Risselada Marije, Mathews Kyle G, Griffith Emily
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.
Department of Statistics, College of Agriculture and Life Sciences, North Carolina State University, Raleigh, North Carolina.
Vet Surg. 2016 Jul;45(5):563-70. doi: 10.1111/vsu.12481. Epub 2016 May 14.
To assess the effect of various tissue apposition techniques on specimens after formalin fixation, and to assess canine cadaveric composite skin-muscle-fascia specimen changes after excision without and with addition of a tumor model.
Canine cadaveric study; unbalanced paired design.
Fresh canine cadavers (n = 30) METHODS: Experiment 1: Paired 7 cm diameter, circular skin-muscle-fascia specimens were harvested bilaterally from three sites (thorax, abdomen, and thigh) on 10 cadavers. For each pair, the skin-to-fascia was sutured with a circumferential continuous pattern in one specimen and left unsutured in the other during excision. Specimen length and width were measured post-excision and post-fixation. Specimen rotation, translation, and distortion was measured post-fixation. Experiment 2: A subcutaneous tumor model was implanted at 2 sites (neck, thorax) on 20 cadavers and specimens were then excised with 2 cm lateral margins and a deep fascial plane. Three suturing techniques of the skin-to-fascia at both sites were performed during excision: unsutured versus circumferential continuous suture (10 pairs) or circumferential versus 4 interrupted quadrant sutures (10 pairs). Lateral margins were compared post-excision and post-fixation.
Experiment 1: There was significant reduction in the length and width of the fascia and skin post-excision, but no further reduction after fixation. The circumferential suture decreased rotation and translation of the tissue layers but did not significantly affect specimen shrinkage or distortion compared with the unsutured specimen. Experiment 2: All 4 lateral margins decreased significantly post-excision and post-fixation compared with the planned pre-excision margins. No difference was found between any of the 4 lateral margins for any skin-to-fascia suture technique.
Canine skin-muscle-fascia specimens significantly decrease in size from gross pre-excision dimensions after removal. Suturing the specimen during surgery before excision will significantly improve alignment of tissue planes without creating distortion of the sample, but may alter the length, width, and lateral margins of the specimen.
评估福尔马林固定后各种组织贴合技术对标本的影响，并评估切除后犬类尸体复合皮肤-肌肉-筋膜标本在未添加和添加肿瘤模型情况下的变化。
犬类尸体研究；非平衡配对设计。
新鲜犬类尸体（n = 30）
实验1：从10具尸体的三个部位（胸部、腹部和大腿）双侧采集直径7厘米的圆形皮肤-肌肉-筋膜标本。对于每一对标本，在切除过程中，一个标本的皮肤与筋膜采用环形连续缝合法缝合，另一个不缝合。切除后和固定后测量标本的长度和宽度。固定后测量标本的旋转、平移和变形情况。实验2：在20具尸体的两个部位（颈部、胸部）植入皮下肿瘤模型，然后以2厘米的外侧边缘和深筋膜平面切除标本。切除过程中在两个部位对皮肤与筋膜进行三种缝合技术操作：不缝合与环形连续缝合（10对）或环形与4针间断象限缝合（10对）。切除后和固定后比较外侧边缘。
实验1：切除后筋膜和皮肤的长度和宽度显著减小，但固定后没有进一步减小。与未缝合的标本相比，环形缝合减少了组织层的旋转和平移，但对标本收缩或变形没有显著影响。实验2：与切除前计划的边缘相比，所有4个外侧边缘在切除后和固定后均显著减小。对于任何皮肤与筋膜缝合技术，4个外侧边缘之间均未发现差异。
犬类皮肤-肌肉-筋膜标本切除后尺寸较切除前大体尺寸显著减小。切除前在手术过程中缝合标本将显著改善组织平面的对齐，而不会造成样本变形，但可能会改变标本的长度、宽度和外侧边缘。
