Analyze Diet

Topic:Post-Operative Period

The post-operative period in horses refers to the timeframe following surgical procedures during which the animal undergoes recovery and rehabilitation. This period involves careful monitoring and management to ensure proper healing and to minimize complications. Key aspects of the post-operative period include pain management, wound care, and the prevention of infections. Horses may require restricted movement, dietary adjustments, and regular veterinary evaluations to assess recovery progress. This page compiles peer-reviewed research studies and scholarly articles that explore the management strategies, physiological responses, and outcomes associated with the post-operative period in equine patients.
Segmental ostectomy of the second and fourth metacarpal and metatarsal bones in horses: 17 cases (1993-2002).
Journal of the American Veterinary Medical Association    January 23, 2004   Volume 224, Issue 2 271-274 doi: 10.2460/javma.2004.224.271
Jenson PW, Gaughan EM, Lillich JD, Bryant JE.To determine clinical findings in and outcome of horses with fractures of the second or fourth metacarpal or metatarsal bone that underwent segmental ostectomy, leaving the proximal and distal portions of the bone undisturbed. Methods: Retrospective case series. Methods: 17 horses. Methods: Medical records were reviewed, and information on signalment, affected bone, lesion type, surgical procedure, amount of bone removed, and surgical and postsurgical complications was obtained. Follow-up information was obtained through telephone conversations with owners, trainers, and referring veterinarian...
Use of a three-drill-tract technique for arthrodesis of the distal tarsal joints in horses with distal tarsal osteoarthritis: 54 cases (1990-1999).
Journal of the American Veterinary Medical Association    December 24, 2003   Volume 223, Issue 12 1800-1805 doi: 10.2460/javma.2003.223.1800
Dechant JE, Baxter GM, Southwood LL, Crawford WH, Jackman BR, Stashak TS, Trotter GW, Hendrickson DA.To assess the long-term clinical outcome of horses with distal tarsal osteoarthritis (OA) in which a 3-drill-tract technique was used to induce arthrodesis of the affected joints, identify any preoperative or operative factors associated with outcome, and describe any complications associated with the technique. Methods: Retrospective study. Methods: 54 horses. Methods: Medical records were reviewed for information on signalment, use, history, physical and lameness examination findings, surgical technique, and postoperative care. Radiographs were examined, and severity of OA was graded. Follow...
Laparoscopic repair of a small intestinal mesenteric rent in a broodmare.
Veterinary surgery : VS    December 23, 2003   Volume 33, Issue 1 92-95 doi: 10.1111/j.1532-950x.2004.04012.x
Sutter WW, Hardy J.To describe standing laparoscopic repair of mesoduodenal rent inaccessible by ventral median celiotomy. Methods: Clinical case report. Methods: A 6-year-old Thoroughbred broodmare with a right displacement of the dorsal colon and small intestinal incarceration in a mesoduodenal rent. Methods: Two days after correction of a right dorsal displacement of the ascending colon, small intestinal incarceration, and partial closure of mesoduodenal rent, standing left and right flank laparoscopy was used to explore the abdomen to identify the mesoduodenal defect. The mesenteric rent was repaired from ri...
Complications associated with cannula insertion techniques used for laparoscopy in standing horses.
Veterinary surgery : VS    December 3, 2003   Volume 32, Issue 6 501-506 doi: 10.1053/jvet.2003.50057
Desmaizières LM, Martinot S, Lepage OM, Bareiss E, Cadoré JL.To report our experience and complications associated with different cannula insertion techniques for laparoscopy in standing horses. Methods: Retrospective study. Methods: Forty horses that had laparoscopy for diagnostic or surgical purposes. Methods: After a physical examination, including rectal palpation, standing laparoscopy was performed in 40 sedated horses. Local anesthetic was injected at each site of cannula insertion in the left flank. Horses were divided into 5 groups: Pneumoperitoneum was induced before cannula insertion using a Verres needle (group 1, n = 3) or a 12-g catheter (g...
Results of plate fixation of type 1b olecranon fractures in 24 horses.
Equine veterinary journal    December 3, 2003   Volume 35, Issue 7 670-675 doi: 10.2746/042516403775696249
Swor TM, Watkins JP, Bahr A, Honnas CM.Previous olecranon fracture reports contain a small proportion of type 1b fractures, with only a few repaired by tension band plate fixation. Objective: To evaluate subject details, history, clinical findings and outcome of type 1b olecranon fractures in a large group of horses treated by tension band plate fixation. Methods: Medical records of 77 horses diagnosed with an olecranon fracture were reviewed. Twenty-four horses (31%) were classified as having type 1b olecranon fractures. Clinical details and follow-up results (4-128 months post operatively) were recorded. Results: Treatment includ...
Evaluation of a vessel-sealing device for small intestinal resection and anastomosis in normal horses.
Veterinary surgery : VS    December 3, 2003   Volume 32, Issue 6 574-579 doi: 10.1111/j.1532-950x.2003.00574.x
Rumbaugh ML, Burba DJ, Natalini C, Hosgood G, Moore RM.To compare arterial bursting pressure after vessel closure using a vessel-sealing device (LigaSure Atlas Laparoscopic Sealer/Divider Instrument; Valleylab, Boulder, CO), a ligate-and-divide stapling device (LDS), and 2-0 polydioxanone suture. To evaluate the LigaSure Atlas as a method for ligation of the mesenteric vasculature during small intestinal resection in normal horses. Methods: Experimental study. Methods: Part A: jejunal segments from 19 horses. Part B: 6 horses, aged 1 to 18 years, weighing 330 to 509 kg. Methods: Part A: Jejunal segments with mesenteric vessels were collected from ...
Laryngoplasty with ventriculectomy or ventriculocordectomy in 104 draft horses (1992-2000).
Veterinary surgery : VS    December 3, 2003   Volume 32, Issue 6 530-538 doi: 10.1111/j.1532-950x.2003.00530.x
Kraus BM, Parente EJ, Tulleners EP.To evaluate efficacy and safety of laryngoplasty with vetriculectomy (VE) or ventriculocordectomy (VCE) for treatment of laryngeal hemiplegia (LH) in draft horses. Methods: Retrospective study. Methods: One hundred four draft horses used for competitive hitch competitions. Methods: Medical records and postoperative endoscopy for competitive hitch draft horses diagnosed with left LH and treated with laryngoplasty and VE or VCE between January 1992 and December 2000 were reviewed. Follow-up information was obtained from telephone interviews with owners and trainers, and performance scores of 1 t...
Life-threatening hemorrhage from enterotomies and anastomoses in 7 horses.
Veterinary surgery : VS    December 3, 2003   Volume 32, Issue 6 553-558 doi: 10.1111/j.1532-950x.2003.00553.x
Doyle AJ, Freeman DE, Rapp H, Murrell JA, Wilkins PA.To report our experience with horses that presumptively had severe intraluminal hemorrhage from enterotomy or anastomosis. Methods: Clinical study. Methods: Six adult horses and 1 adult donkey. Methods: A retrospective study was conducted at the University of Illinois (April 1994 to December 2001) to determine the clinical course and outcome of horses with melena and/or anemia and evidence of life-threatening hemorrhage from intestinal incisions. Medical records of all horses that had colic surgery were reviewed to determine the proportion of horses with this complication. In addition, horses ...
Evaluation of Carolina Rinse solution as a treatment for ischaemia reperfusion of the equine jejunum.
Equine veterinary journal    December 3, 2003   Volume 35, Issue 7 642-646 doi: 10.2746/042516403775696302
Dabareiner RM, White NA, Donaldson L.Ileus and peritoneal adhesions are the most common complications following surgery for small intestinal obstruction. Carolina Rinse (CR) has been shown to decrease reperfusion injury in intestine and other organs. Objective: CR decreases intestinal inflammation and subsequent scarring associated with reperfusion injury. Methods: CR was infused intra-arterially and applied topically just prior to reperfusion in jejunum exposed to experimental ischemia. Vascular permeability, neutrophil accumulation and serosal scarring were compared in treated and untreated intestine. Results: CR maintained a n...
Study of the clinical effects of postoperative parenteral nutrition in 15 horses.
The Veterinary record    November 7, 2003   Volume 153, Issue 16 493-498 doi: 10.1136/vr.153.16.493
Durham AE, Phillips TJ, Walmsley JP, Newton JR.Several clinical variables were compared in two groups of 15 horses recovering from resection and anastomosis of a strangulated small intestine; 15 were treated with parenteral nutrition and 15 were starved routinely. There was some evidence that parenteral nutrition had a short-lived adverse effect on both the catheter sites and gastric emptying, but there were no marked adverse clinical effects and no evidence of any improvement in the horses' condition.
Scapulohumeral arthrodesis in miniature horses.
Veterinary surgery : VS    October 22, 2003   Volume 32, Issue 5 416-420 doi: 10.1053/jvet.2003.50053
Semevolos SA, Watkins JP, Auer JA.To describe surgical arthrodesis of the scapulohumeral joint and to evaluate its efficacy in reducing morbidity associated with severe shoulder dysfunction in miniature horses. Methods: Retrospective study. Methods: Four miniature horses. Methods: Medical records and radiographs were reviewed for history, physical examination findings, lameness evaluation, radiographic evaluation, surgical techniques, postoperative complications, and outcome. A 10- or 11-hole, 4.5-mm narrow dynamic compression plate and 4.5-mm cortical screws were applied to the cranial surface of the scapula and cranial surfa...
Comparison of perioperative versus postoperative intratumoral administration of cisplatin for treatment of cutaneous sarcoids and squamous cell carcinomas in horses.
Journal of the American Veterinary Medical Association    October 22, 2003   Volume 215, Issue 11 1655-1660 
Théon AP, Pascoe JR, Galuppo LD, Fisher PE, Griffey SM, Madigan JE.To determine the benefits of reducing the interval between surgical cytoreduction and intratumoral administration of cisplatin. Methods: Randomized clinical study. Methods: 70 horses with 89 incompletely resected T2- and T3-stage sarcoids (n = 64) and squamous cell carcinomas (25). Methods: Horses were given 4 intratumoral treatments of cisplatin at 2-week intervals. The first treatment was given at the time of, or immediately after, surgical resection for horses treated in accordance with the perioperative protocol (group 1). Horses in group 2 were treated with cisplatin after the skin healed...
Endoscopic surgery in the treatment of contaminated and infected synovial cavities.
Equine veterinary journal    October 1, 2003   Volume 35, Issue 6 613-619 doi: 10.2746/042516403775467225
Wright IM, Smith MR, Humphrey DJ, Eaton-Evans TC, Hillyer MH.Contamination and infection of synovial cavities are a common occurrence in clinical practice and, if inadequately treated, may have career or life threatening consequences for affected horses. Objective: The objectives in treating contamination and infection of joints, tendon sheaths and bursae are most effectively met by endoscopic surgery. Methods: Over a 6 year period, cases of synovial contamination and infection admitted to a referral clinic were evaluated and treated endoscopically. The horses received local and systemic antimicrobial drugs with minimal nonsteroidal anti-inflammatory me...
Problems associated with perioperative morphine in horses: a retrospective case analysis.
Veterinary anaesthesia and analgesia    September 23, 2003   Volume 30, Issue 3 147-155 doi: 10.1046/j.1467-2995.2003.00092.x
Mircica E, Clutton RE, Kyles KW, Blissitt KJ.To identify the incidence of adverse effects caused by morphine 100-170 micro g kg-1 administration during surgery in horses. Methods: Retrospective case record analysis (1996-2000). Methods: Eighty-four healthy (ASA 1 or 2) horses, mean age 5.5 +/- 3.1 (SD) years (2 months to 16 years), mean weight 524 +/- 14 kg (100-950). Methods: Physiological data and evidence of complications were collected from the anaesthetic records of all animals anaesthetized with romifidine, ketamine, diazepam and halothane and undergoing laryngeal surgery or orchiectomy at the Royal (Dick) School of Veterinary Stud...
Preliminary evaluation of a behaviour-based system for assessment of post-operative pain in horses following arthroscopic surgery.
Veterinary anaesthesia and analgesia    September 23, 2003   Volume 30, Issue 3 124-137 doi: 10.1046/j.1467-2995.2003.00139.x
Price J, Catriona S, Welsh EM, Waran NK.To develop a method for objective assessment of equine post-operative pain. Methods: Prospective nonblinded clinical study. Methods: Twelve adult horses: Group 1 (G1, n = 6), admitted for arthroscopy (under general anaesthesia, with multimodal analgesia); Group 2 (G2, n = 6), 'pain free' controls. Methods: Horses were filmed continuously (CVI, time-lapse video recorder) over 72 hours, from 24 hours pre-surgery (PS) to 48 hours post-recovery (PR) (G1), and over 24 hours (G2). Activity budgets were determined from 24 to 0 hours PS, 0-24 and 24-48 hours PR (G1) and for 24 hours (G2). Using direct...
Use of a rigid-type polyethylene T-cannula, silicone tubing, and adhesion netting for surgical cannulation of ileum of the horse.
The Journal of veterinary medical science    September 3, 2003   Volume 65, Issue 8 927-930 doi: 10.1292/jvms.65.927
Taniguchi K, Obitsu T, Ohmura H, Hiraga A, Hata H, Aida H, Akiyama K, Tanaka K.A rigid-type of polyethylene T-cannula was fitted into the anterior ileum of six horses in order to improve the cannulation techniques. A piece of polyethylene net was fastened onto the intestinal wall around the cannula to prevent dislodgment of the cannula by promoting a secure adhesion between the ileum and the abdominal wall. The cannula barrel sheathed with silicone tubing was exteriorized through a stab incision at the lateral ventral wall on the transverse line of the second lumber vertebra, and a flange was screwed onto the barrel. The feeding regime gradually increased concentrate wit...
[Thermal injury and wound healing of the endometrium subsequent to minimally invasive transendoscopic use of Nd:YAG-laser-and electrosurgery in horses].
DTW. Deutsche tierarztliche Wochenschrift    August 13, 2003   Volume 110, Issue 7 271-280 
Bartmann CP, Stief B, Schoon HA.Transendoscopic thermal preparation techniques like laser- or electrosurgery have proved to be most reliable for minimal invasive intrauterine surgery during operative hysteroscopy in mares. To determine the effect of Nd:YAG laser surgery on the endometrium and the complete uterine wall compared with electrosurgery, standard lesions were obtained by transendoscopic monopolar electrosurgery (loop electrode, cutting blade) and Nd:YAG laser surgery (contact, bare fibre, 25 Watt, exposure time four seconds, non contact, 80 Watt, exposure time four seconds) in five healthy mares on days d 0, 7, 14,...
Accuracy of pulse oximetry and capnography in healthy and compromised horses during spontaneous and controlled ventilation. Koenig J, McDonell W, Valverde A.The objective of this prospective clinical study was to evaluate the accuracy of pulse oximetry and capnography in healthy and compromised horses during general anesthesia with spontaneous and controlled ventilation. Horses anesthetized in a dorsal recumbency position for arthroscopy (n = 20) or colic surgery (n = 16) were instrumented with an earlobe probe from the pulse oximeter positioned on the tip of the tongue and a sample line inserted at the Y-piece for capnography. The horses were allowed to breathe spontaneously (SV) for the first 20 min after induction, and thereafter ventilation wa...
Long-term survey of laryngoplasty and ventriculocordectomy in an older, mixed-breed population of 200 horses. Part 1: Maintenance of surgical arytenoid abduction and complications of surgery.
Equine veterinary journal    July 26, 2003   Volume 35, Issue 4 389-396 doi: 10.2746/042516403776014172
Dixon RM, McGorum BC, Railton DI, Hawe C, Tremaine WH, Dacre K, McCann J.Laryngoplasty (LP) is currently the most common surgical treatment for equine laryngeal paralysis, however, there have been no reports quantifying the degree of retention of arytenoid abduction following LP. Additionally, the complications of LP have been poorly documented. Objective: To record the degree of arytenoid abduction retention following LP and to accurately document all complications of surgery. Methods: A study (1986-1998) of 200 horses of mixed breed and workload, median age 6 years (prospective 136 cases and retrospective 64 cases) undergoing LP (using 2 stainless steel wires) an...
Long-term survey of laryngoplasty and ventriculocordectomy in an older, mixed-breed population of 200 horses. Part 2: Owners’ assessment of the value of surgery.
Equine veterinary journal    July 26, 2003   Volume 35, Issue 4 397-401 doi: 10.2746/042516403776014217
Dixon PM, McGorum BC, Railton DI, Hawe C, Tremaine WH, Dacre K, McCann J.There is continuing debate on the clinical benefit of laryngoplasty (LP) in the treatment of equine laryngeal paralysis. In particular, there is little information available on the clinical value of this surgery in older horses, in non-Thoroughbreds or in sports or pleasure horses; nor on the relationship between the degree of LP abduction achieved and the clinical value of LP. Objective: To evaluate the owner's assessment of the value of LP (and combined ventriculocordectomy) in an older, mixed breed and mixed workload population of horses and to also assess the relationship between the degre...
[Splenectomy in a dressage pony: end of sports career?].
Tijdschrift voor diergeneeskunde    July 23, 2003   Volume 128, Issue 13 406-411 
Westerduin FE, Lankveld DP, van der Velden MA, Back W, Sloet van Oldruitenborgh-Oosterbaan MM.A 14-year-old Arabian cross-bred gelding was referred to the University Clinic because of mild, recurrent signs of colic for 5 days. The pony showed icteric mucous membranes, haemolytic blood, and dark coloured urine. Internal examination did not give a clear diagnosis. Unidentified intra-abdominal strands were found and haemorrhagic abdominocentesis led to the decision to perform an exploratory laparatomy. An extremely enlarged spleen was the sole finding. A splenal biopsy sample was taken and surgery was completed. The pony remained colicky, so the spleen was examined by ultrasonography. Aft...
Use of a dynamic compression plate and a cable cerclage system for repair of a fracture of the radius in a horse.
Journal of the American Veterinary Medical Association    July 4, 2003   Volume 223, Issue 1 89-60 doi: 10.2460/javma.2003.223.89
Bolt DM, Burba DJ.A pregnant 9-year-old Peruvian Paso mare was evaluated because of a fracture involving the left radius. On examination, grade IV/V lameness of the left forelimb was observed; radiography of the limb revealed a longitudinal oblique displaced fracture that extended from the caudal cortex of the radial mid-diaphysis into the humeroradial joint. To minimize the development of degenerative joint disease in the humeroradial joint, repair with internal fixation was recommended. A dynamic compression plate was applied to the cranial aspect of the radius; three 2-mm stainless steel cable cerclages were...
Multifocal eosinophilic enteritis associated with a small intestinal obstruction in a standardbred horse.
The Veterinary record    June 7, 2003   Volume 152, Issue 21 648-651 doi: 10.1136/vr.152.21.648
Swain JM, Licka T, Rhind SM, Hudson NP.A seven-year-old standardbred gelding developed marked signs of colic associated with an acute small intestinal obstruction. Surgical exploration revealed three intramural, circumferential constricting lesions in the small intestine, the two most severe of which were in the jejunum and were resected. The horse was euthanased owing to postoperative complications. Histopathological examination confirmed the diagnosis of idiopathic multifocal eosinophilic enteritis.
Hand-assisted laparoscopic left nephrectomy in standing horses.
Veterinary surgery : VS    June 5, 2003   Volume 32, Issue 3 206-212 doi: 10.1053/jvet.2003.50028
Keoughan CG, Rodgerson DH, Brown MP.To describe a hand-assisted, laparoscopic technique to remove the left kidney in standing horses. Methods: Prospective evaluation. Methods: Eight horses. Methods: Food was withheld for a minimum of 12 hours. Horses were sedated with detomidine hydrochloride (0.01-0.02 mg/kg, intravenously) and restrained in standing stocks. The left paralumbar fossa was prepared for surgery, and the surgical site was infiltrated with 2% mepivacaine. Hand-assisted, laparoscopic removal of the left kidney was performed through an incision in the center of the paralumbar fossa; the surgeon's hand was used to isol...
Evaluation of the harmonic scalpel for laparoscopic bilateral ovariectomy in standing horses.
Veterinary surgery : VS    June 5, 2003   Volume 32, Issue 3 242-250 doi: 10.1053/jvet.2003.50022
Düsterdieck KF, Pleasant RS, Lanz OI, Saunders G, Howard RD.To evaluate use of the Harmonic Scalpel (Ethicon Endo-Surgery Inc., Cincinnati, OH) for performing laparoscopic bilateral ovariectomy in standing horses. Methods: Experimental study. Methods: Eight mares aged 2-20 years and weighing 410-540 kg. Methods: Standing laparoscopic bilateral ovariectomy was performed in 8 mares with normal reproductive tract anatomy. The Harmonic Scalpel (an ultrasonically activated instrument) was used to simultaneously transect and obtain hemostasis of the ovarian pedicle. Necropsy was performed on 4 mares 3 days after surgery and 4 mares 30 days after surgery. Gro...
Use of a hydroxyapatite orbital implant in a cosmetic corneoscleral prosthesis after enucleation in a horse.
Journal of the American Veterinary Medical Association    February 5, 2003   Volume 222, Issue 3 343-316 doi: 10.2460/javma.2003.222.343
Gilger BC, Pizzirani S, Johnston LC, Urdiales NR.A hydroxyapatite orbital implant was used after enucleation of an eye from a 5-year-old performance horse. A custom-made corneoscleral prosthesis was made and fitted over the hydroxyapatite implant. The implant and surgery were well tolerated. Placement of a cosmetic prosthesis is desired after enucleation of equine eyes to allow horses to return to competition. Synthetic spheres consisting of methylmethacrylate or silicone have been used, although reported complications have included extrusion, infection, and poor cosmetic results. Hydroxyapatite orbital implants made from marine coral allow ...
Use of an active intra-abdominal drain in 67 horses.
Veterinary surgery : VS    January 10, 2003   Volume 32, Issue 1 1-7 doi: 10.1053/jvet.2003.50013
Nieto JE, Snyder JR, Vatistas NJ, Spier SJ, Van Hoogmoed L.To describe the insertion technique, efficacy, and complications associated with the use of an active (closed-suction) abdominal drain in horses. Methods: Retrospective study. Animals-Sixty-seven horses with abdominal contamination treated by abdominal lavage and use of a closed-suction abdominal drain. Methods: Medical records of horses (1989-1996) that had a closed-suction abdominal drain were reviewed. Follow-up information was obtained by telephone interviews with owners. Results: Sixty-eight closed-suction abdominal drains were used in 67 horses that had abdominal contamination, peritonit...
Laparoscopic repair of ruptured urinary bladder in a stallion.
Journal of the American Veterinary Medical Association    December 24, 2002   Volume 221, Issue 12 1737-1715 doi: 10.2460/javma.2002.221.1736
Walesby HA, Ragle CA, Booth LC.A 12-year-old stallion was evaluated because of pollakiuria; endoscopy of the urinary tract during general anesthesia revealed that the urinary bladder was intact. After recovery, the stallion developed clinical and biochemical signs of bladder rupture, which was confirmed by endoscopy. Cystoplasty in adult stallions represents a unique surgical dilemma; the large distance between the incision site and the bladder necessitates the repair be accomplished under maximum tension with minimal exposure. Because traditional surgical approaches through ventral midline or paramedian incisions provide l...
[Colic surgery in the horse: a retrospective study of 272 patients].
Tijdschrift voor diergeneeskunde    December 10, 2002   Volume 127, Issue 22 682-686 
Wiemer P, Bergman HJ, van der Veen H, Pruissen L.In the period from January 1995 until December 2000, 272 horses underwent a laparotomy for gastrointestinal disorders. The results of these surgeries were evaluated. From these 272 patients 176 (= 65%) were discharged in good health from the hospital. When the patients that were euthanized immediately after the start of the surgery, because of a fatal deterioration, were not taken into account, the short time survival rate was 77%. Strangulated small and large intestinal obstructions (48%) had a lower short time survival rate than non-strangulated obstructions (87%). Fatal postoperative compli...
Intravenous lidocaine and small-intestinal size, abdominal fluid, and outcome after colic surgery in horses.
Journal of veterinary internal medicine    December 6, 2002   Volume 16, Issue 6 736-741 doi: 10.1892/0891-6640(2002)016<0736:ilassa>2.3.co;2
Brianceau P, Chevalier H, Karas A, Court MH, Bassage L, Kirker-Head C, Provost P, Paradis MR.Twenty-eight horses with the diagnosis of an intestinal disorder requiring surgical intervention were randomly assigned to lidocaine (n = 13) or saline (control, n = 15) treatment groups. After induction of anesthesia, treated horses received a loading dose of 2% lidocaine (0.65 mg/kg) intravenously, followed by a continuous rate of infusion of 1% lidocaine (0.025 mg/kg/min) until the discontinuation of anesthesia. Upon recovery from anesthesia, a 2nd loading dose of 2% lidocaine (1.3 mg/kg) was administered, followed by an infusion of 1% lidocaine (0.05 mg/kg/min) for 24 hours postoperatively...
1 … 42 43 44 45 46 … 76