@article{mckay_duffy_chang_beamon_moore_2023, title={Biomechanical evaluation of three adjunctive methods of orthopedic tension band-wire fixation to augment simulated patella tendon repairs in dogs}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.14000}, abstractNote={To evaluate the effects of three adjunctive methods of tension band wire fixation (TBWF) on the biomechanical properties, gap formation, and failure mode in simulated canine patella tendon rupture (RPT).Randomized, ex vivo.Paired hindlimbs from 32 dog cadavers.Patellar tendons (PTs) and associated bone-muscle-tendon units were harvested. Each PT was transected then sutured using a core locking loop and simple continuous epitendinous pattern. Each hindlimb was randomly assigned to one of three groups (n = 18 hindlimbs/group) using 18 gauge 316 L wire, anchored to the tibial crest distally, to perform transpatellar, suprapatellar, or combined tension band-wire (TBW) augmentation. Ten hindlimbs were utilized as control specimens. Yield, peak, and failure loads, stiffness, loads to 1 and 3 mm gap formation, and failure mode were evaluated.Combined transpatellar and suprapatellar TBW augmentation was superior to transpatellar or suprapatellar groups alone. Yield (p = .0008), peak (p = .004), and failure loads (p = .005) were greater for the combined group than for the transpatellar (p = .048) and suprapatellar groups (p = .01) respectively. There was no difference regarding the occurrence of 1 or 3 mm gap formation (1 mm, p = .05; 3 mm, p = .06); however, loads required to cause gap formation were greater in the combined group (p = .036). Mode of failure differed between techniques used for PT augmentation (p < .001).Combined transpatellar and suprapatellar adjunctive TBW augmentation for simulated PT repairs was biomechanically superior to either transpatellar or suprapatellar TBWF alone.Combined suprapatellar and transpatellar TBWF may offer a viable surgical option for increased repair-site strength and greater loads to gap formation. Further studies investigating alternative techniques and materials for RPT repair augmentation are warranted.}, journal={VETERINARY SURGERY}, author={McKay, Rachel M. and Duffy, Daniel J. and Chang, Yi-Jen and Beamon, Weston and Moore, George E.}, year={2023}, month={Aug} }
 @article{hawbecker_duffy_chang_moore_2023, title={Influence of Kirschner-Wire Insertion Angle on Construct Biomechanics following Tibial Tuberosity Osteotomy Fixation in Dogs}, ISSN={["2567-6911"]}, DOI={10.1055/s-0042-1759868}, abstractNote={The aim of this study was to evaluate the effect of Kirschner wire insertion angle on the biomechanical characteristics following tibial tuberosity osteotomy fixation in dogs. Twelve pairs of cadaveric tibia were harvested and randomly assigned to two treatment groups. Kirschner wires were placed either transversely (0 degrees) or placed caudodistally (30 degrees) with respect to the tibial tuberosity osteotomy. Each limb acted as its own respective control. Radiographic analysis allowed for the calculation of Kirschner wire insertion angle variance. Constructs were tested to monotonic failure while evaluating yield, peak, and failure forces, construct stiffness, and failure mode. Kirschner wire insertion angles were 1.1 ± 2.2 degrees and 30.5 ± 2.3 degrees, respectively, for 0-degree and 30-degree groups (p <0.0001). Yield (p = 0.0095), peak (p <0.024) and failure loads (p <0.030) were all significantly greater for Kirschner wires inserted at an angle of 0 degrees compared with 30 degrees. Construct stiffness did not differ regardless of insertion angle (p = 0.068). Failure mode did not differ (p = 0.87) with tibial tuberosity avulsion and Kirschner wire pull-out seen in the majority of constructs (67%). Kirschner wires placed transversely (0 degrees) for tibial tuberosity osteotomy fixation were biomechanically superior, increasing yield, peak, and failure forces by 1.6 times, 1.3 times, and 1.4 times, respectively, to those placed in a caudodistal (30 degrees) orientation. Kirschner wire insertion angle is an important consideration following tibial tuberosity osteotomy in dogs, with Kirschner wires placed at 0 degrees conferring increased resistance of the repair to construct deformation.}, journal={VETERINARY AND COMPARATIVE ORTHOPAEDICS AND TRAUMATOLOGY}, author={Hawbecker, Tyler J. and Duffy, Daniel J. and Chang, Yi-Jen and Moore, George E.}, year={2023}, month={Jan} }
 @article{haas_duffy_kendall_chang_moore_2023, title={Influence of three different closure techniques on leakage pressures and leakage location following partial cystectomies in normal dogs}, volume={9}, ISSN={2053-1095 2053-1095}, url={http://dx.doi.org/10.1002/vms3.1137}, DOI={10.1002/vms3.1137}, abstractNote={Abstract Background Transitional cell carcinoma (TCC) is the most common neoplasia affecting the canine urinary bladder. Partial cystectomy, when used adjuctively with medical management, has been shown to meaningfully extend medial survival time. Surgical stapling devices have a wide variety of uses and advantages over traditional closure methods and, to date, investigation into their use in canine partial cystectomies has not been documented. Objective To determine the influence of three closure techniques on ex vivo leakage pressures and leakage location following canine partial cystectomy. Methods Specimens were assigned to one of three closure techniques: simple continuous appositional closure with 3‐0 suture, closure with a 60 mm gastrointestinal stapler with a 3.5 mm cartridge, and placement of a Cushing suture to augment the stapled closure, with each group containing 12 specimens. Mean initial leakage pressure (ILP), maximum leakage pressure (MLP), and leakage location at the time that ILP was recorded were compared between groups. Results Oversewn stapled constructs leaked at significantly higher ILP (28.5 mmHg) than those in the sutured (17 mmHg) or stapled (22.8 mmHg) group, respectively. MLP was greater in the oversewn stapled construct group compared to other groups. Leakage was detected in 97% partial cystectomies, with leakage occurring from the needle holes in 100% of the sutured closure group, from the staple holes in 100% of the stapled only group, and from the incisional line in 83% and from bladder wall rupture in 8% of the augmented staple closure group. All closure methods withstood normal physiologic cystic pressures. Conclusions Placement of a Cushing suture to augment stapled closures improved the ability of partial cystectomies to sustain higher intravesicular pressures compared with sutured or stapled bladder closures alone. Further in vivo studies are required to determine the clinical significance of these findings and the role of stapling equipment for partial cystectomy, as well as the clinical significance of suture penetration through the urinary bladder mucosa during closure.}, number={4}, journal={Veterinary Medicine and Science}, publisher={Wiley}, author={Haas, Jason M. and Duffy, Daniel J. and Kendall, Allison and Chang, Yi‐Jen and Moore, George E.}, year={2023}, month={Jun}, pages={1513–1520} }
 @article{beamon_duffy_chang_moore_2022, title={Effect of calcanean bone-tunnel orientation for teno-osseous repair in a canine common calcanean tendon avulsion model}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13796}, abstractNote={Abstract Objective To determine the influence of bone‐tunnel anchoring technique on teno‐osseous repair of the common calcanean tendon (CCT) in dogs. Study design Randomized, ex vivo, biomechanical. Population Forty‐two skeletally mature canine hindlimbs. Methods Canine hindlimbs were dissected to produce a model simulating avulsion of the CCT and accessory tendons from the calcaneus. Hindlimbs were randomized to 1 of 3 anchoring techniques ( n = 14/group): a single transverse tunnel (TT), vertical tunnels (VT), or modified bone tunnels (MT) for teno‐osseous repair in a 3‐loop‐pulley (3LP) pattern using 0 USP polypropylene. Yield, peak and failure loads, construct stiffness, loads to produce a 3 mm teno‐osseous gap, and failure modes were compared between groups. Results The only difference detected consisted of TT constructs yielding at loads 25% higher than MT constructs ( P = .027). Conclusion Although yield loads were lower in MT constructs than other groups, the bone‐tunnel anchoring techniques tested here did not appear to influence the biomechanical properties or gapping characteristics of teno‐osseous repairs in this canine CCT avulsion model. Clinical significance All drilling techniques and bone‐tunnel orientations tested in the study reported here offer viable options to reattach the CCT to the calcaneus. Surgeons should evaluate how bone‐tunnel orientation may affect placement of adjunctive fixation methods to stabilize the talocrural joint after primary CCT repair in dogs.}, journal={VETERINARY SURGERY}, author={Beamon, Weston L. and Duffy, Daniel J. and Chang, Yi-Jen and Moore, George E.}, year={2022}, month={Mar} }
 @article{downey_duffy_chang_fisher_moore_2022, title={Effect of epitendinous suture augmentation to a double Krackow suture pattern for canine gastrocnemius tendon repair}, volume={83}, ISSN={["1943-5681"]}, DOI={10.2460/ajvr.21.07.0100}, abstractNote={To evaluate the effect of a double Krackow suture pattern (DK), with and without epitendinous suture augmentation (ES), in a canine gastrocnemius tendon (GT) model.Paired GTs from 12 adult dog cadavers and 4 control GT.GTs were assigned to 2 groups (n = 12/group). Transverse tenotomy was performed and repaired with a DK or DK + ES. Yield, peak, and failure force, stiffness, occurrence of 1-and 3-mm gapping, and failure mode were examined.Yield, peak, and failure loads were greater for DK + ES. Yield force was 48% greater for DK + ES (mean ± SD, 149.56 ± 53.26 N) versus DK (101.27 ± 37.17 N; P = 0.017). Peak force was 45% greater for DK + ES P < 0.001). Failure force was 47% greater for DK + ES (193.752 ± 31.43 N) versus DK (131.54 ± 22.28 N; P < 0.001). Construct stiffness was 36% greater for DK + ES (P = 0.04). All 12 DK and 10 of 12 DK + ES repairs produced a 1-mm gap, with all DK and 4 DK + ES repairs producing a 3-mm gap (P < 0.001). Loads required to create a 3-mm gap were significantly greater for DK + ES (P < 0.013). Suture breakage occurred in all DK repairs, which differed from DK + ES, where suture breakage (7/12) and tissue failure (5/12; P = 0.037) predominated.Augmentation of a primary DK repair with an ES significantly improved construct strength in canine GT constructs while increasing loads required to cause 1- and 3-mm gap formation, respectively. ES augmentation is a simple technique modification that can be used to significantly increase construct strength, compared with DK alone.}, number={7}, journal={AMERICAN JOURNAL OF VETERINARY RESEARCH}, author={Downey, Amy C. and Duffy, Daniel J. and Chang, Yi-Jen and Fisher, Matthew B. and Moore, George E.}, year={2022}, month={Jul} }
 @article{chang_duffy_beamon_moore_2022, title={Ex vivo biomechanical characteristics and effects on gap formation of using an internal fixation plate to augment primary three-loop pulley repair of canine gastrocnemius tendons}, volume={83}, ISSN={["1943-5681"]}, DOI={10.2460/ajvr.21.07.0088}, abstractNote={To evaluate the effects of using an internal fixation plate to augment primary 3-loop pulley (3LP) repair of canine gastrocnemius tendons (GTs).48 cadaveric GTs from 24 adult dogs.GTs were dissected free from other tissues, transected, and randomly assigned to 4 groups (n = 12/group). GTs were repaired with 2-0 polypropylene with a 3LP repair alone or a 3LP repair augmented with a 3-hole veterinary cuttable plate (3VCP), a 5-hole veterinary cuttable plate (5VCP), or a 7-hole veterinary cuttable plate (7VC P). Biomechanical loads, construct stiffness, gap formation, and failure modes were compared between groups.Yield, peak, and failure loads were all significantly increased for the 5VCP and 7VCP groups, compared with the 3LP alone group. Increasing plate length from 3VCP to 5VCP and from 3VCP to 7VCP increased yield, peak, and failure loads. No differences were found between the 3LP and 3VCP groups with regard to yield and peak loads, but failure load was increased in the 3VCP group. Loads to create 1-mm and 3-mm gaps were significantly greater for the 5VCP and 7VCP groups, compared with the 3LP alone and 3VCP groups. Mode of plate attachment failure differed among groups.Tendon plate augmentation may be a viable surgical option to increase the strength of the tenorrhaphy in dogs. However, in vivo studies evaluating the effects of plate augmentation on the tendon blood supply and progression of healing are needed prior to clinical application.}, number={4}, journal={AMERICAN JOURNAL OF VETERINARY RESEARCH}, author={Chang, Yi-Jen and Duffy, Daniel J. and Beamon, Wes and Moore, George E.}, year={2022}, pages={305–311} }
 @article{duffy_chang_moore_2022, title={Influence of barbed suture oversew of the transverse staple line during functional end-to-end stapled anastomosis in a canine jejunal enterectomy model}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13827}, abstractNote={Abstract Objective To evaluate the influence of barbed suture oversew of the transverse staple line during functional end‐to‐end stapled anastomosis (FEESA) in dogs. Study design Randomized, experimental, ex vivo. Animals or sample population Grossly normal jejunal segments from 14 adult canine cadavers. Methods Ninety‐eight jejunal segments ( n = 14/FEESA group, n = 14 controls) were harvested and randomly assigned to a control group, FEESA + monofilament suture oversew, FEESA + unidirectional barbed suture oversew or FEESA + bidirectional barbed suture oversew. Oversew techniques were performed using a Cushing suture pattern. Initial (ILP) and maximum leakage pressure (MLP), repair time (s), and location of observed leakage were recorded. Results No differences were detected in ILP ( p = .439) or MLP ( p = .644) respectively between experimental groups. Repairs times using barbed suture were ~ 18% faster (~25 s faster; p < .001) compared to monofilament suture. There was no difference between barbed suture types ( p = .697). Mean ILP ( p < .001) and MLP ( p < .0001) were 6.6x and 5.1x greater respectively in the control group. Leakage location occurred predominately at the crotch of the FEESA in all groups. Conclusion FEESAs closed with a transverse staple line oversew using barbed suture, regardless of barb orientation, were completed faster and resulted in similar resistance to anastomotic leakage compared to monofilament suture. Clinical significance Oversewing the transverse staple line following FEESA using barbed suture offers similar resistance to anastomotic leakage, and may be associated with decreased surgical times in dogs compared to monofilament suture. Further studies are necessary to determine the benefits of barbed suture use in both open and laparoscopic gastrointestinal surgical applications following FEESA in dogs.}, journal={VETERINARY SURGERY}, author={Duffy, Daniel J. and Chang, Yi-Jen and Moore, George E.}, year={2022}, month={May} }
 @article{duffy_chang_moore_2022, title={Influence of crotch suture augmentation on leakage pressure and leakage location during functional end-to-end stapled anastomoses in dogs}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13764}, abstractNote={To determine the influence of anastomotic crotch suture augmentation on leakage pressures and leakage location following intestinal functional end-to-end stapled anastomosis (FEESA) in dogs.Ex vivo, randomized, experimental.Chilled jejunal segments from 3 adult dogs.Jejunal specimens were tested within 24 hours of collection. A FEESA was performed and randomly assigned to 1 of 4 treatment groups (n = 12/group): (1) no crotch suture (NCS); (2) simple interrupted crotch suture (SICS); (3) two simple interrupted crotch sutures (TCS) placed laterally on opposing jejunal limbs; (4) simple continuous crotch suture (SCCS) augmentation. Crotch sutures were performed using 3-0 USP polydioxanone. Initial (ILP) and maximal (MLP) leakage pressures (Mean ± SD mm Hg) and leakage location were recorded and compared between groups.Initial leakage pressure was greater after placement of TCS (37.8 ± 6.4, P < .039) and SCCS (47.6 ± 11.0, P < .002) than NCS (27.1 ± 2.5) and SICS (33.0 ± 6.0). Maximal leakage pressure was greater in specimens including SICS, TCS, and SCCS than those without crotch suture augmentation (P < .043). Leakage occurred at the anastomotic crotch in 8/12 NCS, 6/12 SICS, 11/12 TCS, and 12/12 SCCS constructs (P < .001).Augmentation of FEESA with TCS and SCCS increased ILP and decreased the occurrence of leakage from the anastomotic crotch, while all methods of anastomotic crotch augmentation increased MLP.Augmenting the FEESA with crotch suture(s) improved the resistance of the jejunal anastomosis to leakage in normal cadaveric segments. Placing 2 crotch sutures or use of a simple continuous pattern for anastomotic augmentation appeared to be superior to the placement of a single suture.}, journal={VETERINARY SURGERY}, author={Duffy, Daniel J. and Chang, Yi-Jen and Moore, George E.}, year={2022}, month={Jan} }
 @article{chang_duffy_moore_2022, title={Loop diameter of a modified Kessler locking-loop suture affects in vitro tensile strength and gapping characteristics of canine flexor tendon repairs}, volume={83}, ISSN={["1943-5681"]}, DOI={10.2460/ajvr.21.12.0212}, abstractNote={To evaluate effects of loop diameter of a modified Kessler locking-loop (LL) suture on in vitro tensile strength and gapping characteristics of canine flexor tendon repairs.48 cadaveric superficial digital flexor tendons from 24 adult medium- to large-breed dogs.Flexor tendons were randomly assigned to 4 groups (n = 12/group) and repaired with 2-0 polypropylene in a LL pattern with loops measuring 1, 2, 3, or 4 mm in diameter. Biomechanical loads, gap formation between tendon ends, and failure modes were evaluated and compared between groups.Increasing loop diameter from 1 to 4 mm significantly increased yield (P = .048), peak (P < .001), and failure (P < .001) loads. There were no significant differences in yield, peak, and failure loads between 1- and 2-mm loops. Load to 3-mm gap formation was significantly (P < .001) greater for 4-mm loops, compared with 1-, 2-, and 3-mm loops. Failure mode did not differ significantly among experimental groups, with 46 of 48 (96%) of constructs failing because of suture breakage.Loop diameter of a LL suture pattern is an important biomechanical variable that influences construct biomechanics of canine tendon suture repairs. Loop diameters > 3 mm are recommended when the size of the tendon allows. Further studies are necessary to determine the in vivo effect of these findings, particularly the effects on tendon blood supply.}, number={9}, journal={AMERICAN JOURNAL OF VETERINARY RESEARCH}, author={Chang, Yi-Jen and Duffy, Daniel J. and Moore, George E.}, year={2022}, month={Sep} }
 @article{duffy_beamon_chang_moore_2022, title={Loop modification of the traditional three-loop pulley pattern improves the biomechanical properties and resistance to 3-mm gap formation in a canine common calcanean teno-osseous avulsion model}, volume={83}, ISSN={["1943-5681"]}, DOI={10.2460/ajvr.21.09.0139}, abstractNote={Abstract OBJECTIVE To compare the biomechanical properties and gapping characteristics following loop modification of a 3-loop-pulley (3LP) pattern in an ex vivo canine common calcaneal tendon (CCT) avulsion repair model. SAMPLE 56 skeletally mature hindlimbs from 28 canine cadavers. PROCEDURES The CCTs were randomized to 1 of 4 experimental groups (n = 14/group) then sharply transected at the teno-osseous junction. Groups consisted of a 3LP, 4-loop-pulley (4LP), 5-loop-pulley (5LP), or 6-loop-pulley (6LP) pattern with loops placed 60° apart using size-0 polypropylene. Yield, peak, and failure loads, construct stiffness, loads to produce a 3-mm teno-osseous gap, and failure mode were evaluated and compared between groups. RESULTS Yield ( P = 0.001), peak ( P < 0.001), and failure loads ( P < 0.001), construct stiffness ( P < 0.001), and loads to 3-mm gap formation ( P = 0.005) were all significantly greater for 6LP compared to all other groups. Mode of failure did not differ among groups ( P = 0.733) with 75% (42/56) of repairs failing by mechanism of core sutures pulling through the tendinous tissue. Pattern modification by increasing the number of loops increased the repair site strength by 1.4, 1.6, and 1.8 times for 4LP, 5LP, and 6LP compared to 3LP, respectively. CLINICAL RELEVANCE Increasing the number of suture loops compared to a traditional 3LP repair is a relatively simple technique modification that significantly increases teno-osseous repair site strength and loads required to cause 3-mm gap formation. The results of this study justify further focused investigation of increasing the number of suture loops in vivo for teno-osseous CCT repair in dogs.}, number={8}, journal={AMERICAN JOURNAL OF VETERINARY RESEARCH}, author={Duffy, Daniel J. and Beamon, Weston L. and Chang, Yi-Jen and Moore, George E.}, year={2022}, month={Aug} }
 @article{wang_lynch_balko_duffy_robertson_posner_2022, title={Point-of-care viscoelastic coagulation assessment in healthy dogs during the perianesthetic period}, volume={18}, ISSN={["1746-6148"]}, url={http://www.scopus.com/inward/record.url?eid=2-s2.0-85138097516&partnerID=MN8TOARS}, DOI={10.1186/s12917-022-03442-x}, abstractNote={The viscoelastic coagulation monitor (VCM Vet) is a novel, portable device that provides a global assessment of hemostasis. The study aims were to evaluate serial viscoelastic analysis during the perianesthetic period in healthy dogs and to compare the agreement between two VCM Vet devices. Twenty healthy dogs undergoing orthopedic surgery were enrolled. Whole blood samples were collected from an intravenous catheter at four time points: baseline, 15 min after premedication, 60 min after inhalant initiation, and 60 min after inhalant termination. Viscoelastic tests were performed in duplicate on different devices, providing: clot time (CT; seconds), clot formation time (CFT; seconds), alpha angle (α; degrees), amplitude (units) at 10 (A10) and 20 (A20) minutes post clot time, maximum clot firmness (MCF; units), and lysis index (%) at 30 (Li30) and 45 (Li45) minutes post maximum clot formation.One hundred sixty samples were analyzed. The speed of CT and CFT significantly decreased an average of 25.5 s (95% confidence interval [CI]15.9-35.0) and 6.9 s (95% CI 3.1-10.7) per time point, respectively. There were no significant changes in clot strength or lysis variables. The Bland-Altman style plot shows an acceptable rate of agreement for all variables with intra-class correlation ranging from 0.64-0.94.The rate of clot formation (CT and CFT) decreased over the perianesthetic period in healthy dogs undergoing surgery. These changes were small and occurred without changes in clot strength or fibrinolysis rate, thus were not clinically relevant. There was clinically acceptable consistency between devices.}, number={1}, journal={BMC VETERINARY RESEARCH}, author={Wang, Wen H. and Lynch, Alex M. and Balko, Julie A. and Duffy, Daniel J. and Robertson, James B. and Posner, Lysa P.}, year={2022}, month={Sep} }
 @article{dimichele_duffy_chang_moore_2022, title={Superficial digital flexor tendon graft augmentation improves the tensile strength and resistance to gap formation following primary gastrocnemius tendon repair in dogs}, volume={83}, ISSN={["1943-5681"]}, DOI={10.2460/ajvr.22.03.0039}, abstractNote={Abstract OBJECTIVE To evaluate the influence of superficial digital flexor tendon (SDFT) graft augmentation on the biomechanical properties and resistance to gap formation in a canine gastrocnemius tendon repair model. SAMPLE POPULATION 28 canine cadaveric hind limbs. PROCEDURES Respective hindlimbs from each dog were randomized to one of two groups (n = 14/group) using a 3-loop–pulley (3LP) pattern alone or 3LP + SDFT graft augmentation. Biomechanical parameters evaluated included yield, peak, and failure loads; tensile loads required to create 1- and 3-mm gap formations; and mode of construct failure. RESULTS Mean yield and failure loads for the 3LP + SDFT graft group were 483.6 ± 148.0 N and 478.3 ± 147.9 N, respectively, and were greater compared to the 3LP group (34.2 ± 6.7 N and 34.0 ± 8.0 N, P < .0001). Loads to both 1- and 3-mm gap formations for the 3LP + SDFT graft group were greater compared to 3LP alone ( P < .001). Failure modes did not differ between groups ( P = .120), with constructs failing most commonly by suture pulling through opposed tendinous tissues whereas SDFT grafts remained intact. CLINICAL RELEVANCE SDFT graft augmentation increased yield, peak, and failure forces 14-fold across all examined biomechanical variables compared to the 3LP group. The 3LP + SDFT graft group required 3.6X and 6.5X greater loads to cause a 1- and 3-mm gap, respectively, between tendon ends. These data support the biomechanical advantages of SDFT graft augmentation to increase repair-site strength and to promote resistance to gap formation of the tenorrhaphy. Additional in vivo studies are required to determine the effect of SDFT augmentation on clinical function and active limb use after graft harvest in dogs.}, number={9}, journal={AMERICAN JOURNAL OF VETERINARY RESEARCH}, author={DiMichele, Julianna K. and Duffy, Daniel J. and Chang, Yi-Jen and Moore, George E.}, year={2022}, month={Sep} }
 @article{piegols_hayes_lin_singh_langlois_duffy_2021, title={Association between biliary tree manipulation and outcome in dogs undergoing cholecystectomy for gallbladder mucocele: A multi-institutional retrospective study}, volume={50}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13542}, abstractNote={Abstract Objective To determine whether catheterization of the common bile duct (CBD) is associated with outcome in dogs undergoing cholecystectomy for gallbladder mucocele and to determine whether this association is modified by the catheterization method. Study design Multi‐institutional retrospective cohort study. Animals Dogs (n = 252) that underwent cholecystectomy for gallbladder mucocele. Methods Dogs were identified via electronic medical record review at four veterinary teaching hospitals. Baseline dog characteristics, surgical findings, and methods including normograde vs retrograde CBD catheterization, intraoperative outcomes, and postoperative outcomes and complications were recorded. Variables were compared between dogs with and without catheterization. Results Catheterized dogs had higher American Society of Anesthesiologists scores ( P = .04), higher total bilirubin ( P = .01), and were more likely to have dilated CBD at the time of surgery ( P < .01). Incidence of major and minor intraoperative complications was similar between the two groups. Surgical time was longer for the catheterized group ( P = .01). The overall incidence of postoperative complications was similar between the groups; however, postoperative pancreatitis was associated with performing CBD catheterization ( P = .01). This association was retained as an independent association in a multivariable model that addressed baseline group differences ( P = .04). Likelihood of developing postoperative pancreatitis was not different between normograde and retrograde catheterization ( P = .57). Conclusion Catheterization of the CBD was associated with development of postoperative pancreatitis. This was not influenced by the method of catheterization. Clinical significance The requirement for catheterization of the CBD during open cholecystectomy in dogs should be carefully considered, particularly in dogs without evidence of biliary obstruction because the procedure may induce postoperative pancreatitis.}, number={4}, journal={VETERINARY SURGERY}, author={Piegols, Hunter J. and Hayes, Galina M. and Lin, Samantha and Singh, Ameet and Langlois, Daniel K. and Duffy, Daniel J.}, year={2021}, month={May}, pages={767–774} }
 @article{duffy_chang_fisher_moore_2021, title={Biomechanical analysis of accessory tendon graft augmentation for primary gastrocnemius tendon reconstruction in dogs}, volume={50}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13645}, abstractNote={Abstract Objective To evaluate the effect of accessory tendon graft (ATG) augmentation as an adjunct to a core locking‐loop (LL) and epitendinous suture (ES) repair in a gastrocnemius tendon (GT) model. Study Design Randomized, ex vivo, biomechanical. Population Twenty‐two canine GT musculotendinous constructs. Methods GT repair constructs were randomly divided into two groups ( n = 10/group). After transection, paired GT were repaired with LL + ES alone or with concurrent ATG augmentation. Yield, peak and failure loads, tensile loads required to create 1 and 3 mm gapping, and failure modes were evaluated. Four GT were used as intact controls for validation of testing methodology. ATG constructs were compared to LL + ES and control specimens. Results Yield ( p < .0001), peak ( p = .0001) and failure loads ( p = .0003) were greater when ATG was used for repair. Greater force was required to cause 1 mm ( p = .0001) and 3 mm ( p = .0002) gap formation in the ATG group, however, the frequency of gap formation did not differ between groups. All repaired constructs failed exclusively by suture pull‐through. Conclusion Autologous ATG augmentation as an adjunct to primary GT repair increased yield, peak and failure forces by approximately 1.6×, 1.9×, 1.8× respectively and required 2.1× greater force to cause 1 and 3 mm formation respectively compared to LL + ES repairs alone. Clinical Significance ATG augmentation should be considered as an autologous method to support and strengthen the primary GT repair. These results justify studies to determine the effect of ATG on clinical function following graft harvest in dogs.}, number={5}, journal={VETERINARY SURGERY}, author={Duffy, Daniel J. and Chang, Yi-Jen and Fisher, Matthew B. and Moore, George E.}, year={2021}, month={Jul}, pages={1147–1156} }
 @article{duffy_chang_fisher_moore_2021, title={Biomechanical evaluation of a novel barbed suture pattern with epitendinous suture augmentation in a canine flexor tendon model}, volume={50}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13653}, abstractNote={Abstract Objective To determine the effect of a novel barbed suture pattern (NBSP) compared to a three‐loop‐pulley (3LP) with and without epitendinous suture (ES) augmentation on the biomechanical strength and gap formation of repaired canine tendons. Study Design Ex vivo, cadaveric, randomized, experimental study. Sample Population Forty, adult superficial digital flexor tendons (SDFT). Methods SDFT were randomly assigned to one of four groups ( n = 10/group). Sharp tenotomy was performed and repaired with 3LP, NBSP, 3LP + ES, and NBSP + ES. Constructs were tested to failure while evaluating yield, peak, and failure loads, loads at 1 and 3 mm gap formation, and failure mode. Results Constructs augmented with ES sustained 80% greater yield ( p < .001), peak ( p < .001), and failure ( p < .001) loads, with no difference between 3LP + ES and NBSP + ES constructs regarding peak ( p = .614), and failure forces ( p = .865). Loads resulting in 1 and 3 mm gap formation were greater when constructs were augmented with an ES ( p ≤ .003). Failure mode differed between groups ( p < .001), occurring predominantly due to suture pull‐through in 3LP and NBSP groups compared to tissue failure distant to the repair site in ES augmented constructs. Conclusion Tendons repaired with the NBSP used in this study resisted similar forces as those repaired with 3LP. Augmentation with an ES improved the biomechanical properties of repaired constructs, including resistance to gap formation. Clinical Relevance The NBSP repair tested here may be advantageous over monofilament suture repair as it uses a similar‐sized barbed core suture but eliminates the requirement for knot tying.}, number={5}, journal={VETERINARY SURGERY}, author={Duffy, Daniel J. and Chang, Yi-Jen and Fisher, Matthew B. and Moore, George E.}, year={2021}, month={Jul}, pages={1128–1136} }
 @article{gleason_phillips_mccoy_gutierrez-nibeyro_mckiernan_duffy_feign_kim_kersh_2021, title={Biomechanical properties of canine staphylectomies closed with barbed or smooth suture}, volume={50}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13544}, abstractNote={Abstract Objective To compare the duration of closure and biomechanical properties of staphylectomies closed with absorbable bidirectional barbed suture or smooth monofilament suture in a simple continuous or interrupted pattern Study design Ex vivo study Sample population Soft palates (n = 60) harvested from mesaticephalic canine cadavers Methods One centimeter of tissue was excised from the caudal border of each soft palate, and the oral and nasopharyngeal mucosal surfaces were apposed with 2‐0 bidirectional Quill Monoderm knotless closure device barbed suture (Q), 3‐0 Monocryl in a simple continuous (MC) pattern, or 3‐0 Monocryl in a simple interrupted (MI) pattern (n = 20 per group). Duration of closure was compared between groups. Tissues were tested under tension to failure, and mode of failure data were collected by video capture. Results Closure time was longer for MI closures than for Q and MC closures, with means of 259.9, 215.4, and 196.7 seconds, respectively ( P < .0001). No difference was detected in yield force, force to first tissue rupture, maximum force, and energy required for yield and maximum force between groups. Energy to yield was 190.0, 167.8, and 188.95 N‐mm for MI, Q, and MC closures, respectively. Conclusion Biomechanical properties of staphylectomies closed with barbed or smooth sutures did not differ in this cadaveric model. Clinical significance Barbed suture can be considered as an alternative for closure of canine staphylectomies. These results provide evidence to justify additional research to evaluate clinical outcomes in dogs undergoing staphylectomy.}, number={1}, journal={VETERINARY SURGERY}, author={Gleason, Hadley E. and Phillips, Heidi and McCoy, Annette M. and Gutierrez-Nibeyro, Santiago D. and McKiernan, Brendan C. and Duffy, Daniel J. and Feign, Ian M. and Kim, Woojae Jason and Kersh, Mariana E.}, year={2021}, month={Jan}, pages={196–206} }
 @article{corrie_duffy_chang_moore_2021, title={Effect of knot location on the biomechanical strength and gapping characteristics of ex vivo canine gastrocnemius tenorrhaphy constructs}, volume={82}, ISSN={["1943-5681"]}, DOI={10.2460/ajvr.21.03.0038}, abstractNote={To evaluate the effect of knot location on the biomechanical strength and gapping characteristics of ex vivo canine gastrocnemius tenorrhaphy constructs.36 cadaveric gastrocnemius tendons from 18 adult dogs.Tendons were randomly assigned to 3 groups (12 tendons/group) and sharply transected and repaired by means of a core locking-loop suture with the knot at 1 of 3 locations (exposed on the external surface of the tendon, buried just underneath the external surface of the tendon, or buried internally between the apposed tendon ends). All repairs were performed with size-0 polypropylene suture. All constructs underwent a single load-to-failure test. Yield, failure, and peak forces, mode of failure, and forces required for 1- and 3-mm gap formation were compared among the 3 knot-location groups.Mean yield, failure, and peak forces and mean forces required for 1- and 3-mm gap formation did not differ significantly among the 3 groups. The mode of failure also did not differ significantly among the 3 groups, and the majority (33/36 [92%]) of constructs failed owing to the suture pulling through the tendinous substance.Final knot location did not significantly affect the biomechanical strength and gapping characteristics of canine gastrocnemius tenorrhaphy constructs. Therefore, all 3 evaluated knot locations may be acceptable for tendon repair in dogs. In vivo studies are necessary to further elucidate the effect of knot location in suture patterns commonly used for tenorrhaphy on tendinous healing and collagenous remodeling at the repair site.}, number={12}, journal={AMERICAN JOURNAL OF VETERINARY RESEARCH}, author={Corrie, Jessica L. and Duffy, Daniel J. and Chang, Yi-Jen and Moore, George E.}, year={2021}, month={Dec}, pages={942–947} }
 @article{duffy_cocca_chang_moore_2021, title={Evaluation of staple line reinforcement after partial gastrectomy closure in an ex vivo canine model}, volume={50}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13550}, abstractNote={Abstract Objective To determine the influence of stapling on leakage pressures after canine partial gastrectomy. Study design Ex vivo study. Sample population Gastric specimens from 24 adult canine cadavers. Methods Partial gastrectomy constructs were assigned to one of three closure techniques (n = 8 per group): group 1, stapled closure with a 90‐mm thoracoabdominal stapling device and a 4.8‐mm staple cartridge; group 2, hand‐sewn double‐layer inverting suture closure with 3‐0 glycomer 631; and group 3, staple line reinforcement with an inverting Cushing suture pattern. Leakage and pressure testing were performed. Initial leakage pressure (ILP), maximal leakage pressure (MLP), and leakage location were recorded. Significance was set at P < .05. Results Placement of a Cushing suture (group 3) increased ILP and MLP by 3.2‐fold and 2.8‐fold, respectively, compared with stapled closures alone ( P < .001). Constructs closed with double‐layer suture closure reached ILP and MLP 4.5‐fold and threefold greater, respectively, compared with those with stapled closures alone ( P < .001). Maximal leakage pressure did not differ between groups 2 and 3 ( P = .14). Leakage occurred from the inverting suture line in all constructs of groups 2 and 3 and from staple holes in six of eight group 1 constructs. Conclusion Double‐layer suture closure of canine partial gastrectomies achieved superior biomechanical properties compared with stapled closure techniques. Reinforcing staple closures with an inverting suture line improved resistance to leakage. Clinical significance Reinforcing single‐layer closure of partial gastrectomies with an inverting Cushing pattern is recommended to improve resistance to leakage. In vivo investigation is warranted to evaluate influence of closure technique on gastric healing, postoperative stasis, ischemic injury, and postoperative dehiscence.}, number={2}, journal={VETERINARY SURGERY}, author={Duffy, Daniel J. and Cocca, Christina J. and Chang, Yi-Jen and Moore, George E.}, year={2021}, month={Feb}, pages={435–443} }
 @article{curcillo_duffy_chang_moore_2021, title={Ex Vivo Biomechanical Assessment of a Novel Multi-Strand Repair of Canine Tendon Lacerations}, ISSN={["2567-6911"]}, DOI={10.1055/s-0041-1725014}, abstractNote={Abstract Objective This study aimed to evaluate the effect of increasing the number of suture strands traversing the transection site, level of suture purchase and depth of suture penetrance on the biomechanical properties of repaired gastrocnemius tendons. Study Design Thirty-eight adult cadaveric gastrocnemius tendons were randomized, transected and repaired with either two-, four- or six-strand locking multi-level repair. Tensile loads required to create a 1 and 3 mm gap, yield, peak and failure loads and failure mode were analysed. Significance was set at p < 0.05. Results Mean ± standard deviation yield, peak and failure force for six-strand repairs was 90.6 ± 22.1 N, 111.4 ± 15.2 N and 110.3 ± 15.1 N respectively. This was significantly greater compared with both four-strand (55.0 ± 8.9 N, 72.9 ± 7.8 N and 72.1 ± 8.2 N) and two-strand repairs (24.7 ± 8.3 N, 36.5 ± 6.0 N and 36.1 ± 6.3 N) respectively (p < 0.001). Occurrence of 3 mm gap formation was significantly less using six-strand repairs (p < 0.001). Mode of failure did not differ between groups with all repairs (36/36; 100%) failing by suture pull-through. Conclusion Pattern modification by increasing the number of suture strands crossing the repair site, increasing points of suture purchase from the transection site and depth of suture penetrance is positively correlated with repair site strength while significantly reducing the occurrence of gap formation in a canine cadaveric model. Additional studies in vivo are recommended to evaluate their effect on tendinous healing, blood supply and glide resistance prior to clinical implementation.}, journal={VETERINARY AND COMPARATIVE ORTHOPAEDICS AND TRAUMATOLOGY}, author={Curcillo, Chiara P. and Duffy, Daniel J. and Chang, Yi-Jen and Moore, George E.}, year={2021}, month={Mar} }
 @article{chiu_duffy_chang_gaffney_fisher_2021, title={Ex vivo evaluation of novel core tenorrhaphy patterns in dogs}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13678}, abstractNote={To compare the biomechanical properties and gapping characteristics of four novel tenorrhaphy patterns in a canine flexor tendon model.Ex vivo, randomized, biomechanical study.Superficial digital flexor tendons of 60 forelimbs (30 dogs).Each tendon was transected 25 mm distal to its musculotendinous junction prior to tenorrhaphy with 2-0 polypropylene. Repair patterns included the three-loop pulley (3LP, control), exposed double-cross-lock (ExDCrL), embedded double-cross-lock (EmDCrL), triple-circle-lock (TCiL), and Modified-Tang patterns (MTang) were randomly assigned to each experimental group (n = 12/group). Yield, peak, and failure loads, gap formation and failure modes were compared.Tendons repaired with ExDCrL (p < .0001), EmDCrL (p < .0001), and MTang (p < .0001) sustained yield, peak, and failure loads ~2.2x, ~2.0x, and ~1.9x, respectively, greater than those repaired with 3LP. Loads to 1 and 3 mm gapping were also higher for ExDCrL (p < .0001), EmDCrL (p < .0004), and MTang constructs (p < .0017) compared to 3LP. Although TCiL constructs sustained higher loads, their resistance to gap formation did not differ from that of 3LP repairs. Failure mode differed between groups (p < .0001), EmDCrL, ExDCrL, MTang, and TCiL constructs failing predominantly by suture breakage compared to 3LP repairs that failed by suture pull-through.Use of novel patterns ExDCrL, EmDCrL, and MTang improved resistance to loads and gap formation and were biomechanically superior compared to 3LP in healthy canine tendon repairs.These results justify in vivo evaluation of ExDCrL, EmDCrL, or MTang pattern for tenorrhaphy in dogs.}, journal={VETERINARY SURGERY}, author={Chiu, King Wa and Duffy, Daniel J. and Chang, Yi-Jen and Gaffney, Lewis and Fisher, Matthew B.}, year={2021}, month={Jul} }
 @article{page-karjian_whitmore_stacy_perrault_farrell_shaver_walker_frandsen_rantonen_harms_et al._2021, title={Fibropapillomatosis and Chelonid Alphaherpesvirus 5 Infection in Kemp's Ridley Sea Turtles (Lepidochelys kempii)}, volume={11}, ISSN={["2076-2615"]}, url={https://doi.org/10.3390/ani11113076}, DOI={10.3390/ani11113076}, abstractNote={Fibropapillomatosis (FP), a debilitating, infectious neoplastic disease, is rarely reported in endangered Kemp's ridley sea turtles (Lepidochelys kempii). With this study, we describe FP and the associated chelonid alphaherpesvirus 5 (ChHV5) in Kemp's ridley turtles encountered in the United States during 2006-2020. Analysis of 22 case reports of Kemp's ridley turtles with FP revealed that while the disease was mild in most cases, 54.5% were adult turtles, a reproductively valuable age class whose survival is a priority for population recovery. Of 51 blood samples from tumor-free turtles and 12 tumor samples from turtles with FP, 7.8% and 91.7%, respectively, tested positive for ChHV5 DNA via quantitative polymerase chain reaction (qPCR). Viral genome shotgun sequencing and phylogenetic analysis of six tumor samples show that ChHV5 sequences in Kemp's ridley turtles encountered in the Gulf of Mexico and northwestern Atlantic cluster with ChHV5 sequences identified in green (Chelonia mydas) and loggerhead (Caretta caretta) sea turtles from Hawaii, the southwestern Atlantic Ocean, and the Caribbean. Results suggest an interspecific, spatiotemporal spread of FP among Kemp's ridley turtles in regions where the disease is enzootic. Although FP is currently uncommon in this species, it remains a health concern due to its uncertain pathogenesis and potential relationship with habitat degradation.}, number={11}, journal={ANIMALS}, author={Page-Karjian, Annie and Whitmore, Liam and Stacy, Brian A. and Perrault, Justin R. and Farrell, Jessica A. and Shaver, Donna J. and Walker, J. Shelby and Frandsen, Hilary R. and Rantonen, Elina and Harms, Craig A. and et al.}, year={2021}, month={Nov} }
 @article{putterman_selmic_kindra_duffy_risselada_phillips_2021, title={Influence of normograde versus retrograde catheterization of bile ducts in dogs treated for gallbladder mucocele}, volume={50}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13632}, abstractNote={Abstract Objective To determine the influence of normograde (NG) versus retrograde (RG) catheterization of the cystic duct and common bile duct (CBD) in dogs with gallbladder mucoceles (GBM) treated with open cholecystectomy. Study design Retrospective study. Animals Dogs ( n = 117) with GBM. Methods Medical records were reviewed for signalment, history, clinical laboratory and diagnostic imaging findings, details of surgery including catheterization method, complications, and outcome. Long‐term follow‐up data were obtained by telephone or electronic communication. Relationships between catheterization method and clinical variables and outcome were evaluated. Results Dogs catheterized RG were more likely to experience any postoperative complication ( p = .0004) including persistence of gastrointestinal signs ( p = .0003). Survival to discharge and long‐term survival did not differ by group ( p = .23 and p = .49). Total bilirubin (TB) decreased by 70.3% after NG catheterization compared to 39.1% after RG catheterization ( p = .03) and increased in 14.9% dogs catheterized NG and 38.0% dogs catheterized RG ( p = .004). The presence of a diplomate surgeon at surgery resulted in decreased incidences of any perioperative or postoperative complication ( p = .003 and p = .05). Conclusion Retrograde catheterization was associated with more postoperative concerns than NG catheterization, but similar survival times. Surgery should be performed by diplomates experienced in biliary surgery to minimize complications. Clinical significance Although both NG and RG techniques to catheterize the cystic duct and CBD are options for treatment of GBM with low mortality, results of this study provide some evidence to recommend NG over RG catheterization.}, number={4}, journal={VETERINARY SURGERY}, author={Putterman, Allison B. and Selmic, Laura E. and Kindra, Cameron and Duffy, Daniel J. and Risselada, Marije and Phillips, Heidi}, year={2021}, month={May}, pages={784–793} }
 @article{chang_duffy_moore_2021, title={Influence of preconstructed effector loop location using a barbed unidirectional suture on leakage pressures following canine enterotomy closure}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13710}, abstractNote={Abstract Objective To evaluate the influence of preconstructed effector loop location using a barbed unidirectional suture on leakage pressures following canine enterotomy closure. Study design Randomized, experimental, cadaveric. Animals or sample population Grossly normal jejunal segments from three canine cadavers. Methods Jejunal segments were harvested and randomly assigned based upon effector loop location from the beginning of the incisional line. Groups ( n = 12/group) included 0 mm, 5 mm, 10 mm, 15 mm, and intact controls ( n = 6/group), repaired using a 3–0 unidirectional barbed suture in a simple continuous pattern. Initial leakage pressure (ILP), maximum intraluminal pressure (MIP), repair time, and leakage location were recorded. Results Mean ILP for 0 mm group (24.42 ± 8.43 mmHg) was lower ( p ≤ .001) compared to all experimental groups with ILP ~40% lower. There was no difference in MIP among experimental groups ( p = .239). Repair time increased ( p < .0001) as the distance of the effector loop increased ≥5 mm from the beginning of the incisional line. Leakage location differed among groups ( p < .001) with leakage in the 0 mm group from the incisional line (75%), compared to leakage from predominantly from the suture holes in other groups, respectively. Conclusion Effector loop location influenced ILP and leakage location. Effector loops placed at the beginning of the incisional line (0 mm) decreased ILP compared to loops placed at 5, 10, and 15 mm. Clinical significance Effector loop location using a unidirectional barbed suture should be placed ≥5 mm from beginning of the incisional line for enterotomy closure. Further in vivo studies are necessary to determine the clinical significance of these findings.}, journal={VETERINARY SURGERY}, author={Chang, Yi-Jen and Duffy, Daniel J. and Moore, George E.}, year={2021}, month={Aug} }
 @article{maxwell_dugat_waltenburg_upchurch_soto-elias_duffy_spector_petrovsky_payton_2021, title={Outcomes of dogs undergoing immediate or delayed surgical treatment for gastrointestinal foreign body obstruction: A retrospective study by the Society of Veterinary Soft Tissue Surgery}, volume={50}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13520}, abstractNote={Abstract Objective To evaluate gastrointestinal injury and outcomes between dogs treated with immediate surgical intervention vs those treated with delayed surgical intervention for gastrointestinal foreign body obstruction (GIFBO). Study design Retrospective cohort study. Sample population Client‐owned dogs (n = 855) from five referral hospitals. Methods Medical records of dogs in which GIFBO had been diagnosed between 2007 and 2017 were reviewed for preoperative management, timing of surgery, intraoperative findings, postoperative management, outcome, and survival. Surgical intervention was classified as immediate when it occurred within 6 hours of presentation and delayed when it occurred >6 hours after presentation. Results Outcomes did not differ between dogs treated immediately (n = 584) or over 6 hours after presentation (n = 210). Intestinal necrosis and perforations were more common when surgery was delayed ( P = .008; P = .019) but became nonsignificant after controlling for preoperative differences. Risk factors for necrosis and perforations included duration of clinical signs, increased lactate, linear foreign material, and timing of surgery. Enterectomies ( P = .004) as well as the duration of surgery ( P = .004) and anesthesia ( P = .001) were increased when surgery was delayed. Immediate surgery was associated with earlier return to feeding ( P = .004) and discharge from the hospital ( P < .001); (5%) dogs in each group (n = 33 immediate; n = 11 delayed) either had a negative explore or the foreign body was milked aborally into the colon at the time of surgery. Conclusion Although outcomes were not associated with surgical timing, the unadjusted prevalence of gastrointestinal injury and, thus, the requirement for complex surgical procedures was higher in the delayed group. Clinical significance: Earlier surgical treatment of stabilized dogs with GIFBO may involve fewer complex procedures and accelerate recovery.}, number={1}, journal={VETERINARY SURGERY}, author={Maxwell, Elizabeth A. and Dugat, Danielle R. and Waltenburg, Michelle and Upchurch, David and Soto-Elias, Pedro and Duffy, Daniel J. and Spector, Daniel and Petrovsky, Brian and Payton, Mark}, year={2021}, month={Jan}, pages={177–185} }
 @article{duffy_curcillo_chang_gaffney_fisher_moore_2020, title={Biomechanical evaluation of an autologous flexor digitorum lateralis graft to augment the surgical repair of gastrocnemius tendon laceration in a canine ex vivo model}, volume={49}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13453}, abstractNote={Abstract Objective To evaluate the effect of an autologous flexor digitorum lateralis (FDL) graft to augment a three‐loop pulley (3LP) core repair in a canine cadaveric gastrocnemius tendon (GT) laceration model. Study design Ex vivo, biomechanical study. Sample population Twenty‐six canine cadaveric hind limbs. Methods Tendons were divided into two groups (n = 13). After sharp transection, paired GT were repaired with 3LP or 3LP + FDL tendon augmentation. Yield, peak and failure loads, tensile loads required to create 1 and 3‐mm gapping, and failure modes were analyzed. Significance was set at P < .05. Results Yield and failure force (mean ± SD) for 3LP + FDL were 134.9 ± 44.1 N and 205.4 ± 46.4 N, respectively, which were greater than for 3LP alone (67.9 ± 12.2 N and 91.8 ± 9.9 N, respectively, P < .0001). No constructs (0%) formed 1 or 3‐mm gaps in the 3LP + FDL graft group compared with 84% and 39% for 3LP, respectively ( P < .0001). Failure modes were different between groups ( P < .001), with 85% of 3LP + FDL constructs failing by tissue rupture at the myotendinous junction, distant to the repair site. Conclusion Addition of an autologous FDL graft to a core 3LP tendon repair increased yield, peak, and failure forces by twofold, 2.3‐fold, and 2.2‐fold, respectively, compared with core 3LP alone while preventing the occurrence of gap formation. Clinical significance Use of FDL tendon augmentation for GT laceration may increase repair site strength and resist gap formation better than 3LP core suture use alone. Additional studies are required in vivo to determine the effect of FDL graft augmentation on clinical function.}, number={8}, journal={VETERINARY SURGERY}, author={Duffy, Daniel J. and Curcillo, Chiara P. and Chang, Yi-Jen and Gaffney, Lewis and Fisher, Matthew B. and Moore, George E.}, year={2020}, month={Dec}, pages={1545–1554} }
 @article{scharf_oblak_hoffman_skinner_neal_cocca_duffy_wallace_2020, title={Clinical features and outcome of functional thyroid tumours in 70 dogs}, volume={61}, ISSN={["1748-5827"]}, DOI={10.1111/jsap.13183}, abstractNote={Objective To describe the clinical features and outcome of functional thyroid tumours in dogs. Materials and Methods Retrospective multi‐institutional study of 70 dogs diagnosed with thyroid mass and concurrent hyperthyroidism. Clinical data regarding presentation, treatment, outcome and functional thyroid status were retrieved. Results Overall median survival of dogs with functional thyroid tumours was 35.1 months and 1‐ and 3‐year survival rates were 83 and 49%, respectively. Median survival time was 72.6 months for dogs treated with surgical excision and 15.7 months for dogs that did not receive surgery. Of the 50 dogs treated by surgery and for which thyroid status was known following treatment, 64% developed hypothyroidism after surgery. Histopathologically confirmed metastasis was identified in 3% of dogs. Clinical Significance Dogs with functional thyroid tumours may survive a long time after surgical excision, although post‐operative hypothyroidism is common.}, number={8}, journal={JOURNAL OF SMALL ANIMAL PRACTICE}, author={Scharf, V. F. and Oblak, M. L. and Hoffman, K. and Skinner, O. T. and Neal, K. M. and Cocca, C. J. and Duffy, D. J. and Wallace, M. L.}, year={2020}, month={Aug}, pages={504–511} }
 @article{duffy_chang_fisher_moore_2020, title={Effect of partial vs complete circumferential epitendinous suture placement on the biomechanical properties and gap formation of canine cadaveric tendons}, volume={49}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13494}, abstractNote={Abstract Objective To determine the effect of partial vs complete circumferential epitendinous suture (ES) placement in addition to a core suture on the biomechanical strength and gapping characteristics of repaired canine tendinous constructs. Study design Ex vivo, biomechanical study. Sample population Thirty‐six canine superficial digital flexor tendons. Methods Superficial digital flexor tendons were randomly assigned to three groups (n = 12), sharply transected and repaired with a core locking‐loop suture with Group 1 a partial circumferential ES, 180° on the palmar side; Group 2 a complete circumferential ES, 360° and double knotting technique; or Group 3 a complete circumferential ES, 360° and single knotting technique. After preloading, constructs were distracted to monotonic failure. Failure mode, gap formation, yield, peak, and failure forces were analyzed. Results Mean yield (group 1 = 68.6 N, group 2 = 106.5 N, group 3 = 114 N, P < .013), peak (group 1 = 92.8 N, group 2 = 134.6 N, group 3 = 147.3 N; P < .001), and failure (group 1 = 88.7 N, group 2 = 133.0 N, group 3 = 145.5 N, P < .001) loads differed between groups. No difference in yield ( P = .874), peak ( P = .434), or failure load ( P = .434) was detected between complete circumferential ES groups. Force to create 1‐mm ( P < .001) and 3‐mm ( P < .038) gap formation was greater in specimens with complete vs partial circumferential ES placement. Complete circumferential ES repairs failed primarily by suture pull‐through compared with suture breakage in most partial circumferential ES constructs. Conclusion Addition of a complete circumferential ES with a single or double knotting technique increased the biomechanical strength of normal tendon repairs while reducing gap formation compared with partial ES placement alone. Clinical significance Complete circumferential ES is recommended over partial ES placement.}, number={8}, journal={VETERINARY SURGERY}, author={Duffy, Daniel J. and Chang, Yi-Jen and Fisher, Matthew B. and Moore, George E.}, year={2020}, month={Dec}, pages={1571–1579} }
 @article{duffy_chang_balko_moore_2020, title={Effect of presurgical storage conditions on leakage pressures of enterotomy sites closed with unidirectional barbed suture material in fresh, chilled, and frozen-thawed cadaveric canine jejunal specimens}, volume={81}, ISSN={["1943-5681"]}, DOI={10.2460/ajvr.81.3.220}, abstractNote={To evaluate the effect of presurgical storage conditions on leakage pressures of enterotomy sites closed with unidirectional barbed suture material in fresh, chilled, and frozen-thawed cadaveric canine jejunal specimens.36 grossly normal jejunal segments obtained from 4 dog cadavers.9 jejunal segments were harvested immediately from each euthanized dog and randomly assigned to be tested within 4 hours after collection (fresh segments), stored at 4°C for 24 hours before testing (chilled segments), or stored at -20°C for 7 days and thawed at 21°C for 6 hours before testing (frozen-thawed segments). For leakage pressure testing, a 3-cm-long antimesenteric enterotomy was performed and repaired with 3-0 unidirectional barbed suture material in a simple continuous pattern in each segment. Time to complete the enterotomy, initial leakage pressure, maximum intraluminal pressure, and leakage location were recorded for each segment.Mean ± SD initial leakage pressure for fresh, chilled, and frozen-thawed segments was 52.8 ± 14.9 mm Hg, 51.8 ± 11.9 mm Hg, and 33.3 ± 7.7 mm Hg, respectively. Frozen-thawed segments had significantly lower mean initial leakage pressure, compared with findings for fresh or chilled segments. Time to complete the enterotomy, maximum intraluminal pressure, and leakage location did not differ among groups.Leak pressure testing of cadaveric jejunal segments that are fresh or chilled at 4°C for 24 hours is recommended for enterotomy studies involving barbed suture material in dogs. Freezing and thawing of cadaveric jejunal tissues prior to investigative use is not recommended because leak pressure data may be falsely low.}, number={3}, journal={AMERICAN JOURNAL OF VETERINARY RESEARCH}, author={Duffy, Daniel J. and Chang, Yi-Jen and Balko, Julie A. and Moore, George E.}, year={2020}, month={Mar}, pages={220–226} }
 @article{chu_duffy_vieson_moore_2020, title={Ex vivo comparison of leakage pressures and leakage location with a novel technique for creation of functional side-to-side canine small intestinal anastomoses}, volume={49}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13408}, abstractNote={Abstract Objective To determine the ability of functional side‐to‐side small intestinal anastomoses (FSS‐SIA) created with an electrothermal bipolar vessel sealing (EBVS) device to resist leakage. Study design Experimental, ex vivo. Sample population Jejunal segments (n = 130) from 10 healthy canine cadavers. Methods Four types of anastomoses were created (two segments/construct and 15 constructs/group): EBVS (group A), EBVS + transverse stapling (group B), stapled (group C), and EBVS + suture augmentation (group D). Initial leakage pressure (ILP), initial leakage location (ILL), and maximal intraluminal pressure were compared between groups, and five group A constructs were analyzed histologically. Results Initial leakage pressure was greater in group D than in groups A, B, and C ( P < .011). There was a difference in ILL among groups ( P = .003). Leakage occurred at the side‐to‐side intestinal anastomosis fusion line in 13 of 15 (87%) constructs for groups A and B and in nine of 15 (60%) constructs for group D. Maximal intraluminal pressure was greater in group C than in groups A, B, and D ( P < .004). Histological examination was consistent with collagenous fusion without cavitation defects. Conclusion Functional side‐to‐side small intestinal anastomosis was consistently achieved with an EBVS device. Augmentation of EBVS anastomoses with simple interrupted sutures along the anastomotic fusion line increased ILP compared with stapled anastomoses. Clinical significance Despite the success and feasibility of creating an FSS‐SIA with an EBVS device, additional in vivo studies are required to determine the effectiveness of intestinal fusion prior to clinical implementation.}, number={5}, journal={VETERINARY SURGERY}, author={Chu, Kyle L. and Duffy, Daniel J. and Vieson, Miranda D. and Moore, George E.}, year={2020}, month={Jul}, pages={1024–1034} }
 @article{duffy_chang_balko_moore_2020, title={Ex vivo comparison of the effect of storage temperature on canine intestinal leakage pressures}, volume={49}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13339}, abstractNote={Abstract Objective To determine the effect of storage temperature on cadaveric small intestinal leakage pressures after enterotomy. Study design Experimental ex vivo study. Animals Grossly normal jejunal segments from four canine cadavers. Methods Thirty‐six jejunal segments (n = 12 segments/group) were harvested immediately after euthanasia and assigned to a fresh group (tested within 4 hours), chilled group (stored for 24 hours at 4°C before testing), or freeze–thaw group (frozen at −20°C for 7 days and thawed at 21°C for 6 hours before testing). A 2‐cm antimesenteric enterotomy was performed and repaired with 4‐0 monofilament suture in a simple‐continuous pattern. Initial leakage pressure (ILP), maximal intraluminal pressure (MIP), and leakage location were recorded, with testing performed at room temperature. Results Mean ± SD ILP for fresh, chilled, and frozen–thawed specimens was 52.9 ± 8.4, 51.8 ± 11.9 and 29.8 ± 4.4 mm Hg, respectively. There was a difference in ILP among groups ( P < .003), with freeze–thaw samples demonstrating lower ILP compared with other groups. There was no difference in MIP between groups ( P = .186) There was a difference in leakage location among groups ( P = .004), with the majority of chilled and freeze–thaw samples leaking at the suture holes compared with the incisional line in fresh samples. Conclusion Freezing and subsequent thawing prior to specimen testing reduced ILP compared with use of fresh and chilled specimens but did not affect MIP among experimental groups. Clinical significance Cadaveric canine intestinal specimens tested immediately after collection or after chilling for 24 hours should be recommended for ex vivo burst pressure assessment in dogs. Additional studies to evaluate loss in testing viability of chilled intestinal specimens are warranted to help govern experimental methodologies.}, number={3}, journal={VETERINARY SURGERY}, author={Duffy, Daniel J. and Chang, Yi-Jen and Balko, Julie A. and Moore, George E.}, year={2020}, month={Apr}, pages={496–501} }
 @article{cocca_duffy_kersh_moore_2020, title={Influence of Interlocking Horizontal Mattress Epitendinous Suture Placement on Tendinous Biomechanical Properties in a Canine Common Calcaneal Laceration Model}, volume={33}, ISSN={["2567-6911"]}, DOI={10.1055/s-0040-1702141}, abstractNote={Abstract Objective This article evaluates the effect of an interlocking horizontal mattress epitendinous suture (IHMES) in addition to a three-loop pulley (3LP) core suture for canine tendon repair. Study Design Twenty-eight cadaveric common calcaneal tendons were randomized, sharply transected and repaired with either a 3LP or 3LP + IHMES. Tensile loads required to create a 1- and 3-mm gap, yield, peak and failure loads, and mode of failure were analysed. Significance was set at p < 0.05. Results Mean ± standard deviation yield and failure force for 3LP + IHMES was 178.0 ± 45.3 N and 242.1 ± 47.8 N, respectively, which was significantly greater compared with 3LP alone, 97.9 ± 36.2 N and 119.3 ± 35.6 N (p < 0.0001). Occurrence of 3-mm gap formation was significantly less in the 3LP + IHMES group (p < 0.013). Mode of failure was significantly different between the groups (p < 0.001) with 3LP + IMHES patterns failing by suture breakage (13/14) compared with suture pull-through in the 3LP (11/14). Conclusion Addition of an epitendinous suture pattern significantly reduced gap formation between tendon ends and significantly increased loads at yield (1.8 × ), peak (2.0 × ) and failure (2.0 × ) force of repairs. Use of an epitendinous suture should be considered to significantly increase biomechanical strength of repairs; however, further in vivo testing is necessary to evaluate its effect on tendinous blood supply.}, number={3}, journal={VETERINARY AND COMPARATIVE ORTHOPAEDICS AND TRAUMATOLOGY}, author={Cocca, Christina J. and Duffy, Daniel J. and Kersh, Mariana E. and Moore, George E.}, year={2020}, month={May}, pages={205–211} }
 @article{eby_duffy_chang_gaffney_fisher_moore_2020, title={Influence of barbed epitendinous suture combined with a core locking-loop sutures to repair experimental flexor tendon lacerations}, volume={49}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13496}, abstractNote={Abstract Objective To determine the influence of barbed epitendinous sutures (ES) on the biomechanical properties and gap formation of repaired canine tendons. Study design Ex vivo, experimental study. Sample population Eighty (n = 16/group) canine superficial digital flexor tendons (SDFT). Methods After transection, SDFT were repaired with a locking‐loop (LL) pattern alone (group 1), an LL + smooth ES with monofilament suture (group 2), an LL + V‐loc‐ES (group 3), an LL + Quill‐ES (group 4), or an LL + Stratafix‐ES (group 5). All core LL repairs were performed with 0 USP polypropylene, and all ES were placed with 2‐0 USP equivalent. Constructs were preloaded and tested to failure. Yield, peak, and failure loads; occurrence of gap formation; and failure modes were compared. Results Yield loads were greater for groups 2 and 5 ( P < .0001). Peak and failure loads were greater when an ES was used ( P < .005), especially for groups 2 and 5 ( P < .0001). Groups with an ES required higher loads to generate 1‐ and 3‐mm gaps compared with specimens without an ES ( P < .002). Force to create 1‐ and 3‐mm gaps was greater for group 5 ( P < .0001) and groups 2 and 5 ( P < .0001), respectively. Failure mechanism did not differ ( P = .092) between ES groups, consisting of suture breakage in 51 of 64 constructs compared with pull‐through in seven of 16 group 1 constructs. Conclusion Epitendinous suture placement improved the biomechanical properties of repaired tendons. Stratafix barbed suture performed better as an ES compared with other barbed sutures and similarly to monofilament suture. Clinical significance Stratafix barbed suture eliminates the requirement for knot tying and seems to be equivalent to smooth monofilament suture when used as an ES in this pattern.}, number={8}, journal={VETERINARY SURGERY}, author={Eby, Adam C. and Duffy, Daniel J. and Chang, Yi-Jen and Gaffney, Lewis and Fisher, Matthew B. and Moore, George E.}, year={2020}, month={Dec}, pages={1590–1599} }
 @article{duffy_chang_moore_2020, title={Influence of closure technique on leakage pressures in an ex vivo canine typhlectomy model}, volume={49}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13405}, abstractNote={Abstract Objective To determine the influence of three closure techniques on leakage pressures of canine typhlectomies. Study design Experimental, ex vivo. Sample population Grossly normal cecal segments from 24 adult canine cadavers. Methods Typhlectomies were assigned to one of three closure techniques: simple continuous closure with a Parker‐Kerr pattern with 4‐0 polydioxanone (group 1), closure with a 60‐mm gastrointestinal stapler loaded with a 3.8‐mm staple cartridge (group 2), and placement of a Cushing suture to augment the stapled closure (group 3). The median (range) of initial leakage pressure (ILP) and maximum leakage pressure (MLP) was compared between groups along with leakage location. Results Typhlectomies in group 3 leaked at higher ILP (310 mm Hg; 188‐310) than those in groups 1 (43 mm Hg; 31‐80) and 2 (109.5 mm Hg; 68‐173; P < .0001). Maximum leakage pressure were greater in group 3 than in other groups ( P < .0001). Leakage was detected in 20 of 24 (83%) typhlectomies, located at the incisional line in 13 of 24 (54%) specimens and from suture holes in seven of 24 (29%) specimens. Conclusion Placement of a Cushing suture pattern to augment stapled incisions improved the ability of typhlectomies to sustain pressure compared with sutured or stapled cadaveric specimens alone. Clinical significance These results provide evidence to support placement of a Cushing suture pattern to augment the staple line for typhlectomies in dogs, although in vivo studies are required to determine the clinical significance of these findings.}, number={6}, journal={VETERINARY SURGERY}, author={Duffy, Daniel J. and Chang, Yi-Jen and Moore, George E.}, year={2020}, month={Aug}, pages={1213–1220} }
 @article{duffy_moore_2020, title={Influence of oversewing the transverse staple line during functional end-to-end stapled intestinal anastomoses in dogs}, volume={49}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13451}, abstractNote={Abstract Objective To determine the effect of oversewing the transverse staple line after functional end‐to‐end stapled intestinal anastomoses (FEESA) on canine jejunal leakage pressures. Study design Experimental, ex vivo, randomized study. Sample population Jejunal segments from three adult canine cadavers. Methods Jejunal segments were harvested within 2 hours of euthanasia and anastomosed (24 jejunal segments per group, consisting of two segments per construct with n = 12/ group). Constructs were then randomly assigned to receive FEESA alone, FEESA + Cushing oversew, or FEESA + simple‐continuous oversew of the transverse staple line with 3‐0 polydioxanone. Results for initial leakage pressure (ILP) and maximal leakage pressure (MLP) and initial leakage location (LL) were compared between groups. Results Mean ILP was 1.8‐fold higher for FEESA + Cushing oversew (62.4 ± 7.8 mm Hg) compared with FEESA alone and FEESA + simple‐continuous oversew ( P < .001). Mean MLP were higher for both oversewn techniques compared with FEESA alone ( P < .001). Oversewing the transverse staple line with either pattern increased mean MLP by 1.4‐fold compared with FEESA alone. Leakage occurred at the level of the transverse staple line in nonoversewn constructs ( P < .001). Conclusion Oversewing the transverse staple line after FEESA increased MLP and decreased the occurrence of leakage at this location. Oversewing with a Cushing pattern increased ILP compared with oversew with a simple‐continuous pattern. Clinical significance Our results provide evidence to support oversewing the transverse staple line after FEESA. Doing so may reduce the occurrence of postoperative dehiscence. These findings warrant additional focused investigation in vivo through a prospective randomized clinical trial.}, number={6}, journal={VETERINARY SURGERY}, author={Duffy, Daniel J. and Moore, George E.}, year={2020}, month={Aug}, pages={1221–1229} }
 @article{cocca_duffy_kersh_kim_groenewold_moore_2019, title={Biomechanical comparison of three epitendinous suture patterns as adjuncts to a core locking loop suture for repair of canine flexor tendon injuries}, volume={48}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13266}, abstractNote={Abstract Objective To determine the effects of different epitendinous sutures (ES) in addition to core locking‐loop (LL) sutures on the mechanical properties and gap formation in a canine cadaveric tendon model. Study design Experimental, ex vivo, biomechanical study. Sample population Seventy‐two cadaveric superficial digital flexor tendon specimens. Methods Superficial digital flexor tendon specimens were divided into four groups (n = 18): sharply transected and repaired with LL, LL + simple continuous ES, LL + Silfverskiöld cross‐stitch ES, and LL + interlocking horizontal mattress ES. Constructs were loaded to monotonic failure. Failure modes, gapping, yield, peak, and failure forces were analyzed. Significance was set at P < .05. Results Yield, peak, and failure forces increased by 2.5‐fold, two‐fold, and twofold, respectively when ES groups were compared with core LL suture patterns alone ( P < .0001). Resistance to 1‐ and 3‐mm gap formation was greater in ES groups compared with core LL constructs alone ( P < .0001). No differences in yield, peak, failure force, or gapping were observed among ES patterns ( P > .827). Conclusion Adding an ES reduced gap formation and increased yield, peak, and failure forces of tenorrhaphies. No difference was detected between the epitendinous patterns tested in this study. Clinical significance The addition of an ES seems more relevant than the specific type of pattern to improve the biomechanical properties of flexor tendon repairs. In vivo studies are warranted to determine the biological implications of the patterns tested here.}, number={7}, journal={VETERINARY SURGERY}, author={Cocca, Christina J. and Duffy, Daniel J. and Kersh, Mariana E. and Kim, Woojae and Groenewold, Andrew and Moore, George E.}, year={2019}, month={Oct}, pages={1245–1252} }
 @article{phillips_corrie_engel_duffy_holt_kendall_schmiedt_vetter_meren_follette_et al._2019, title={Clinical findings, diagnostic test results, and treatment outcome in cats with hiatal hernia: 31 cases (1995-2018)}, volume={33}, ISSN={["1939-1676"]}, DOI={10.1111/jvim.15583}, abstractNote={Abstract Background Information regarding clinical signs, assessment, treatment, and outcome in cats with hiatal hernia (HH) is limited. Objectives To characterize the clinical presentation of HH and medical and surgical outcomes in a cohort of affected cats. Animals Thirty‐one client‐owned cats with HH. Methods Medical records of cats with HH were retrospectively reviewed for signalment, history, results of diagnostic tests, details of surgical and medical treatments, complications, and outcome. Long‐term follow‐up data were obtained by telephone communication. Relationships between clinical variables and outcome were evaluated by regression analysis. Results Type I HH was present in 85.7% (24/28) of cats, and 64.5% (20/31) were >3 years of age at diagnosis. Twenty‐one of 31 (67.7%) cats underwent surgical repair including phrenoplasty, esophagopexy, and left‐sided gastropexy, and 10 of 31 cats were treated medically without surgery. Concurrent illness was common, and 77.4% cats had comorbidities. All cats survived to discharge, and median time to death or follow‐up was 959 days (range, 3‐4015 days). Cats treated medically survived longer than cats treated surgically, with median time to death or follow‐up of 2559 and 771 days, respectively. Conclusions and Clinical Importance Type I HH is the most common type of HH in cats. A congenital etiology is possible, but many cats with HH were >3 years of age at diagnosis and suffered from comorbidities, including upper airway obstruction. Case selection and the presence of comorbidities likely influenced the outcome. Cats with HH may not be diagnosed until disease is advanced or concurrent illness draws attention to clinical signs.}, number={5}, journal={JOURNAL OF VETERINARY INTERNAL MEDICINE}, author={Phillips, Heidi and Corrie, Jessica and Engel, Danielle M. and Duffy, Daniel J. and Holt, David E. and Kendall, Allison R. and Schmiedt, Chad W. and Vetter, Autumn and Meren, Ilyssa L. and Follette, Christelle and et al.}, year={2019}, month={Sep}, pages={1970–1976} }
 @article{duffy_kindra_moore_2019, title={Comparison of initial leak pressures after single- and double-layer cystotomy closure with barbed and nonbarbed monofilament suture material in an ex vivo ovine model}, volume={48}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13160}, abstractNote={To compare initial leakage pressure after double-layer inverting and single-layer appositional closures with unidirectional barbed suture or an analogous monofilament absorbable suture in an ex vivo ovine model.Experimental study.Ovine cadaveric bladders (n = 48).A 4-cm ventral cystotomy was performed in each bladder. Bladders were randomly divided into 4 groups (n = 12 each group) and sutured in an open setting with a single-layer appositional or a double-layer inverting pattern of unidirectional 2-0 barbed or an analogous monofilament suture. Intraluminal pressure at initial leakage and leakage location were recorded. Analysis of variance was used to compare initial leak pressure between the 4 groups (P < .05).Ovine urinary bladders closed with double-layer inverting closures leaked at intraluminal pressures about twofold greater than bladders closed with single-layer appositional closures (P < .0001) whether barbed or nonbarbed suture was used (P ≥ .987). Bladders most commonly leaked at the suture hole after single-layer closure. Bladders that had been repaired with a double-layer closure leaked at the knot in nonbarbed closures or at the preconstructed end loop in barbed closures.Double-layer closure increased leakage pressures compared with single-layer closures, irrespective of the suture type used.This study provides evidence to support double-layer rather than single-layer closure of cystotomies in clinical cases. The use of barbed suture may be suitable for cystorrhaphy in sheep.}, number={3}, journal={VETERINARY SURGERY}, author={Duffy, Daniel J. and Kindra, Cameron G. and Moore, George E.}, year={2019}, month={Apr}, pages={424–430} }
 @article{reagan_selmic_fallon_sutton_lafferty_ben-aderet_culp_liptak_duffy_simons_et al._2019, title={Complications and outcomes associated with unilateral thyroidectomy in dogs with naturally occurring thyroid tumors: 156 cases (2003-2015)}, volume={255}, ISSN={["1943-569X"]}, DOI={10.2460/javma.255.8.926}, abstractNote={To describe complications and outcomes of dogs undergoing unilateral thyroidectomy for the treatment of thyroid tumors.156 dogs undergoing unilateral thyroidectomy for a naturally occurring thyroid tumor.Dogs that underwent a unilateral thyroidectomy in 2003 through 2015 were included in a multi-institutional retrospective study. For each dog, information gathered through evaluation of electronic and paper records included perioperative complications, short-term outcome (survival to discharge from the hospital vs nonsurvival), and long-term outcome (survival time).In the perioperative period, complications occurred in 31 of the 156 (19.9%) dogs; hemorrhage was the most common intraoperative complication (12 [7.7%] dogs). Five of 156 (3.2%) dogs received a blood transfusion; these 5 dogs were among the 12 dogs that had hemorrhage listed as an intraoperative complication. Immediately after surgery, the most common complication was aspiration pneumonia (5 [3.2%] dogs). One hundred fifty-three of 156 (98.1%) dogs that underwent unilateral thyroidectomy survived to discharge from the hospital. One hundred-thirteen dogs were lost to follow-up; from the available data, the median survival time was 911 days (95% confidence interval, 704 to 1,466 days).Results indicated that unilateral thyroidectomy in dogs with a naturally occurring thyroid tumor was associated with a perioperative mortality rate of 1.9% and a complication rate of 19.9% and that hemorrhage and aspiration pneumonia were the most common complications. Long-term survival of dogs undergoing unilateral thyroidectomy for the treatment of thyroid tumors was not uncommon.}, number={8}, journal={JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION}, author={Reagan, Jennifer K. and Selmic, Laura E. and Fallon, Caroline and Sutton, Blake and Lafferty, Mary and Ben-Aderet, Daniel and Culp, William T. N. and Liptak, Julius M. and Duffy, Daniel and Simons, Micha and et al.}, year={2019}, month={Oct}, pages={926–932} }
 @article{putterman_duffy_kersh_rahman_moore_2019, title={Effect of a continuous epitendinous suture as adjunct to three-loop pulley and locking-loop patterns for flexor tendon repair in a canine model}, volume={48}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.13268}, abstractNote={Abstract Objective To evaluate the effect of combining a continuous epitendinous suture with three‐loop pulley (3LP) and locking‐loop (LL) core patterns for flexor tendon repair. Study design Ex vivo biomechanical study. Sample population Seventy‐two cadaveric superficial digital flexor musculotendon (SDFT) units. Methods Tendons were divided into four groups (n = 18/group). After sharp transection, SDFT were repaired with 3LP, LL, 3LP + epitendinous (E), or LL + E suture patterns. After preloading, repaired constructs were tested to failure. Video data acquisition allowed evaluation of failure mode and quantitation of gap formation. Yield, peak, and failure force were measured from force‐displacement data. Significance was set at P < .05. Results Mode of failure did not differ between repairs with or without an epitendinous suture ( P = .255). Gap formation was best prevented with 3LP compared with LL when used alone ( P = .001). Mean yield force for 3LP, LL, 3LP + E, and LL + E were 91.4 N ± 25.4, 61.3 N ± 18.4, 195.2 N ± 66.0, 165.3 N ± 46.8, respectively. Tenorrhaphies combined with an epitendinous suture achieved higher yield ( P < .0001), peak ( P < .0001), and failure forces ( P < .0001), without gapping between tendon ends. Conclusion Addition of an epitendinous suture eliminated gapping between tendon ends until failure and increased resistance to loads tolerated at the repair site. Clinical significance The addition of an epitendinous suture may increase the strength of tendon repairs and resistance to gap formation over core suture use alone. The influence of epitendinous suture placement on tendinous healing and blood supply warrants in‐vivo testing.}, number={7}, journal={VETERINARY SURGERY}, author={Putterman, Allison B. and Duffy, Daniel J. and Kersh, Mariana E. and Rahman, Hafizur and Moore, George E.}, year={2019}, month={Oct}, pages={1229–1236} }
 @article{duffy_chang_gaffney_fisher_moore_2019, title={Effect of bite depth of an epitendinous suture on the biomechanical strength of repaired canine flexor tendons}, volume={80}, ISSN={["1943-5681"]}, DOI={10.2460/ajvr.80.11.1043}, abstractNote={To determine effects of bite depth for placement of an epitendinous suture on the biomechanical strength and gap formation of repaired canine tendons.48 superficial digital flexor tendons (SDFTs) obtained from 24 canine cadavers.Tendons were assigned to 3 groups (16 tendons/group). Each SDFT was transected and then repaired with a continuous epitendinous suture placed with a bite depth of 1, 2, or 3 mm for groups 1, 2, and 3, respectively. Specimens were loaded to failure. Failure mode, gap formation, yield force, peak force, and failure force were analyzed.Yield, peak, and failure forces differed significantly between groups 1 and 3 and groups 2 and 3 but not between groups 1 and 2. Comparison of the force resisted at 1 and 3 mm of gapping revealed a significant difference between groups 1 and 3 and groups 2 and 3 but not between groups 1 and 2. Failure mode did not differ among groups; suture pull-through occurred in 43 of 48 (89.6%) specimens.Increasing bite depth of an epitendinous suture toward the center of the tendon substance increased repair site strength and decreased the incidence of gap formation. Repair of tendon injuries in dogs by use of an epitendinous suture with bites made deep into the tendon should result in a stronger repair, which potentially would allow loading and rehabilitation to begin sooner after surgery. Suture techniques should be investigated in vivo to determine effects on tendinous healing and blood supply before clinical implementation.}, number={11}, journal={AMERICAN JOURNAL OF VETERINARY RESEARCH}, author={Duffy, Daniel J. and Chang, Yi-Jen and Gaffney, Lewis S. and Fisher, Matthew B. and Moore, George E.}, year={2019}, month={Nov}, pages={1043–1049} }
 @article{duffy_cocca_kersh_kim_moore_2019, title={Effect of bite distance of an epitendinous suture from the repair site on the tensile strength of canine tendon constructs}, volume={80}, ISSN={["1943-5681"]}, DOI={10.2460/ajvr.80.11.1034}, abstractNote={To evaluate effects of bite distance of an interlocking horizontal mattress epitendinous suture (IHMES) from the repair site on tensile strength of canine tendon repairs.72 canine cadaveric superficial digital flexor tendons (SDFTs).Transverse tenotomy was performed, and SDFTs were repaired with a locking-loop construct (LL construct) or 3 LL constructs with IHMES suture bites placed 5 (LL + 5ES construct), 10 (LL + 10ES construct), or 15 (LL + 15ES construct) mm from the transection site (18 SDFTs/group). Constructs were loaded to failure. Load at 1- and 3-mm gapping, yield force, failure load, and failure mode were evaluated.Mean ± SD yield force and failure load for LL constructs were significantly lower than for IHMES constructs. Load at 1- and 3-mm gapping was significantly higher for IHMES constructs. Increasing the bite distance significantly increased construct strength (134.4 ± 26.1 N, 151.0 ± 16.8 N, and 182.1 ± 23.6 N for LL + 5ES, LL + 10ES, and LL + 15ES constructs, respectively), compared with strength for the LL construct. Failure mode differed significantly among constructs when an IHMES was used.Addition of an IHMES to an LL construct led to increased ultimate tensile strength by 2.5 times and significantly reduced gap formation. Increasing the IHMES bite distance increased yield force by 2.1, 2.3, and 2.7 times for bites placed 5, 10, and 15 mm from the tenotomy, respectively. Positioning an IHMES at a greater distance from the repair site provided superior biomechanical strength for tendon repairs in dogs.}, number={11}, journal={AMERICAN JOURNAL OF VETERINARY RESEARCH}, author={Duffy, Daniel J. and Cocca, Christina J. and Kersh, Mariana E. and Kim, Woojae and Moore, George E.}, year={2019}, month={Nov}, pages={1034–1042} }
 @article{schlein_connolly_moran_duffy_2019, title={Pathology in Practice}, volume={255}, ISSN={["1943-569X"]}, DOI={10.2460/javma.255.1.67}, number={1}, journal={JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION}, author={Schlein, Lisa J. and Connolly, Sara L. and Moran, Clara and Duffy, Daniel J.}, year={2019}, month={Jul}, pages={67–70} }
 @article{duffy_duddy_keating_gutierrez-nibeyro_2018, title={Influence of barbed suture on leak pressures after double-layer inverting closure of cystotomy sites in sheep}, volume={47}, ISSN={["1532-950X"]}, DOI={10.1111/vsu.12935}, abstractNote={To determine the influence of barbed suture on double-layer inverting closure of cystotomy sites in sheep.Ex vivo study.Urinary bladders harvested from ovine (n = 26) cadaveric specimens.After collection and specimen preparation, a 3-cm-long incision was created on the ventral aspect of the urinary bladder. The cystotomy was repaired with barbed (n = 13) or nonbarbed analogous monofilament absorbable suture (n = 13) in a double-layer inverting suture pattern. Time required for closure in seconds was recorded for each test. Each bladder was connected to a pressure transducer to monitor intraluminal pressure during infusion with dyed Hartmann's solution until leakage occurred. Intraluminal pressure at time of initial leakage and leakage site were also recorded. Two-sample t tests were used to compare initial leakage pressure and closure time between the 2 types of suture (P = .05).The mean ( ± SD) leakage pressure of ovine urinary bladder incisions did not differ between closures with barbed sutures (42.3 ± 21.7 mmHg) and nonbarbed closures (32.5 ± 14.4 mmHg, P = .187). Cystorrhaphies were performed faster with barbed suture (307 ± 50 seconds) than with nonbarbed suture (390 ± 62 seconds, P = .001).The use of barbed suture did not affect mean leakage pressure of ovine urinary bladder incisions but decreased the time required to complete cystorrhaphies in this model.This study provides evidence to support the use of knotless barbed suture for open ovine cystorrhaphies. Use of such suture for laparoscopic and laparoscopic-assisted procedures in sheep warrants caution until cyclic and in vivo testing is performed with appropriate laparoscopic instrumentation.}, number={7}, journal={VETERINARY SURGERY}, author={Duffy, Daniel J. and Duddy, Hugh R. and Keating, Stephanie and Gutierrez-Nibeyro, Santiago D.}, year={2018}, month={Oct}, pages={902–907} }