Оглавление
Группа авторов. Complications in Equine Surgery
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
COMPLICATIONS IN EQUINE SURGERY
Foreword
References
Preface
Acknowledgements
List of Contributors
1 Surgical Complications
Overview
List of Complications Associated with Surgery:
Morbidity and Mortality
Surgical Checklists
Perioperative Consequences to Surgical Trauma
Metabolic and Nutritional Effects
Neuroendocrine
Systemic Inflammatory Response
Pain
Impact of Host Factors and Comorbid Conditions
References
2 Complications of Parenteral Administration of Drugs
Overview
List of Complications Associated with the Parenteral Administration of Drugs:
Intramuscular Administration. Anatomical and Procedural Considerations
Local Muscle Reaction: From Mild Inflammation to Abscess Formation
Clostridial Myonecrosis
Intra‐Synovial Administration
Post‐Injection Synovitis and Lameness
Medication Errors
References
3 Complications of Intravascular Injection and Catheterization
Overview
List of Complications Associated with Intravascular Injection and Catheterization
Anatomic Considerations
Perivascular Swelling and Inflammation
Intra‐Arterial Injection or Catheterization
Catheter‐Related: Difficult or Incorrect Placement, Dislodgement and Loss of Patency
Thrombophlebitis
Intravascular Foreign Bodies
Vascular Air Embolism/Bleeding
References
4 Complications of Endoscopy
Overview
List of Complications Associated with Endoscopy
Epistaxis/Mucosal Trauma
Equipment Damage
Insufflation‐related complications
Air Embolism
References
5 Complications of Nasogastric Intubation
Overview
List of Complications Associated with Nasogastric Intubation
Epistaxis
Misplacement of Tube
Esophageal/Pharyngeal Trauma
Fragmentation of Tube
Administration of Fluid into Lungs
Sinusitis
References
6 Complications of Fluid Therapy
List of Complications Associated with Fluid Therapy
Fluid Overload Using Crystalloid Solutions
Complications Associated with the Type of Crystalloid Fluid Infused
Sodium Imbalance
Potassium Imbalance
Other Electrolyte Imbalances
Complications Due to Administration of Sodium Bicarbonate
Complications Due to Glucose‐/Dextrose‐Containing Fluids
Complications Associated with Intravascular Plasma Administration
Immunological Reactions
Type of plasma
Administration of plasma
Other
Diagnosis
Treatment
Expected outcome
Non‐Immunogenic Complications. Bacterial contamination
Transmission of disease
Serum Hepatitis
Circulatory overload
Storage‐associated changes
Complications Associated with Administration of Colloid Therapy
Complications of Enteral Fluid Therapy
Complications Due to Administration Setup
Complications Due to Volume of Fluid Used
Complication Due to Type of Fluid Used
Complications Associated with Administration of Parenteral Nutrition Solutions
Catheter‐Associated Complications
Metabolic Aberrations
Complications Due to Withholding of Enteral Feeding
References
7 Complications Associated with Hemorrhage
Overview
List of Complications Associated with Hemorrhage
Intraoperative Hemorrhage
Local treatment
Fluid therapy and blood transfusion
Adjunctive systemic treatment
Expected outcome
Postoperative Hemorrhage
References
8 Complications of Blood Transfusion
Overview
Complications Associated with Blood transfusion
Immune Reactions. Hemolytic Transfusion Reactions
Allergic and Febrile Reactions
Transfusion‐Related Acute Lung Injury
Nonimmune Reactions. Volume Overload
Transfusion‐Transmitted Infections
RBC Storage Lesion
References
9 Complications Associated with Sutures
Overview
List of Complications Associated with Sutures
Dehiscence. Definition
Risk factors
Pathogenesis. Infection
Suture placement
Poor knotting technique
Inappropriate suture material
Premature suture removal
Improper suture needle selection
Inadequate suture line tension
Excessive suture line tension
Dead space
Suturing of nonviable tissue
Inappropriate support and immobilization of a suture line
Prevention
Diagnosis
Treatment
Expected outcome
Infection Without Dehiscence
Suture Reactions
Suture material
Inappropriately large suture
Excessive suture material
Inappropriate suture technique
Prevention
Diagnosis
Treatment
Expected outcome
Ligature Loop Failure
Suture material
Suture size
Inappropriate ligation knotting
Inappropriate ligation placement
Tissue bulk
Prevention
Diagnosis
Treatment
Expected outcome
References
10 Complications of Bone Graft Harvesting, Handling, and Implantation
Overview
List of Complications Associated with Bone Grafts
Intraoperative Complications. Reduced Viability of the Graft
Monitoring
Treatment
Expected outcome
Early Postoperative Complications. Morbidity Associated with Incision at Donor Site
Fracture at Donor Site
Pneumothorax/Hemothorax
Late Postoperative Complications. Suboptimal Integration of Bone Graft
References
11 Complications of Cryosurgery
Overview
List of Complications Associated with Cryosurgery
Intraoperative Complications. Inadequate Choice of Cryosurgical Equipment and Technique
"Run‐off " of Cryogen
Early Postoperative Complications. Bleeding after Cryosurgery
Excessive Local Edema and Pain
Excessive Tissue Necrosis
Late Postoperative Complications. Tumor Recurrence
References
12 Complications of Laser Surgery
Overview
List of Complications Associated with Laser Surgery
Laser Physics and Tissue Interaction
Lasers Commonly Used in Veterinary Surgery. Carbon Dioxide Laser
Neodymium Yttrium Aluminum Garnet (Nd:YAG) and Gallium Aluminum Arsenide (GAA) Diode Lasers
Laser Safety
Specific Complications of Laser Surgery in Horses. Patient Complications
General surgery
Prevention
Pathogenesis. Endoscopic Laser Surgery
Prevention
Pathogenesis. Tarsal arthrodesis complications
Prevention
Equipment Complications. Definition
Risk factors
Pathogenesis
Prevention
Summary
Reference
13 Complications of Systemic Analgesic Drugs
Overview
List of Complications associated with systemic analgesic drugs
Intra‐Op Complications. Bradyarrythmias
Anaphylactoid Reaction
Negative Effect on Recovery from General Anesthesia. Alpha‐2 adrenergic agonists: excessive sedation and ataxia. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Ketamine: excitement and emergence hallucination. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Lidocaine: ataxia and visual dysfunction. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Postop complications. Opioids: Excitement
Ileus
References
14 Complications of Loco‐Regional Anesthesia
Overview
List of Complications Associated with Loco‐Regional Anesthesia
General Complications. Vascular Puncture
Nerve Injury
Myotoxicity
Chondrotoxicity
Allergic Reactions
Complications Related to Specific Loco‐Regional Blocks. Epidural Analgesia. Ataxia/recumbency. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Infection inside the spinal canal. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Pruritus. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Retrobulbar Blocks. Brainstem anesthesia. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Inferior Alveolar Nerve Block (Maxillary block) Self‐inflicted lingual trauma. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Intravenous Regional Anesthesia (IVRA) Tourniquet failure. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Local and systemic effects of tourniquet ischemia. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
References
15 Complications of Sedative and Anesthesia Medications
Overview
List of Complications Associated with Sedative and Anesthesia Medications
Complications During Standing Sedation
Complications During General Anesthesia. Unanticipated Movement
Hypotension
Cardiac Arrhythmias
Hypoventilation
Hypoxemia
Aberrations in Body Temperature
Complications During Anesthetic Recovery. Poor Recovery Quality
Other Complications Associated with Sedative and Anesthetic Drugs. Increased Urine Output
Blood Glucose Abnormalities
Decreased Gastrointestinal Motility
Summary
References
16 Complications During Recovery from General Anesthesia
Overview
List of Complications Associated with Recovery from General Anesthesia
Morbidity and Mortality of General Anesthesia
Risk Factors in General
Complications Associated with Recovery from General Anesthesia
General Measures for Prevention
Pathogenesis in General
Musculoskeletal/Nervous System
Myopathy
Additional Actions
Central and Peripheral Neuropathies. Central (Spinal Cord Malacia)
Peripheral Nerve Damage
Cardiovascular System
Isotonic crystalloid fluids
Hypertonic saline
Colloids
Inotropes
Expected outcome
Respiratory System
Hypoxemia
Airway obstruction
Pulmonary edema
Diagnosis
Treatment. Oxygen supplementation
Salbutamol
Tracheostomy
Pulmonary edema
Expected outcome
General Expected Outcomes
References
17 Complications Associated with Surgical Site Infections
Overview
List of Complications Associated with Surgical Site Infections
Definition and Classification
Procedural Definitions
Duration of the anesthetic procedure
Duration of the surgical procedure [8]
Wound Definitions
Infection Definitions
SSI Epidemiology
The Basic SSI Risk Index
Infection Rates and Risk Factors
SSI Prevention. Understanding the Occurrence of SSI
Overall Preventive Measures. Time is SSI
Surgical experience, technique and operating room etiquette
Hand hygiene
Optimizing the cleanliness of the surgical procedure
Lack of compliance as contributor to SSI
Pre‐Operative Preventive Measures. Postponing elective surgeries in case of remote infection or systemic disease
Antimicrobial prophylaxis
Postoperative antimicrobials
Perioperative Preventive Measures
Post‐op. Wound protection and hygienic care
SSI surveillance
SSI Recognition
Common Pathogens Recovered from Equine Surgical Site Infections
Sampling of Wound and Interpretation of Results
Management of SSI
Multidrug Resistance
References
18 Complications of Reconstructive Surgery
Overview
List of Complications Associated with Reconstructive Surgery
Intraoperative: Failure to Close the Wound with Reconstructive Surgery
Early Postoperative: Hemorrhage
Late Postoperative: Wound Dehiscence
References
19 Complications of Excessive Granulation Tissue
Overview
List of Complications Associated with Excessive Granular Tissue
EGT Formation
Damage to Important Structures During Excision of EGT
References
20 Complications of Skin Neoplasia
Overview
List of Complications Associated with Skin Neoplasia
Intraoperative/technical. Incomplete Surgical Excision
Recurrence of Neoplasia
Metastatic Spread
Hemorrhage
Damage to Adjacent Structures
Early Postoperative. Incisional Dehiscence and Delayed Healing
Poor Cosmetic or Functional Result
References
21 Complications of Skin Grafting
Overview
List of Complications Associated with Skin Grafting
Intraoperative/technical. Hemorrhage
Insufficient Donor Skin
Early Postoperative. Graft Failure
Graft Displacement/Removal
Pain or Dehiscence at the Donor Site
Formation of Excessive Granulation Tissue After Grafting
Late Postoperative. Self‐Mutilation (Biting or Rubbing)
Poor Cosmetic/Functional Outcome
References
22 Complications of Oral and Salivary Gland Surgery
Overview
List of Complications Associated with Oral and Salivary Gland Surgery
Complications Associated with Local Nerve Blocks
Infra‐Orbital and Mental Nerve Blocks
Violent Reaction/Nerve Trauma During Needle Placement
Inferior Alveolar and Maxillary Nerve Blocks
Inferior alveolar nerve block: tongue trauma. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome. Maxillary nerve block: periorbital hematoma and infection
Definition
Risk factors for periorbital hemorrhage
Risk factors for retrobulbar infections
Diagnosis
Prevention
Treatment
Expected outcome
Complications Associated with Incisor Dentistry. Complications of Orthodontic Treatment of Overjet and Overbite
Trauma to the buccal branches of the facial nerve. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Damage to the greater palatine artery. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Postoperative pain and nursing problems. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Damage to orthodontic prostheses. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Incisor and gingival damage. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Complications of Incisor Extraction. Infection. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Complications Associated with 1st Premolar “Wolf Tooth” (Triadan 05) Extraction. Fracture of Wolf Teeth During Extraction
Laceration of the Greater Palatine Artery
Complications Associated with Cheek Teeth Dentistry. Complications of Widening of Cheek Teeth Diastemata. Pulpar thermal damage or pulp exposure. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Complications of Reducing Overgrowths (Odontoplasty) of Cheek Teeth. Pulpar exposure or thermal injury during cheek teeth reductions. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Fracture and pulpar exposure of the mandibular Triadan 11 cheek teeth. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Complications of Cheek Tooth Repulsion
Trauma to the infraorbital nerve. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Damage to adjacent structures. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Delayed healing of alveolus. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Orosinus (oromaxillary) fistula. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Oronasal fistula. Definition
Risk Factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Persistent postoperative sinusitis following cheek tooth extraction. Definition
Risk factor
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Complications of Oral Extraction
Damage to adjacent structures. Definition
Risk Factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Fracture of teeth during extraction. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment and expected outcome
Non‐healing alveoli. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Damage to the soft palate during oral extractions. Definition
Risk factors
Pathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Laceration of the greater palatine artery
Complications of Removal of the Lateral Alveolar Plate (Lateral Buccotomy Technique)
Iatrogenic damage of the buccal nerve. Definition
Risk factors
Pathogenesis
Prevention
Treatment and expected outcome
Iatrogenic damage to the parotid duct. Definition
Pathogenesis
Risk factors
Diagnosis
Prevention
Treatment
Expected outcome
Complications Associated with Salivary Gland Surgery
Complications of Parotid Salivary Gland Ablation
References
23 Complications of Esophageal Surgery
Overview
List of Complications Associated with Esophageal Surgery
Water, Electrolyte, Acid–Base and Metabolic Disturbances
Mucosal Dehiscence and Ulceration
Periesophageal Infection
Esophageal Fistula Formation
Stricture
Aspiration Pneumonia and Pleuropneumonia
Laryngeal Hemiplegia and Horner’s Syndrome
Laminitis
References
24 Complications of Stomach Surgery
Overview
List of Complications Associated with Stomach Surgery
Septic Peritonitis
Failure to Thrive and Recurrent or Chronic Colic
Aspiration Pneumonia (see Chapter 23: Complications of Esophageal Surgery)
Melena
Gastric Ulceration and Perforation
References
25 Complications of Splenic Surgery
Overview
List of Complications of Splenic Surgery
Splenic Trauma
Splenic Adhesions
Hemorrhage
Gastrosplenic Ligament Trauma
Pneumothorax
References
26 Complications of Abdominal Approaches
Overview
List of Complications Associated with Abdominal Approaches
Incisional Edema
Incisional Drainage
Surgical factors
Illness severity of the patient
Wound protection
Repeat Laparotomy
Hernia
Wound healing
Mechanical stress
Patient factors
Surgical factors
Pathogenesis
Diagnosis
Prevention
Treatment. Conservative treatment
Surgical repair
Expected outcome
References
27 Complications of the Intraoperative Colic Patient
Overview
List of Complications Associated with the Intraoperative Colic Patient
Ruptured Viscus
Excessive Intra‐Abdominal Contamination
Partial Thickness Tears
Hemorrhage from Small Intestinal Mesentery
Rupture of the Portal Vein
Hemorrhage from Large Colon Mesentery
Miscellaneous Intra‐Abdominal Hemorrhage
Intraoperative Injury to Small Intestinal Mesentery
Miscellaneous Iatrogenic Vascular Injuries
Intestinal Ischemia at the Anastomosis
Anesthesia‐Related Complications
Intestinal Rotation
Failure to Identify the Lesion
Failure to Correct the Lesion
Instrument Failure
Failure to Remove an Intra‐Abdominal Surgical Item
Enteropexy
References
28 Complications of the Postoperative Colic Patient
Overview
List of Complications Associated with Postoperative Colic Patient
Pain/colic
Pyrexia
Incisional Complications
Postoperative Reflux and Postoperative Ileus
Diarrhea
Intravenous Catheter‐Associated Complications
Hemoperitoneum
Enterotomy and Enterectomy Complications
Septic peritonitis
Postoperative Intraperitoneal Adhesions
Metabolic Complications
Endotoxemia/SIRS and shock
Laminitis
References
29 Complications of Surgery of the Rectum and Anus
Overview
List of Complications Associated with Surgery of the Rectum and Anus
Intraoperative/Technical Complications. Failure of Epidural Block
Early Postoperative Complications. Surgical Site Impaction
Intraoperative Complications. Inadequate Surgical Closure of the Perineum
Hind Limb Weakness, Paresis or Paralysis
Dehiscence
Reference
30 Complications of Abdominal Surgery: Incisional Hernia
Overview
List of Complications Associated with Hernia Repair
Hernia Repair Methods
Intraoperative Complications. Inadvertent Enterotomy
Postoperative Complications. Seroma
Surgical Site Infection (SSI)
Mesh Infection
Suture Sinus/Fistula
Hernia Recurrence
Adhesion/Abrasion‐Related Complications
Abdominal Muscle Rupture
References
31 Complications of Equine Laparoscopy
Overview
List of Complications Associated with Equine Laparoscopy
Standing Positioning
Position: Dorsal Recumbency
Epidural Sedation
Anesthetic Blockade
Access
Insufflation
Thermal Injuries
Ligation
Ligating Loops
Stapling Devices
Surgical Laser
Vessel Sealing
Ultrasonic Cutting and Coagulating Devices
Cryptorchid Castration
Ovariectomy
Nephrosplenic Space Ablation
Urinary Surgery
Thorascopy
References
32 Complications of Endoscopic Laser Surgery
Overview
List of Complications Associated with Endoscopic Laser Surgery
Laser Surgery Methods
Intraoperative Complications. Hemorrhage
Iatrogenic Tissue Damage
Smoke (Laser Plume) Accumulation and Toxicity
Airway Fire
Granulation Tissue Formation
References
33 Complications Following Surgery of the Equine Nasal Passages and Paranasal Sinuses
Overview. Pertinent Anatomy for Surgery of the Paranasal Sinuses and Nasal Passages
Clinical Diagnosis of Sinus Disease
Complications Associated with Surgery of the Equine Nasal Passages and Paranasal Sinuses
Intraoperative/Technical Complications. Hemorrhage
Trauma
Incomplete Septal Resection (Crossing of Wires)
Early Postoperative Complications. Incisional Infection
Suture Periostitis
Sinus Packing Complications
Late Postoperative Complications. Incomplete Resolution of Primary Disease or Recurrence
Airway Narrowing Due to Adhesions, Granulation Tissue Formation or Facial Bone collapse
Etiopathogenesis
Diagnosis
Prevention
Treatment
Expected outcome
Facial Abnormalities
Respiratory Noise
References
34 Complications in Pharynx Surgery
Overview
List of Complications Associated with Pharyngeal Surgery
Laryngeal Tie Forward
Intraoperative Complications. Intraoperative bleeding. Definition
Risk factors
Pathogenesis
Prevention
Treatment
Expected outcome
Cartilage/Bone Breakage or Laceration
Early Postoperative Complications. Seroma
Incisional infection
Late Postoperative Complications. Vocal Cord Collapse
Unilateral Breakage of the Suture
Fracture Stylohyoid Bone Postoperatively
Failed Laryngeal Tie Forward
Staphylectomy
Dysphagia/Pharyngeal Incompetence
Sternothyroideus Partial Myectomy
Intraoperative Complications. Bleeding. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Postoperative Complications. Recurrence of DDSP. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Laser Palatoplasty
Postoperative Complications. Dysphagia and coughing
Definition
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Perforation of the soft palate
Definition
Risk factors
Prevention
Pathogenesis
Diagnosis
Treatment
Expected outcome
References
35 Complications in Larynx Surgery
Overview
List of Complications Associated with Larynx Surgery
Prosthetic Laryngoplasty
Intraoperative Complications. General anesthesia. General concepts on pathogenesis and risk factors in horses undergoing PL under general anesthesia
General recommendations to minimize complications when performing a laryngoplasty under general anesthesia
Hemorrhage. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Needle breakage. Definition
Risk factors
Pathogenesis
Prevention
Treatment
Perforation of the laryngeal/nasopharyngeal/esophageal mucosa. Definition
Pathogenesis/risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Early Postoperative Complications. Seroma formation. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Wound infection. Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Sudden major loss of abduction. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Acute dysphagia and coughing. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Late Postoperative Complications. Gradual loss of abduction. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Chronic coughing and dysphagia. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Laser Ventriculo‐Cordectomy
Preoperative Complication. Bleeding. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Immediate Postoperative Complication. Swelling/edema. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Late Postoperative Complications. Webbing. Definition
Pathogenesis/risk factors
Pathogenesis/risk factors
Prevention
Diagnosis
Treatment
Expected outcome
Partial Arytenoidectomy
Intraoperative Complications
Immediate Postoperative Complication. Dyspnea. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Late Postoperative Complications. Dysphagia and coughing. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Intra‐laryngeal granulation tissue. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Residual noise
Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Epiglottic Entrapment
Preoperative Complications. Iatrogenic damage to the soft palate, esophagus, epiglottis or pharynx. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Iatrogenic burn at the tip of the epiglottis when using the laser. Definition
Risk factors
Pathogeneis
Prevention
Diagnosis
Treatment
Expected outcome
Short‐Term Complications. Edema/epiglottitis/sub‐epiglottic granuloma. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Long‐Term Complications. Re‐entrapment. Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
Dorsal displacement of the soft palate (DDSP) Definition
Risk factors
Pathogenesis
Prevention
Diagnosis
Treatment
Expected outcome
References
36 Complications of Surgery for Diseases of the Guttural Pouch
Overview
List of Complications Associated with Surgery for Diseases of the Guttural Pouch
Complications of Surgery for Guttural Pouch Empyema
Failure to Resolve
Peripheral Nerve Injury
Parotid Gland/Duct Trauma
Complications of Surgery for Guttural Pouch Tympany
Peripheral Nerve Injury
Complications of Surgery for Guttural Pouch Mycosis
Failure of Ligation Procedures
Complications with Balloon‐Tipped Catheters
Complications with Transarterial Embolization Techniques
Complications of Surgery for Temporohyoid Osteoarthropathy (Middle Ear Disease)
Hemorrhage
Peripheral Nerve Injury – Hypoglossal Nerve
Regrowth of the Stylohyoid Bone
Iatrogenic Fractures
References
37 Complications of Equine Tracheal Surgery
Overview
List of Complications Associated with Equine Tracheal Surgery
Intraoperative and Technical Complications. Hemorrhage
Hematoma and Seroma
Infection
Subcutaneous Emphysema
Reference
38 Complications of Equine Thoracic Surgery
Overview
List of Complications Associated with Equine Thoracic Surgery
Intraoperative and Technical Complications. Hemorrhage
Lung and Diaphragmatic Injury
Early Postoperative Complications. Pneumothorax
Hemothorax
Late Postoperative Complications. Infection
References
39 Complications of Testicular Surgery
Overview
List of Complications Associated with Testicular Surgery
Complications Associated with Castration of Entire Stallions
Preoperative and Operative Considerations
Hemorrhage>
Visceral Prolapse or Evisceration
Scrotal Infection and Excessive Edema
Pyrexia
Septic Funiculitis
Tetanus
Septic Peritonitis
Penile Damage
Hydrocele
Signs of Colic
Retention of Masculine Behavior
Complications Associated with Hemicastration
Miscellaneous Complications of Castration
Complications Associated with Improper Care after Castration
Complications Associated with Cryptorchidectomy. Failure to Locate an Abdominal Testis
Evisceration After a Conventional Inguinal Approach for Cryptorchidectomy
Complications of Cryptorchidectomy Associated with Choice of Approach
Complications Associated with Laparoscopic Cryptorchidectomy
References
40 Complications of Penile and Preputial Surgery
Overview
List of Complications Associated with Penile and Preputial Surgery
Complications Associated with Partial Phallectomy
Hemorrhage
Dehiscence
Urinary Obstruction
Recurrence of Neoplasia
Complications Associated with Segmental Posthetomy
Dissimilar Size of Circumferential Incisions
Dehiscence of the Sutured Internal Lamina
Complications Associated with the Bolz Technique of Phallopexy
Invasion of Preputial Cavity or Urethra with a Suture
Necrosis of Skin Beneath the Bolsters
Complications of Corporeal Anastomosis to Resolve Priapism
Failure of the Shunt to Prevent the Stallion from Becoming Impotent
Other Possible Complications Associated with Corporeal Anastomosis
References
41 Complications of Ovarian and Uterine Surgery
Overview
List of Complications of Ovarian and Uterine Surgery
Complications Associated with Ovariectomy
Complications Associated with Poor Selection of Approach
Difficulty Exteriorizing the Ovary
Severe Hemorrhage
Evisceration
Septic Peritonitis
Metastasis of Ovarian Neoplasia
Signs of Colic
Intra‐Abdominal Adhesions
Incisional Complications
Damage to a Viscus or the Cervix
Neuropraxia, Localized or Generalized Myositis Associated with General Anesthesia
Failure of Bilateral Ovariectomy to Eliminate Undesirable Behavior
Complications Associated Laparoscopic Ovariectomy
Complications Associated with Total and Partial Ovariohysterectomy
Poor Surgical Access
Septic Peritonitis
Hemorrhage
Infection at the Uterine Stump
Signs of Colic
Infertility After Partial Hysterectomy
Complications Associated with Cesarean Section
Uterine Hemorrhage
Uterine Adhesions
Retained Fetal Membranes, Metritis, Laminitis
Septic Peritonitis
Signs of Abdominal Pain
Complications with the Abdominal Incision
Anesthetic Complications
Decreased Fertility
Prevention (i.e. reducing the impact of Cesarean section on fertility)
Treatment
Expected outcome
Death of the Mare or Foal
References
42 Complications of Vulvar, Vestibular, Vaginal, and Cervical Surgery
Overview
List of Complications Associated with Vulvar, Vestibular, Vaginal, and Cervical Surgery
Complications Associated with Surgery to Resolve Vesicovaginal Reflux
Failure of Surgery to Restore Fertility or to Resolve Vesicovaginal Reflux
Complications Associated with the Pouret Procedure
Complications Associated with the Monin Technique of Urethroplasty
Complications Associated with the Brown Technique of Urethroplasty
Complications Associated with the Shires and Kaneps Technique of Urethroplasty
Complications Associated with the McKinnon and Beldon Technique of Urethroplasty
Complications Common to All Techniques of Urethroplasty
Complications Associated with Repair of a Cervical Laceration
Failure to Recognize a Concurrent Abnormality
Poor Surgical Access to the Cervical Laceration
Failure to Achieve a Good Seal After Repairing the Cervix
Intra‐Luminal and Peri‐Cervical Adhesions
Septic Peritonitis
Endometritis
Re‐injury
Failure to Conceive or to Produce a Live Foal
Complications Associated with Cervical Cerclage
Cervical Wedge Resection for Treatment for Pyometra
Septic Peritonitis
Complications Associated with Surgery to Repair a Third‐Degree Perineal Injury
Failure to Recognize a Concurrent Genital Abnormality
Dehiscence of Repair of Third‐Degree Perineal Lacerations
Operative considerations to avoid dehiscence of repair of a rectovestibular fistula
References
43 Complications of Urinary Surgery
Overview
List of Complications Associated with Urinary Surgery
Intraoperative. Hemorrhage
Pneumothorax
Acute Kidney Injury
Difficulties Exteriorizing the Bladder when Removing Bladder Calculi
Postoperative. Uroabdomen/Extravasation of urine
Incontinence
Infection
Urine Scalding
Stricture/Fistula
Complications Related to Suture Choice and Placement
References
44 Complications of Diagnostic Tests for Lameness
Overview
List of Complications Associated with Diagnostic Tests for Lameness
Complications Encountered with Diagnostic Anesthesia. Inaccurate Needle Placement
Unpredictable Desensitization
Complications of Perineural Local Anesthesia
Complications of Intra‐Synovial Anesthesia
Post‐Injection Swelling, Lameness and Infection
Motor Nerve Paresis
Poor Compliance by the Horse
Failure to Block the Lameness
Potential Influence of Diagnostic Anesthesia on Diagnostic Images. Radiography
Ultrasonography
Gamma Scintigraphy
Magnetic Resonance Imaging
Potential Complications of Diagnostic Imaging Techniques
References
45 Complications of Synovial Endoscopic Surgery (Arthroscopy, Tenoscopy, Bursoscopy)
Overview
List of Complications Associated with Synovial Endoscopic
Synovial Endoscopic Surgery Pre‐Planning
Intraoperative Complications. Equipment Problems
Poor Triangulation
Inadequate Limb Position/Limb Manipulation
Visualization
Inadequate distention
Intra‐Synovial Instrument Breakage
Free‐Floating Fragments
Iatrogenic Damage
Postoperative Complications. Early: Myopathy/Neuropathies
Late: Synovitis
References
46 Complications of Equine Orthopedic Surgery
Overview
List of Complications Associated with Equine Orthopedic Surgery
Osteosynthesis: Preoperative Patient Preparation to Decrease Risk and Complications
Osteosynthesis: Intraoperative Complications
Complications of Lag Screw Fixation
Complications of Plate Fixation
Osteosynthesis: Common Complications in Specific Anatomic Sites. Condylar Fractures
Carpal Slab Fractures
Sagittal Fractures of the Proximal Phalanx
Ulnar Fractures
Pastern Arthrodesis
Fetlock Arthrodesis
Osteosynthesis: Recovery and Postoperative Complications. Cast Complications
Complications Secondary to Cast Immobilization
Complications Secondary to Cast Removal
Transfixation Pin Cast Complications
Postoperative Lameness
Supporting Limb Laminitis
Postoperative Infection
References
47 Complications of Surgery of the Equine Foot
Overview
List of Complications Associated with Surgery of the Equine Foot
Hemorrhage
Surgical Site Infection
Persistent/Recurring Infection
Surgical Site Dehiscence and Excessive/Exuberant Granulation Tissue Formation
New, Persistent or Recurrent Lameness
Pathological Fracture of Distal Phalanx or Navicular Bone
Iatrogenic Damage to Related Anatomical Structures
Contraction, Deformation or Abnormal Growth of the Hoof
Hoof Abscess
Laminitis
Neuroma Formation
Rupture of the Deep Digital Flexor Tendon (DDFT)
References
48 Complications of Surgical Correction of Angular Limb Deformities
Overview
List of Complications Associated with Surgical Correction of Angular Limb Deformities
Techniques to Correct Angular Limb Deformities
Hemi‐Circumferential Periosteal Transection and Elevation (HCPT/PE)
Transphyseal Stapling
Transphyseal Screw and Wire
Single Screw Transphyseal Bridging (SSTB)
Intraoperative Complications. Incorrect Placement of Surgical Implant or Failure of Surgical Implant
Incorrect Selection of Surgical Technique or Implant
Surgical Site Hemorrhage or Transection of Important Anatomical Structures
Postoperative Complications. Failure to Correct or Overcorrection
Cosmetic Blemishes
Conclusion
References
49 Complications of Surgical Correction of Flexural Limb Deformities
Overview
List of Complications Associated with Flexural Limb Deformities
Complications to Conservative Treatments. Complications to External Coaptation
Complications to Digital Hyperextension Deformities
Complications to Oxytetracycline Administration
Complications Regarding Shoeing
Complications to Conservative Management of Rupture of the Gastrocnemius
Complications to Surgical Treatments. Desmotomy of the Accessory Ligament of the DDFT
Tenotomy of the DDFT
Desmotomy of the Accessory Ligament of the SDFT (Superior Check ligament Desmotomy)
Tenotomy of SDFT
Tenotomy of Flexor Carpi Ulnaris and Ulnaris Lateralis
Desmotomy of the Suspensory Ligament
Surgical Transection of the Peronius Tertius Muscle
Lateral Release Incisions and Reinforcement of the Medial Patellar Support Structures; and/or Sucloplasty with U‐shaped Cartilage Flap; or Sucloplasty with Wedge Osteotomy
Flexural Deformities Affecting Multiple Regions
References
50 Complications of Splint Bone Fractures
Overview
List of Complications Associated with Splint Bone Fractures
Intraoperative Complications. Iatrogenic Bone, Vascular or Nerve Damage
Instability of the Proximal Fragment
Early Postoperative Complications. Complete Fracture of MC3/MT3
Local Infection, Osteomyelitis, Bone Sequestration and Joint Sepsis
Late Postoperative Complications. Excessive Callus Formation
Non‐union
Suspensory Desmitis
References
51 Complications of Craniomaxillary and Mandible Fractures
Overview
List of Complications Associated with Craniomaxillary and Mandible Fractures
Intraoperative and Technical Complications. Dental Malocclusion
Hemorrhage
Early Postoperative Complications. Poor Mastication
Infection/Bone Sequestration
Implant Failure
Late Postoperative Complications. Poor Cosmesis
References
52 Complications of Tendon Surgery
Overview
List of Complications Associated with Tendon Surgery
Intraoperative Complications. Inaccurate or Ineffective Intra‐tendinous Injection
Iatrogenic Damage to Tendons and Adjacent Vascular Structures
Early Postoperative Complications. Postoperative Tendon Hemorrhage
Tendon or synovial sepsis
Exacerbation of Unrecognized Tendon or Ligament Damage
Late Postoperative Complications. Needle Tracts Following Intra‐Tendinous Injection
Abnormal Tissue Formation after Intra‐Tendinous Injections
Postoperative Neuroma Formation
Adhesion formation
Exacerbation of Tendon or Ligament Pathology after Neurectomy
Tendon rupture following casting
Fragmentation of the Apex of the Patella
Incisional Breakdown, Hematoma Formation and Synovial Fistulae Associated with Open Approaches to Tendon Sheaths
References
53 Complications of Muscle Surgery
Overview
List of Complications Associated with Muscle Surgery
Intraoperative and Technical Complications. Hemorrhage
Early Postoperative Complications. Infection
Hematoma and Seroma
Dehiscence
Peripheral Nerve Injury
Late Postoperative Complications. Fibrosis
Septic Arthritis/Tenosynovitis
References
54 Complications of Regenerative Medicine
Overview
List of Complications Associated with Regenerative Medicine
Immune Reaction
Worsened Inflammation
Ectopic Tissue Formation
Excessive Fibrosis in Tendon or Ligament
References
55 Complications of Osseous Cyst‐Like Lesions
Overview
List of Complications Associated with Osseous Cyst‐Like Lesions
Damage to Surrounding Healthy Structures
Fracture at Site on Trans‐Cortical OCLL Debridement
Fracture at the OCLL
Gas Emboli
Enlargement of OCLL
Inappropriate Screw Position
References
56 Complications of Equine Ophthalmic Surgery
Overview
List of Complications Associated with Equine Ophthalmic Surgery
Globe and Orbit. Complications Associated with Enucleation/Exenteration/Evisceration
Complications Associated with Intravitreal Ciliary Body Ablation
Complications Associated with Orbitotomy/Orbitectomy
Adnexal Surgery. Complications of Entropion Procedures (Temporary Tacking and Hotz‐Celsus)
Complications of Eyelid Laceration Repair
Complications of Eyelid Mass Procedures
Muscular contractions with Electrochemotherapy (ECT)
Tissue swelling and discoloration post‐photodynamic therapy
Complications with Subpalpebral Lavage Placement (SPL)
Complications with Conjunctivectomy/SCC Removal
Complications with Nasolacrimal Punctal Stenosis Surgery
Complications with Third Eyelid Removal Surgery
Ocular Surgery. Complications with Conjunctival Pedicle, Island Graft, or Corneoconjunctival Transposition (CCT)
Complications with Corneal Laceration Repair
Complications with Keratectomy and Adjunctive Treatments (Cryotherapy, Strontium‐90, CO2 laser ablation, or Mitomycin C) for Squamous Cell Carcinoma Management
Complications with Keratectomy for Infection, Foreign Body, or Eosinophilic Disease
Complications with Thermal Keratoplasty
Complications with Suprachoroidal Cyclosporine Implant
Complications with Cyclodestructive Procedures: Cyclophotocoagulation or Cyclocryoablation
Intraocular Surgery. Complications with Endolaser Cyclophotocoagulation (ECP)
Complications of Laser Ablation of Uveal Cyst or Melanoma
Complications of Equine Phacoemulsification
Complications with Pars Plana Vitrectomy
References
57 Complications of Diagnostic Procedures of the Nervous System
Overview
List of Complications Associated with Diagnostic Procedures of the Nervous System
Patient or Personnel Injury
Increased Intracranial Pressure
Complications Associated with Cerebrospinal Fluid Centesis
Blood Contamination of the CSF
Inability to Obtain Sufficient Fluid from Lumbosacral Centesis
Aspiration of Air
Changes in Craniospinal Pressure
Spinal Cord Trauma
Violent Reactions
Complications Associated with Cervical Myelography
Seizures
Exaggeration of Ataxia
Non‐Specific Hyperthermia
Misplacement of the Needle
Non‐Neurologic Complications
Complications Associated with Myeloscopy and Epiduroscopy
Injury to the Spinal Cord or the Subarachnoid Blood Vessels
Decreased Craniospinal Pressure
Increased Craniospinal Pressure
Pneumocephalus and Pneumorachis
Complications Associated with Cervical Articular Process Joint Injection
Complications Associated with Nerve and Muscle Biopsy
Swelling at the Incision Site
Non‐Diagnostic Biopsy
Complications Associated with Electrodiagnostics
References
58 Complications of Anterior Cervical Fusion
Overview
List of Complications Associated with Anterior Cervical Fusion
Intraoperative and Preoperative Planning: Fusing the Incorrect Site
Intraoperative: Insecure Implant
Neuropathy
Horners Syndrome
Recurrent Laryngeal Neuropathy
Hematoma/Seroma
Infection
Traumatic Recovery/Fracture
Fractures in the Rehabilitation Stage
59 Complications of Surgery for Impingement of Dorsal Spinous Processes
Overview
List of Complications Associated with Surgery for Impingement of Dorsal Spinous Processes
Ostectomy of the DSP
Intraoperative Hemorrhage
Sub‐Optimal Surgical Visibility
Wound Complications
Dystrophic Mineralization or New Bone Formation at Surgical Site
Rotation of the Dorsal Spinous Process Contiguous to the Resected Site
Iatrogenic Vertebral Fractures
Sub‐Optimal Cosmetic Outcome
Desmotomy of the Interspinous Ligament
Intraoperative Hemorrhage
Difficult Access to Interspinous Space
Instrument Breakage
Wound Complications and Suboptimal Cosmetic Outcome
References
60. Complications of Peripheral Nerve Surgery
Overview
List of Complications Associated with Peripheral Nerve Surgery
Anatomy and Pathophysiology
Neurectomy Procedures
Palmar or Plantar Digital Neurectomy. Intraoperative Complications
Early Postoperative Complications
Late Postoperative Complications
Evidence‐Based Medicine for Complications of PDN
Neurectomy of the Deep Branch of the Lateral Plantar Nerve
Evidence‐Based Medicine for Complications of Neurectomy of the DBLPN
References
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