Effect of breed, obturator type and surgical experience on tenoscopic portal creation into the digital flexor tendon sheath in horses.

The research article investigates how breed of horse, type of surgical tool used, and surgeon’s expertise affect the process of performing a specific type of surgical procedure on horse’s lower limbs. The study reveals that factors like thicker skin in certain horse breeds and surgeon’s experience influence the time taken and potential damage caused during the procedure.

Study Design and Methodology

• The research involves a prospective experimental cadaveric study, wherein 104 cadaver limbs of horses were used.
• The two types of breeds selected for the study were cob (CB) and non-cob (NC). Cob breed typically has thicker skin compared to non-cob.
• Two different types of instruments called obturators were used in the study. These included a conical obturator (OB) and a switching stick (SS).
• Two surgeons, one boarded (BS) with more experience and one less-experienced resident surgeon (RS), performed procedures on the cadaver limbs.
• The researchers recorded skin measurements, number of attempts, and time taken to enter the digital flexor tendon sheath (DFTS). This is a tendon sheath in the lower limb of the horse.
• After the operations, the DFTS was examined using an endoscope and then dissected, to assess the level of iatrogenic damage (ID) or harm caused by medical intervention.

Results

• The results show significant differences in skin thickness between cob and non-cob breeds. The skin of cob breed (average 8.4mm) was nearly double the thickness of non-cob (average 4.5mm).
• DFTS entry took longer time in cob’s limbs (average 133 seconds) compared to non-cob livestock (average 112 seconds).
• The more experienced boarded surgeon (BS) took lesser time to enter the DFTS in both CB (average 115 seconds) and NC limbs (average 46 seconds).
• The incidence of iatrogenic damage was higher in cob compared to non-cob, suggesting that skin thickness could increase the risk of medical intervention related damage.
• No significant differences were noted between the two types of obturators used in the procedure.

Conclusions

• The study concluded that breed, particularly skin thickness, and a surgeon’s experience affect the time and potential damage caused while performing surgical intervention on horse’s limbs.
• The type of obturator, however, did not influence these outcomes significantly, suggesting it doesn’t influence the probability of damage during surgical intervention.
• Therefore, understanding the challenges associated with certain breeds like cob horses, notably their thicker skin, is critical to minimize potential iatrogenic damage during surgical procedures.