Complications in Equine Surgery. Группа авторов
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the respiratory rate [84]. A leukocytosis occurs in the peripheral blood and granulocytes and macrophages accumulate in the damaged tissues [85]. Many pro‐inflammatory cytokines are released leading to inflammation. The amount of cytokine release is well correlated with both the magnitude and duration of surgery and the risk of postoperative complications. If the initial pro‐inflammatory response is exaggerated, sever systemic inflammatory response syndrome may occur.
Pain
Surgical procedures will lead to a pain response. It is well supported that the more invasive a procedure is, the more pain the patient will experience. Horses are typically stoic animals when it comes to exhibiting pain. It is thought that they mask signs of pain from predators, including humans, to minimize possible predation [86]. In one study, it was determined that horses undergoing surgery paid decreased attention toward novel objects and decreased responsiveness to auditory signals [87]. The relationship between pain, behavioral distress and physiological stress is complex and difficult to determine. Consequently, endocrine measures may not be accurate indicators of pain alone. It is also difficult to separate the inflammatory process associated with surgery and surgical complications from the pain response associated with surgery and surgical complications. The measurement of equine pain is probably best accomplished with multidimensional pain scales [88]. The Horse Grimace Scale has been recently described and is easy to use and has a high reliability between observers [89].
Impact of Host Factors and Comorbid Conditions
Blood loss impairs the body’s ability to deliver oxygen to the tissues and oxygen delivery to the tissues is important during injury [84]. Lack of oxygen impairs the body’s ability to heal. Diagnosing blood loss in the horse can be challenging due to the large reservoir of red blood cells stored in the spleen. Splenic contraction can maintain packed cell volume and total protein in the acute stages of hemorrhage [90]. Fluid volume expansion can actually reduce the effectiveness of oxygen delivery, making blood transfusions an important aspect of improving oxygen delivery.
Pituitary pars intermedia dysfunction is thought to impair corneal wound healing in horses [91]. There also appears to be an association between PPID and degenerative suspensory ligament desmitis [92]. It seems reasonable then that horses with PPID may have difficulty in healing. This should be considered when operating on horses with PPID.
References
1 1 Sokol, D.K. and Wilson. J. (2008).What is a surgical complication? World J. Surg. 32 (6): 942–944.
2 2 Jacbos, J.P., Jacbos. M.L., Mavrudis. C. et al. (2007). What is operative morbidity? defining complications in a surgical registry database. Ann. Thorac. Surg. 84: 1416–1421.
3 3 Tsesis, I. and Rosen, E. (2014). Introduction: an evidence‐based approach for prevention and management of surgical complications. In: Complications in Endodontic Surgery: Prevention, Identification and Management, 1e (ed. I. Tsesis), 1–6. Berlin: Springer‐Verlag.
4 4 Wooley, C.F. and Boudoulas, H. (1993). Clinician. Hellenic J. Cardiol. 34: 241–243.
5 5 Tsesis, I. and Rosen, E. (2014). Approach for prevention and management of surgical complications. In: Complications in Endodontic Surgery: Prevention, Identification and Management, 1e (ed. I. Tsesis), 1–6. Berlin: Springer‐Verlag.
6 6 Isaacs, D. and Fitzgerald, D. (1999). Seven alternatives to evidence based medicine. B.M.J. 319 (7225): 1618.
7 7 Mulholland, M.W. and Doherty, G.M. (2011). Surgical complciations. In: Complications in Surgery, 2e (ed. M.W. Mulholland and G.M. Doherty), 3–4. Philadelphia: Wolters Kluwer. Lipincott Williams & Wilkins.
8 8 Dorland, D. (2011). Dorlands Illustrated Medical Dictionary, 32e. Philadelphia: Saunders.
9 9 William, M.P. (2010). Measuring Morbidity Following Major Surgery. London: University College London.
10 10 Jacobs, J.P., Mavroudis, C., Jacobs, M.L. et al. (2006). What is operative mortality? Defining death in a surgical registry database: a report of the STS Congenital Database Taskforce and the Joint EACTS‐STS Congenital Database Committee. Ann. Thorac. Surg. 81 (5): 1937–1941.
11 11 Sahni, N.R., Dalton, M., Cutler, D.M. et al. (2016). Surgeon specialization and operative mortality in United States: retrospective analysis. B.M.J. 354: i3571.
12 12 Khuri, S.F., Henderson, W.G., DePalma, R.G. et al. (2005). Participants in the VANSQIP: determinants of long‐term survival after major surgery and the adverse effect of postoperative complications. Ann. Surg. 242 (3): 326–341; discussion 341–323.
13 13 Kravet, S.J., Howell, E., and Wright, S.M. (2006). Morbidity and mortality conference, grand rounds, and the ACGME’s core competencies. J. Gen. Intern. Med. 21 (11): 1192–1194.
14 14 Pierluissi, E., Fischer, M.A., Campbell, A.R. et al. (2003). Discussion of medical errors in morbidity and mortality conferences. J.A.M.A. 290 (21): 2838–2842.
15 15 Lecoanet, A., Vidal‐Trecan, G., Prate, F. et al. (2016). Assessment of the contribution of morbidity and mortality conferences to quality and safety improvement: a survey of participants’ perceptions. B.M.C. Health Serv. Res. 16: 176.
16 16 Reines, H.D., Trickey, A.W., and Donovan, J. (2017). Morbidity and mortality conference is not sufficient for surgical quality control: processes and outcomes of a successful attending Physician Peer Review committee. Am. J. Surg. 214 (5): 780–785.
17 17 Tignanelli, C.J., Embree, G.G.R., and Barzin, A. (2017). House staff‐led interdisciplinary morbidity and mortality conference promotes systematic improvement. J. Surg. Res. 214: 124–130.
18 18 Copeland, G.P., Jones, D., and Walters, M. (1991). POSSUM: a scoring system for surgical audit. Br. J. Surg. 78 (3): 355–360.
19 19 Dindo, D., Demartines, N., and Clavien, P.A. (2004). Classification of surgical complications: a new proposal with evaluation in a cohort of 6,336 patients and results of a survey. Ann. Surg. 240 (2): 205–213.
20 20 Imaoka, Y., Itamoto, T., Nakahara, H. et al. (2017). Physiological and Operative Severity Score for the enumeration of mortality and morbidity and modified Physiological and Operative Severity Score for the enumeration of mortality and morbidity for the mortality prediction among nonagenarians undergoing emergency surgery. J. Surg. Res. 210: 198–203.
21 21 Gawande, A. (2007). The checklist: if something so simple can transform intensive care, what else can it do? New Yorker. December 10th: 86–101.
22 22 Oak, S.N., Dave, N.M., Garasia, M.B. et al. (2015). Surgical checklist application and its impact on patient safety in pediatric surgery. J. Postgrad. Med. 61 (2): 92–94.
23 23 Treadwel, J.R., Lucas, S., and Tsou, A.Y. (2014). Surgical checklists: a systematic review of impacts and implementation. B.M.J. Qual. Saf. 23 (4): 299–318.
24 24 Zingiryan, A., Paruch, J.L., Osler, T.M., et al. (2017). Implementation of the surgical safety checklist at a tertiary academic center: impact on safety culture and patient outcomes. Am. J. Surg. 214 (2): 193–197.
25 25 Haugen, A.S., Softeland, E., Almeland, S.K. et al. (2015). Effect of the World Health Organization checklist on patient outcomes: a stepped wedge cluster randomized controlled trial. Ann. Surg. 261 (5): 821–828.
26 26 Gillespie, B.M. and Marshall, A. (2015). Implementation of safety checklists in surgery: a realist synthesis of evidence. Implement. Sci. 10: 137.
27 27 Papaconstantinou, H.T., Smythe, W.R., Reznik, S.I. et al. (2013). Surgical safety checklist and operating room efficiency: results from a large multispecialty tertiary care hospital. Am. J. Surg. 206 (6): 853–859; discussion 859–860.
28 28 Moberg, G.P. (1985). Biological response to stress: key to assessment of animal well‐being? In: Animal Stress, 27–49. Bethesda: American Physiological Society.
29 29 Cuthbertson, D.P. (1932). Observation on the disturbance of metabolism produced by injury to the limbs. Quart. J. Med. 25: 233–246.
30 30