An interview with Sara Manzoni – 2024 Melton Award Winner

20 February 2024

The 2024 Melton Award for the best published paper in small animal surgery in the Journal of Small Animal Practice was awarded to Sara Manzoni. We asked Sara about her research on computed tomography-planned surgical treatment of abscesses and draining tracts on suspected migrating vegetal foreign bodies and oropharyngeal penetrating injuries in dogs and what she learnt from the study.

1. How did you become involved in the study?

I was involved in the study during my surgical Internship at the National Veterinary School of Alfort, the publication project had been undertaken in previous years and given my interest in the topic I proposed to complete the study and write an article to promote the best practice.

2. What question did your research tackle?

In this paper we report the rate of recovery in dogs after computed tomography-planned surgical treatment of abscesses and draining tracts on suspected migrating vegetal foreign bodies and oropharyngeal penetrating injuries in head and neck regions. Head and neck regions are particularly affected by the occurrence of stick injuries and the penetration of foreign bodies due to the exploratory character of the dog. For this reason, these lesions are commonly encountered by first-line veterinarians and can prove to be real therapeutic challenges. A surgical approach without pre-operative imaging can result in a long and tedious surgical exploration in regions with a high density of vital structures; this may preclude an en-bloc excision of the lesions, with the possibility that an inadequate debridement of infected/necrotic tissues will be responsible of relapses. If poorly managed, this clinical condition can lead to multiple recurrences, causing stress in the patient, in the owner and in the clinicians.

3. Briefly, what were the main findings of your study?

Our clinical approach based on the realization of a pre-operative CT scanner, a targeted surgical approach aimed at finding a foreign body (when identified in CT) or only at debridement of the abscesses and draining tract, together with an identification of the specific involved pathogen through bacteriological testing, was associated with a 94.8% success rate in a single procedure with no major complications at surgery. It’s interesting to know that 100% of animals in which a foreign body was identified were cured. When lesions were suspected to be related to either migrating vegetal foreign body or to an oropharyngeal stick injury, but a foreign body was not identified at CT and/or at surgery, a surgical exploration based on CT images allowed a success rate of 93%.

The favorable results of our study encourage that a reasoned surgical approach based on CT images can provide a good long-term outcome while preserving vital structures present in these regions and without causing major complications at surgery.

4. Were the results what you expected, or were you surprised by the outcome?

The results surprised me regarding the very low percentage of recurrences despite a reduced sensitivity of the CT-scanner in the ability to identify a migrating vegetal foreign body. Currently, the use of ultrasound is promoted as the gold standard in the intra-operative research of migrating foreign bodies, in order to further reduce the recurrence rate and be able to get as close to 0% of relapses.

5. What is the one message you’d like vet surgeons to take away from the study?

Accurate surgical planning associated with preoperative imaging analysis is a fundamental aspect of a good surgical practice aimed at obtaining minimal complications and good outcomes.

Read Sara’s paper “Preoperative computed tomography, surgical treatment and long-term outcomes of dogs with abscesses on migrating vegetal foreign bodies and oropharyngeal stick injuries: 39 cases (2010-2021)” in JSAP here. https://onlinelibrary.wiley.com/doi/epdf/10.1111/jsap.13624