牛术后伤口评估:后手触诊的可靠性如何?

IF 2.7 2区 农林科学 Q1 VETERINARY SCIENCES Irish Veterinary Journal Pub Date : 2021-06-16 DOI:10.1186/s13620-021-00195-1
Ioannis Proios, Marian Kusenda, Christian Seiler, Carsten Siewert, Hermann Seifert, Martin Kaske
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引用次数: 0

摘要

背景:作为牛外科临床伤口评估的一部分,通过将手背放在要检查的区域来评估皮肤温度的差异。一般来说,伤口部位皮肤温度长时间升高被认为是伤口愈合受损的一个指标。本研究的目的是验证在牛实践条件下触诊的可靠性,以剖腹手术为例。术前对14头无其他严重并发疾病的左侧皱胃移位奶牛(德国荷斯坦)进行检查,术后10天每天检查一次。通过触诊评估右侧伤口部位的皮肤温度,然后在标准化条件下,每天在封闭的检查室中进行45分钟的适应期后,使用红外相机进行热成像评估。结果:所有切口均愈合,无临床可检出的扰动。研究期间的环境温度范围为7.8 ~ 24.1℃。根据环境温度回顾性分为两组:高环境温度组(HT组);中位数:20.2℃25/75四分位数:18.5℃/ 21.7℃;n = 6)和低环境温度组(LT组;10.8°C;9.4℃/ 12.8℃;n = 8)。评估伤口部位的平均皮肤温度与伤口颅侧定义的参考区域之间的温差(Δϑ)。环境温度(ϑAmb)与Δϑ呈显著负相关(r=-0.51;P 1°C)在伤口部位(敏感性0.20;特异性0.96)。结论:与手工触诊相比,红外热像仪能更可靠地评估伤口部位的温度变化。环境温度显著影响创面局部热疗的程度。
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Postoperative wound assessment in cattle: How reliable is the back hand palpation?

Background: As part of clinical wound assessment in bovine surgery, discrepancies in skin temperature are evaluated by placing the back of the hand on the area to be examined. Generally, an increased skin temperature at the wound site for a prolonged period is considered as an indicator of impaired wound healing. The aim of this study was to verify the reliability of palpation under bovine practice conditions using laparotomy as an example. Fourteen cows (German Holstein) with a left displacement of the abomasum (LDA) without other severe concurrent diseases were examined preoperatively and once daily for ten days after surgery. The skin temperature of the wound site in the right flank was assessed by palpation, followed by thermographic evaluation using an infrared camera after a 45-min acclimatisation period, under standardised conditions in a closed examination room daily for 10 days.

Results: All the incisions healed without clinical detectable perturbances. The ambient temperature range during the study period was 7.8 - 24.1 °C. Two groups were retrospectively defined according to the ambient temperature: high ambient temperature (HT group; median: 20.2 °C 25/75 quartile: 18.5 °C / 21.7 °C; n = 6) and low ambient temperature (LT group; 10.8 °C; 9.4 °C / 12.8 °C; n = 8). The temperature differences (Δϑ) between the mean skin temperature of the wound site and a defined reference area cranial to the wound were assessed. A significant negative correlation was found between the ambient temperature (ϑAmb) and Δϑ (r=-0.51; P < 0.001). The Δϑ was postoperatively higher in the cows in the LT group (median of the individual animals 0.8-2.5 °C) than in the HT group (0.1-0.5 °C; P < 0.05). In contrast to the thermographic findings, manual palpation rarely detected local hyperthermia (> 1 °C) at the wound site (sensitivity 0.20; specificity 0.96).

Conclusions: The infrared thermography provides a more reliable assessment of temperature changes at the wound site in comparison to manual palpation. The ambient temperature markedly affects the extent of local hyperthermia at the wound site.

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来源期刊
Irish Veterinary Journal
Irish Veterinary Journal 农林科学-兽医学
CiteScore
4.80
自引率
3.40%
发文量
1
审稿时长
>36 weeks
期刊介绍: Irish Veterinary Journal is an open access journal with a vision to make a substantial contribution to the dissemination of evidence-based knowledge that will promote optimal health and welfare of both domestic and wild species of animals. Irish Veterinary Journal has a clinical research focus with an emphasis on the effective management of health in both individual and populations of animals. Published studies will be relevant to both the international veterinary profession and veterinary scientists. Papers relating to veterinary education, veterinary ethics, veterinary public health, or relevant studies in the area of social science (participatory research) are also within the scope of Irish Veterinary Journal.
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