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Ever notice how the smallest habits in surgery are the hardest to justify with data? We dig into one of those everyday choices—taper vs. reverse cutting needles for intradermal closure after TPLO—and unpack what the evidence actually says about early incisional healing, complication rates, and the subtle differences that might matter at the 18–24 hour mark. With surgeon-researcher Josh Becker, we trace the path from hunches and mentor preferences to a pragmatic study design that could live in private practice and still push the conversation forward.

We talk candidly about why “non-inferiority” can be a messy label without a clear gold standard, how blinding and standardized photos helped keep bias in check, and why the simplest takeaway is also the most practical: both needle types can perform well in healthy TPLO patients. Josh shares when he reaches for taper vs. cutting based on tissue characteristics and body region, and we explore the mindset shift from “what I’ve always used” to “what this patient and this tissue need today.” The conversation also opens a bigger door: if veterinary medicine had a validated, objective incision scoring system, we could compare techniques, icing and heat protocols, bandaging, and mobilization with far more confidence.

Looking ahead, we map out next steps—replicating signals, expanding to other anatomical sites, and experimenting with image-based analytics or AI to quantify erythema and bruising consistently. Along the way, we keep it human: debriefs after cases, the humility of soft tissue surgery, and advice for students who want to build a thoughtful, evidence-aware surgical career. If you’ve ever argued for a needle out of habit, this episode invites you to choose with intention and ask for proof.

If this conversation helped refine your setup or sparked a change in your closure routine, subscribe, share the episode with a colleague, and leave a review—your feedback helps more vets find data they can use tomorrow.

JAVMA article: https://doi.org/10.2460/javma.25.07.0479

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