↗

Outcome following treatment of vertebral tumors in 20 dogs (1986-1995).

Twenty dogs with histopathologically confirmed primary (n=15) or metastatic (n=5) osteosarcoma (n=14) or fibrosarcoma (n=6) of the vertebral column were treated with surgery (n=4), radiation therapy and chemotherapy (n=6), surgery and chemotherapy (n=2), or surgery, radiation, and chemotherapy (n=8). All dogs died due to their disease; 15 died due to local failure, and five died due to nonvertebral metastasis. Overall median survival time was 135 days, with a range of 15 to 600 days. Of the factors evaluated, only postoperative neurological status had a significant influence on outcome by multivariate analysis. This study supports the overall guarded prognosis for dogs with vertebral neoplasia. Better combinations of surgery, chemotherapy, and radiation therapy remain to be defined for this difficult subset of animal cancer.

Animals↗