In cats and dogs with traumatic diaphragmatic rupture, does surgical timing affect outcome?

PICO question In cats and dogs with traumatic diaphragmatic rupture undergoing herniorrhaphy does surgical timing affect outcome?   Clinical bottom line Category of research question Prognosis The number and type of study designs reviewed Ten studies were critically appraised. All of these were retrospective case series Strength of evidence Zero Outcomes reported Overall, there is not sufficient evidence reporting if timing of surgical intervention has an effect on the mortality rate in dogs and cats with traumatic diaphragmatic rupture. Mortality rate was 6.8–50% in all cases Conclusion There is no statistically significant information available with only several retrospective studies published that are a low quality of evidence. Clinical practice can be reviewed based upon current evidence assessing timing of herniorrhaphy of traumatic diaphragmatic rupture. However, there are no clear recommendations and future studies are warranted   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.