Use of UV-Polymerizable Methacrylate Adhesive as a Post-Recovery Bandage Replacement for Transphyseal Screw Incisions in Horses: A Pilot Study.

Overview

• This pilot study investigated the use of a UV-polymerizable methacrylate adhesive (UV-PMA) as a replacement for traditional bandaging after transphyseal screw surgery in horses, comparing infection rates and adhesive/bandage retention between the two methods.

Background and Objective

• Transphyseal screw placement is a surgical procedure in horses that typically requires postoperative bandaging to protect the incision sites.
• Traditional bandaging can have drawbacks such as bandage slippage, infection risk, and inconvenience.
• Surgical adhesives, like UV-polymerizable methacrylate adhesive, offer a potential alternative by sealing the incision without the need for bulky bandages.
• The study aimed to assess whether UV-PMA is well tolerated and effective as a postoperative protective method compared to bandaging.

Study Design and Methods

• Prospective pilot study using 153 sutured stab incisions from 102 horses post-transphyseal screw placement.
• Incisions were located in either the carpus (knee) or fetlock (ankle) joints.
• Incisions were randomly assigned to either:
  • UV-PMA adhesive treatment (75 incisions)
  • Conventional bandaging treatment (78 incisions)
• Outcomes measured within 30 days post-surgery included:
  • Surgical site infection (SSI)
  • Displacement/slippage of UV-PMA or bandages within 14 days
• Statistical comparison of outcomes was performed using Fisher’s exact test to evaluate differences in infection and displacement rates.

Key Findings

• Carpal Incisions:
  • SSI occurred in 12.9% (4 out of 31) of bandaged incisions but in 0% of UV-PMA treated incisions.
  • The difference in infection rates was statistically significant (p = 0.025), favoring UV-PMA adhesive.
  • Displacement rates of UV-PMA and bandages were similar (11% vs. 10%, p = 1.0), indicating similar retention capability.
• Fetlock Incisions:
  • SSI rates did not significantly differ between UV-PMA (10%) and bandaged groups (12.8%; p = 1.0).
  • UV-PMA displacement (loss of adhesive from the incision site) was significantly higher (30%) compared to bandage slippage (4%; p = 0.003), indicating poorer adhesion retention here.

Interpretation and Implications

• The UV-PMA adhesive demonstrated promising results for carpal incisions, with zero infections and displacement rates comparable to bandages.
• This suggests that UV-PMA could be a viable, potentially superior alternative to bandaging for carpal incisions, offering benefits such as:
  • Reduced SSI risk
  • Less cumbersome postoperative care
  • Potentially better patient comfort and mobility
• For fetlock incisions, however, UV-PMA showed a higher rate of displacement which could compromise protection and wound healing, necessitating further investigation and optimization.
• The study is preliminary; larger, randomized clinical trials are needed to confirm these findings and establish standardized protocols.

Conclusion

• The UV-polymerizable methacrylate adhesive shows preliminary potential as a bandage substitute after equine transphyseal screw surgery, especially effective in carpal joint incisions.
• Further research is required to improve adhesive retention in fetlock incisions and to fully validate clinical efficacy and safety.