Incidence of glove perforation is similar in large animal, human, and small animal surgery and is influenced by duration of wear, invasiveness of the surgery, and role of the wearer. ECT is more sensitive than WLT for detection of glove perforation.

Summary Background Currently, the World Health Organization recommends the use of alcohol‐based hand rubs (ABR) for surgical hand preparation in human surgery. When disinfecting soaps are used, a rubbing technique causes less skin irritation than brush scrubbing. Based on a recent survey, most equine surgeons still use disinfecting soap. The efficacy of scrubbing vs. rubbing and the use of sole ABR compared with chlorhexidine (CHx)‐ based products has not been evaluated in the equine surgical setting. Objectives To compare four surgical hand antisepsis techniques in equine surgery for reduction of aerobic bacterial counts from pre‐ to post‐preparation (immediate efficacy) and at the end of surgery (sustained efficacy). Study design Randomised, prospective clinical trial. Methods A 4% CHx‐based product applied with either a scrub or rub technique, one sole ABR (ET; 80% ethanol) and one CHx/alcohol‐combination (CHx/ET; 1% CHx and 61% ethanol) product both applied with a rub technique were evaluated. Samples were collected by glove juice technique and cultured on 3M™ Petrifilm plates and counted using a 3M™ Petrifilm plate reader. Results Immediate mean bacterial log10 colony forming unit (CFU) reduction was 2.4 for CHx‐scrub, 2.8 for CHx‐rub, 3.1 for CHx/ET and 2.1 for ET. CHx/ET resulted in significantly lower bacterial counts than CHx‐scrub (P<0.005) and ET (P<0.001) while CHx‐rub resulted in significantly lower counts than ET (P<0.001). At the end of surgery bacterial counts were the lowest for CHx‐rub, significantly lower than CHx/ET (P<0.001) and ET (P<0.001). There was no difference between CHx‐rub and ‐scrub techniques (P = 0.7). Main limitations Bacterial counts were used as the outcome measure rather than prevalence of surgical site infection, and the effect of hand preparation on skin health was not assessed. Conclusions ABR did not decrease bacterial log10CFU counts more effectively than CHx products. When using CHx soaps in the equine setting, hand‐rub is as effective as a hand‐scrub‐technique.

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This retrospective case series aims to highlight the advantages and disadvantages of different treatment options for sinus disease in horses, with a special focus on surgical approaches. The medical records of 25 horses with sinusitis which presented to the equine hospital, Vetmeduni Vienna, between August 2020 and January 2022 were analysed. In 11 cases, conservative treatment by the transnasal endoscopic lavage of the affected sinuses through the sinonasal channel or through a developed, pre-existing sinonasal fistula was performed. In the remaining 14 cases, openings into the sinus for subsequent lavage were surgically created either via classical trephination/bone flaps (8) or by transnasal endoscopically guided minimally invasive approaches (8). In some cases (2), a combination of classical extra-nasal and minimally invasive transnasal approaches was required. The minimally invasive techniques used were comprised of laser surgery (3), electrosurgery (3) and balloon sinoplasty (2). The sinusitis and underlying diseases were successfully treated in all of the horses until hospital discharge. Long-term follow-up could be obtained only from a small number of patients due to the temporal proximity (the study began two years ago) to their initial discharge from the hospital, but they showed the continuous resolution of clinical signs in all cases in which follow up data were available. The results of this case series indicate that if surgical intervention is required, minimally invasive techniques appear to be a promising and potentially cheaper alternative to classical extra-nasal approaches for the treatment of sinus disease in selected cases. In the future, the use of these techniques should be considered more commonly with the broader availability of improved endoscopes and instruments. Additionally, by using small-diameter endoscopes, the need for any surgical intervention might be significantly reduced in many cases.

BackgroundThe quantitative effect of strong electrolytes, unmeasured strong anions (UAs), pCO 2, and plasma protein concentrations in determining plasma pH can be demonstrated using the physicochemical approach. Plasma anion gap (AG) and strong ion gap (SIG) are used to assess UAs in different species.HypothesesStrong ions are a major factor influencing changes in plasma pH of hospitalized foals. AG and SIG accurately predict severe hyper‐l‐lactatemia ([l‐lac−] > 7 mmol/L).AnimalsSeven hundred and ninety three hospitalized foals < 7 days old.MethodsRetrospective study. The relationship between measured pH and physicochemical variables, and the relationship between plasma [l‐lac−] and AG and SIG, were determined using regression analyses. Optimal AG and SIG cut points to predict hyper‐l‐lactatemia were identified using an ROC curve analysis.ResultsCombined, the measured strong ion difference and SIG accounted for 54–69% of the changes in the measured arterial pH of hospitalized foals. AG and SIG were significantly associated with plasma [l‐lac−] (P < .0001). The receiver operator characteristics (ROC) AUC of AG and SIG for prediction of severe hyper‐l‐lactatemia were 0.89 (95%CI, 0.8–0.95; P < .0001) and 0.90 (95%CI, 0.81–0.96; P < .0001), respectively. Severe hyper‐l‐lactatemia was best predicted by AG > 27 mmol/L (sensitivity 80%, 95%CI, 56–94, specificity 85%, 95%CI, 73–93; P < .0001) and SIG <−15 mmol/L (sensitivity 90%, 95%CI, 68–98; specificity 80%; 95%CI, 68–90; P < .0001).Conclusion and clinical relevanceAltered concentrations of strong ions (Na+, K+, Cl−) and UAs were the primary cause of acidemia of hospitalized foals. AG and SIG were good predictors of hyper‐l‐lactatemia and could be used as surrogate tests.