Evaluating the efficacy of a topical anaesthetic formulation and ketoprofen, alone and in combination, on the pain sensitivity of dehorning wounds in Holstein-Friesian calves

The aim of this study was to investigate the effect of a topically applied local anaesthetic and the non-steroidal anti-inflammatory drug ketoprofen, alone and in combination, on the pain sensitivity response of calves to dehorning (mean age 2.2 months). Calves were randomly allocated and blocked by age to one of four groups. Groups were: scoop dehorning (D, n = 8), scoop dehorning + i.m. administration of 3 mg/kg ketoprofen (DK, n = 8), scoop dehorning + application of topical anaesthetic (DTA, n = 7) and scoop dehorning + application of topical anaesthetic and i.m. administration of ketoprofen (DKTA, n = 7). A pressure algometer was used to determine the mechanical nociceptive threshold (MNT), being the pressure (kg/f) at which calves withdrew from the stimulus. Measurements were taken before dehorning and at 1 min, 1, 2, 5 and 24 h post-dehorning at both the cut skin edge of the wound and the peri-wound area. The effect of treatment changed over time (P < 0.001). MNT was highest before treatment (MNT = 5.03 kg/f) and tended to decrease over time (MNT = 1.16 kg/f 24 h post-treatment). Overall, D calves exhibited the lowest MNT with an average of 1.77 kg/f. DTA calves had the highest MNT (3.89 kg/f), followed closely by DKTA calves (3.24 kg/f). DK calves exhibited an intermediate MNT of 2.61 kg/f. MNT of the cut skin edge was generally lower than that of the peri-wound area (2.01 vs 3.81 kg/f, respectively, P = 0.02).The topical anaesthetic formulation significantly reduced the pain sensitivity of dehorning wounds. There was no observed enhanced analgesic effect with addition of ketoprofen. The cut skin edge was more sensitive to pressure than the peri-wound area.

Wound healing after craniotomy: a randomized trial comparing scalp clips to artery forceps for scalp hemostasis

Object In this prospective randomized clinical trial, investigators looked at wound healing after craniotomy. The hypothesis was that the self-closing plastic scalp clips used for hemostasis on the skin edge might lead to localized microscopic tissue damage and subsequent delayed wound healing. Methods The trial consisted of 2 arms in which different methods were used to secure scalp hemostasis: 1) the routinely used plastic clips (Scalpfix, Aesculap); and 2) the older method of artery forceps placed on the galea. Participants were restricted to those > 16 years of age undergoing craniotomies expected to last > 2 hours. Repeat operations were not included. One hundred fifty patients were enrolled. They were visited at 3 and 6 weeks postoperatively by an observer blinded to the method used, and the wounds were assessed for macroscopic epithelial closure, signs of infection, and hair regrowth by using a predefined assessment scale. Results The results showed no significant difference in wound healing between the 2 groups at either 3 weeks (OR 0.55, 95% CI 0.27–1.11; p = 0.09) or 6 weeks (OR 0.79, 95% CI 0.39–1.58; p = 0.50). The length of operation was found to be a significant factor affecting wound healing at 6 weeks (OR/hour 0.68, 95% CI 0.51–0.92; p = 0.01). Conclusions The use of Aesculap Scalpfix self-retaining plastic scalp clips on the skin edge during craniotomy surgery does not appear to affect wound healing significantly to the postoperative 6-week mark.