The use of absorbable staples for skin closure after tibial plateau leveling osteotomy

OBJECTIVE: To compare the use of stainless steel staples with absorbable staples for closure of skin incisions in dogs undergoing tibial plateau leveling osteotomy (TPLO). STUDY DESIGN: Prospective study. SAMPLE POPULATION: Client‐owned dogs (n = 80). METHODS: With client consent, dogs were randomly assigned a staple type (stainless steel or absorbable) immediately prior to closure of a TPLO skin incision. Incisions were compared for length, staple type and number, and an inflammation‐infection score 2 weeks after surgery. RESULTS: Overall, 18.8% of incisions were diagnosed with inflammation or infection. No difference was found between inflammation‐infection scores, incision length, number of staples used, or general anesthetic time between the 2 staple groups. However, wound closure was faster with stainless steel staples (22.50 seconds; range, 11‐180) by approximately 30 seconds compared with absorbable staples (56.50 seconds; range, 18‐190; P < .001). Time taken to close the incision correlated negatively with the number of occasions that absorbable staples were used (P = .01). CONCLUSION: Absorbable skin staples were successfully used to close skin incisions after TPLO and were not associated with an increased level of inflammation or infection in our clinical setting. CLINICAL SIGNIFICANCE: Absorbable staples may be considered to close surgical wounds when subsequent suture removal would be impractical, without specific concerns over inflammation or infection of the wound

An Outbreak of Severe Infections with Community-Acquired MRSA Carrying the Panton-Valentine Leukocidin Following Vaccination

Background: Infections with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are emerging worldwide. We investigated an outbreak of severe CA-MRSA infections in children following out-patient vaccination. Methods and Findings: We carried out a field investigation after adverse events following immunization (AEFI) were reported. We reviewed the clinical data from all cases. S. aureus recovered from skin infections and from nasal and throat swabs were analyzed by pulse-field gel electrophoresis, multi locus sequence typing, PCR and microarray. In May 2006, nine children presented with AEFI, ranging from fatal toxic shock syndrome, necrotizing soft tissue infection, purulent abscesses, to fever with rash. All had received a vaccination injection in different health centres in one District of Ho Chi Minh City. Eight children had been vaccinated by the same health care worker (HCW). Deficiencies in vaccine quality, storage practices, or preparation and delivery were not found. Infection control practices were insufficient. CA-MRSA was cultured in four children and from nasal and throat swabs from the HCW. Strains from children and HCW were indistinguishable. All carried the Panton-Valentine leukocidine (PVL), the staphylococcal enterotoxin B gene, the gene complex for staphylococcal-cassette-chromosome mec type V, and were sequence type 59. Strain HCM3A is epidemiologically unrelated to a strain of ST59 prevalent in the USA, althoughthey belong to the same lineage. Conclusions. We describe an outbreak of infections with CA-MRSA in children, transmitted by an asymptomatic colonized HCW during immunization injection. Consistent adherence to injection practice guidelines is needed to prevent CA-MRSA transmission in both in- and outpatient settings

Awareness, concern and willingness to adopt biosecure behaviours: public perceptions of invasive tree pests and pathogens in the UK

The growing incidence of invasive tree pest and disease outbreaks is recognised as an increasing threat to ecosystem services and human wellbeing. Linked to global trade, human movement and climate change, a number of outbreaks have attracted high public and media attention. However, there is surprisingly little evidence characterising the nature of public attentiveness to these events, nor how publics might respond to evolving outbreaks and the management actions taken. This paper presents findings from an online questionnaire involving 1334 respondents nationally-representative of the British public to assess awareness, concern and willingness to adopt biosecure behaviours. Despite revealing low levels of awareness and knowledge, the results indicate that the British public is concerned about the health of trees, forests and woodlands and is moderately willing to adopt biosecure behaviours. A key finding is that membership of environmental organisations and strong place identity are likely to engender higher awareness and levels of concern about tree pests and diseases. Further, those who visit woodlands regularly are likely to be more aware than non-visitors, and gardeners are more likely to be concerned than non-gardeners. Women, older respondents, those with strong place identity and dependence, members of environmental organisations, woodland visitors and gardeners were most likely to express a willingness to adopt biosecure behaviours. A comparison with findings from a survey conducted by the authors 3 years previously shows a decline over time in awareness, concern and willingness