Topic:Suture
Sutures are medical devices used to close wounds or surgical incisions in horses. They are typically made from materials such as nylon, polypropylene, or absorbable polymers and are selected based on the specific requirements of the wound or procedure. Sutures serve to approximate tissue edges, promote healing, and reduce the risk of infection. In equine medicine, the choice of suture material, technique, and pattern can significantly affect the healing process and the outcome of surgical interventions. This page compiles peer-reviewed research studies and scholarly articles that examine the types, applications, and outcomes of suture use in equine veterinary practice.
A non-invasive technique for standing surgical repair of urinary bladder rupture in a post-partum mare: a case report. An 11-year-old mare presented 36 hours after foaling with a ruptured bladder. Uroperitoneum was diagnosed on ultrasound and from the creatinine concentration of the peritoneal fluid. Bladder endoscopy demonstrated tissue necrosis and a rent in the dorsocranial aspect of the bladder. Following stabilisation, including abdominal drainage and lavage, the mare was taken to standing surgery. Under continuous sedation and epidural anaesthesia, and after surgical preparation, a Balfour retractor was placed in the vagina. Using sterile lubricant and moderate force, it was possible to insert a hand int...
Suture exostosis causing obstruction in the nasolacrimal duct in three horses. Three horses were presented with facial swelling and epiphora. Results: All horses had facial swellings and radiographic findings consistent with exostosis at the lacrimomaxillary suture, and ipsilateral epiphora. Positive contrast dacryocystorhinography demonstrated that the site of obstruction of the nasolacrimal duct was located where the duct traverses the lacrimomaxillary suture. Methods: Lacrimomaxillary suture exostosis. Conclusions: Lacrimomaxillary suture exostosis should be considered as a differential diagnosis in cases of epiphora in horses. Dacryocystorhinography, preferably retro...
Effect of prosthesis number and position on rima glottidis area in equine laryngeal specimens. To assess the effect of 1 or 2 laryngeal prosthetic sutures on rima glottidis areas in equine laryngeal specimens. Methods: Experimental, randomized design. Methods: Cadaveric equine larynges (n=16). Methods: Larynges were collected from 10 horses; 2 sutures each were preplaced in the right and left sides of each larynx. A dorsal suture (DS) was placed through the caudal rim of the dorsal midline of the cricoid cartilage, under the cricopharyngeus muscle and through the proximal and rostral aspect of the muscular process. A lateral suture (LS) was placed 1.5 cm lateral to the DS and through th...
In vitro model for testing novel implants for equine laryngoplasty. To develop an in vitro laryngeal model to mimic airflow and pressures experienced by horses at maximal exercise with which to test laryngoplasty techniques. Methods: Randomized complete block. Methods: Cadaveric equine larynges (n=10). Methods: Equine larynges were collected at necropsy and a bilateral prosthetic laryngoplasty suture was placed with #5 Fiberwire suture to achieve bilateral maximal arytenoid abduction. Each larynx was positioned in a flow chamber and subjected to static flow and dynamic flow cycling at 2 Hz. Tracheal pressure and flow, and pressure within the flow chamber were ...
Biomechanical comparison of six suture configurations using a large diameter polyester prosthesis in the muscular process of the equine arytenoid cartilage. To compare biomechanical properties of 6 suture configurations using a large diameter polyester prosthesis in the muscular process (MP) of the arytenoid cartilage and to determine failure mode. Methods: Experimental study. Methods: Cadaveric equine larynges (n=121). Methods: Suture configurations (4 single, 2 double) were inserted, and then constructs were tested in a single-cycle to failure at a 100 mm/min distraction. Load deformation curves were generated to assess the biomechanical properties of each construct. A 1-way ANOVA was used to compare the mean differences in construct failure for...
Management of equine skull fractures using fixation with polydioxanone sutures. Ten horses presented with severe distortion of the facial contour, crepitus on palpation and mild to moderate epistaxis. Individual horses also showed ocular damage, ptosis, severe dyspnoea and movement of the facial bones concurrent with respiration. The fracture fragments were exposed using a large curvilinear incision and elevated using a retractor, periosteal elevator, chisel or Steinmann pin. The fracture fragments were unstable following reduction and fixation was necessary. Stabilisation was achieved with polydioxanone sutures placed through holes drilled in opposing sides of the fractu...
Repair of abdominal wall hernias in horses using primary closure and subcutaneous implantation of mesh. Abdominal incisional hernias in over 40 horses were repaired by exposing the hernial sac and ring and closing the ring with absorbable, interrupted, inverted, cruciate sutures after inverting the hernial sac into the peritoneal cavity. A mesh was sutured, under tension, over the closed ring. Placing the mesh subcutaneously, rather than in the retroperitoneal space, simplified the dissection and minimised the likelihood of penetrating the peritoneal cavity, a problem common to techniques of hernia repair in which the mesh is implanted into the retroperitoneal space. Implanting the mesh subcutan...
Surgical technique to repair grade IV rectal tears in post-parturient mares. To describe a surgical technique for repair of grade IV rectal tears after parturition in mares and to report outcome. Methods: Clinical report. Methods: Horses (n=6) with grade IV rectal tears. Methods: Mares were sedated and restrained in standing stocks. After caudal anesthesia and evacuation of feces from the rectum, the perineal region was aseptically prepared. Four stay sutures were placed through the external anal sphincter before vertical transection (12 o'clock). Caudal retraction of the tear was performed using Allis tissue forceps (5 mares) or stay sutures before accurate apposition...
Intra-articular stabilisation of the equine cricoarytenoid joint. The success of laryngoplasty is limited by abduction loss in the early post operative period. Objective: To determine the efficacy of polymethylmethacrylate (PMMA) in stabilising the cricoarytenoid joint (CAJ) and reducing the force on the laryngoplasty suture. Objective: Injection into the cricoarytenoid joint resists the forces produced by physiological laryngeal air flows and pressures thereby reducing the force experienced by the laryngoplasty suture. Methods: Ten cadaver larynges were collected at necropsy and PMMA was injected into one CAJ at selected random. Each larynx was subjected to...
Intracorporeal suture closure of the internal inguinal and vaginal rings in foals and horses. To report a technique for repair or prevention of inguinal hernia in horses using intracorporeal suture closure of the internal inguinal and vaginal rings. Methods: Case series. Methods: Foals (n=6) and geldings (n=2). Methods: After selection of a peri-umbilical telescope portal, instrument portals were made unilaterally or bilaterally, as needed. Herniated viscera was reduced, castration (foals) or spermatic cord remnant transection at the internal inguinal ring (adults) performed, and then simple interrupted intracorporeal sutures of synthetic absorbable suture material were used to close t...
Do subcutaneous sutures increase risk of laparotomy wound suppuration? Incisional drainage and suppuration occurs commonly following exploratory laparotomy; any technique with the potential to reduce the incidence of this complication warrants investigation. Objective: To determine if abandoning the use of subcutaneous sutures in laparotomy wound closure is safe and whether it reduces the risk of suppuration. Methods: A randomised controlled study was carried out at 2 referral hospitals in the UK, involving 309 horses undergoing exploratory laparotomy; 150 horses underwent '2-layer' closure without a subcutaneous suture, while 159 underwent conventional '3-layer'...
Equine pericardium for dural grafts: clinical results in 200 patients. Serous sheets are currently used in Neurosurgery as dural substitute. The aim of this study is to demonstrate that the horse pericardium, which has the essential charasteristics of reabsorbable membranes and moreover is BSE-free, is an excellent dural substitute. Methods: 200 patients, 53 suffering from cranial traumatic conditions and 97 from cranial and craniospinal neoplastic pathologies, underwent a surgical procedure with the application of horse pericardium as a dural prosthesis. Results: The follow-up controls of the patients included a neurosurgical visit and advanced diagnostic imagin...
An in vitro comparison of two suture intervals using braided absorbable loop suture in the equine linea alba. To compare bursting strength and failure modes of ventral median abdominal incisions closed with loop suture in a simple continuous pattern using two different suture-bite intervals. Methods: In vitro experiment. Methods: Equine cadavers (n=14; weighing >318 kg; postmortem interval <2 hours). Methods: A template was used to make a 25 cm incision with suture interval and bite size of either 1.0 cm x 1.5 cm or 1.5 cm x 1.5 cm. A 200 L polyurethane bladder was inserted within the abdomen and insufflated to create abdominal wall tension. Celiotomies were closed with a #2 braided lactomer 9-1 conti...
A mechanical study of ligature security of commercially available pre-tied ligatures versus hand tied ligatures for use in equine laparoscopy. To determine a hand-tied ligature knot configuration, suture size, and suture type that would be an acceptable substitute to commercially available ligature knots for use in equine laparoscopic surgery. Methods: Three-factor ANOVA with the fixed effects being suture type, suture size, and knot type. The dependent variable was ligature security (load to failure). Methods: Commercially available Endoloop and 4 hand-tied slipknot ligatures were compared with a 4-layer square knot. The hand tied ligature knots tested were the 4S modified Roeder knot, the Brooks knot, the modified Roeder knot, and ...
In vitro comparison of two techniques for suture prosthesis placement in the muscular process of the equine arytenoid cartilage. To compare in vitro the load necessary for a partial and complete rupture of the muscular process arytenoid cartilage when a suture prosthesis is positioned by a bone trocar versus a trocar point needle and to compare failure mode. Methods: Experimental using cadaver specimens. Methods: Larynges from 18 Thoroughbred race horses, aged 2-20 years. Methods: Arytenoid cartilages were separated randomly into 2 groups: group 1-suture prosthesis inserted directly through the muscular process using a curved trocar point needle and group 2-suture passed through a hole predrilled with a 3 mm bone trocar...
Evaluation of a canine cranial cruciate ligament repair system for use in equine laryngoplasty. To report the use of a nylon suture system (Canine Cranial Cruciate Ligament Repair System; Securos Inc Veterinary Orthopedics) as a prosthesis for equine laryngoplasty. Methods: Experimental and prospective clinical study. Methods: Cadaver specimens (n = 5) and 7 horses with left laryngeal hemiplegia. Methods: A commercially available monofilament nylon suture system was implanted as a laryngeal prosthesis. Arytenoid cartilage abduction was achieved with a tensioning device applied to the suture prosthesis during transnasal endoscopic observation. Suture fixation was achieved with crimping cl...
Indications, surgical technique, and long-term experience with laparoscopic closure of the nephrosplenic space in standing horses. To describe surgical technique and outcome after laparoscopic closure of the nephrosplenic space for treatment of recurrent left dorsal displacement of the left colon (LDDLC) in standing horses. Methods: Retrospective study. Methods: Forty-four horses with LDDLC. Methods: Laparoscopic portals were located in the left flank region. After administration of etilefrin intravenously to contract the spleen, the dorsal splenic margin was sutured to the nephrosplenic ligament to obliterate the nephrosplenic space. Horses were re-examined (< or = 3 years) for history of recurrence. In addition, medical...
Ex vivo strength comparison of bioabsorbable tendon plates and bioabsorbable suture in a 3-loop pulley pattern for repair of transected flexor tendons from horse cadavers. To test the failure strength and energy of 2 bioabsorbable implants applied to transected deep digital flexor tendons (DDFT) from adult horses. Methods: Ex vivo biomechanical experiment. Methods: Twelve pairs of deep digital flexor tendons harvested from the forelimbs of fresh equine cadavers. Methods: Poly-L-lactic acid tendon plates were custom manufactured for application to the cylindrical surface of an adult equine deep digital flexor tendon. Twelve pairs of DDFTs were transected 2 cm distal to the insertion of the distal check ligament of the deep digital flexor tendon. One tendon of eac...
Recent advances in equine abdominal surgery. Laparoscopy is a minimally invasive procedure that has applications as a diagnostic, therapeutic and prognostic technique. Specialized equipment is necessary to perform equine laparoscopy, and there is a large range of instruments, both disposable and non-disposable available. Laparoscopic procedures described include ovariectomy, cryptorchidectomy, adhesiolysis and herniorrhaphy. Laparoscopy can be performed in a standing or dorsally recumbent position, depending on surgeon preference, patient status and the procedure to be performed. Stapling equipment is frequently used in gastrointestinal ...
An in vitro biomechanical comparison of the breaking strength and stiffness of polydioxanone (sizes 2, 7) and polyglactin 910 (sizes 3, 6) in the equine linea alba. To determine failure strength, stiffness, and failure mode of 4 suture materials in equine linea alba. Methods: Randomized complete block design. Methods: Linea albas collected from 12 adult horses (mean weight, 475 kg; mean age, 10 years). Methods: The ventral abdominal fascia, including the linea alba, was collected and bisected along the linea alba into right and left halves. Each half was divided into four, 5-cm sections extending from the umbilicus cranially, and randomly assigned to 1 of 4 suture materials: 2 polydioxanone (2 PD), 3 polyglactin 910 (3 PG), 6 polyglactin 910 (6 PG), and 7...
Principles of early wound management. The equine practitioner can positively influence wound healing by dispensing appropriate treatment in the first few hours after injury. Positive actions in the early period include hemostasis, meticulous cleansing and debridement of the wound, the use of effective but nonirritating products to disinfect the wound, closure (if indicated)with minimal tension on the suture line, the judicious use of drains,and ensuring adequate tetanus protection. Furthermore, a thorough assessment of the wound and the patient in the initial period after trauma provides pertinent information on prognosis. Finally...
Use of topical mitomycin C in myoplasty of the medial rectus muscle of rabbits. To possibly reduce postoperative adhesions that occur after ocular myoplasties, we investigated the topical effects of 0.04% mitomycin C on the repaired areas of the medial rectus muscle using an equine renal capsule preserved in 98% glycerin for reinforcement of the sutures. Twenty-four rabbits, divided into two groups of 12 animals each [untreated (control) and treated group (MMC)], were submitted to surgical rupture of the medial rectus muscle of one eye and repair of the defect 24 h later with sutures and an equine renal capsule. Post-operative prophylactic treatment of the two groups cons...
Quantitative effect of tenorrhaphy on intrinsic vasculature of the equine superficial digital flexor tendon. To compare effects of the locking-loop suture pattern (LLP) and 3-loop pulley (3LP) suture pattern for tenorrhaphy on the intrinsic vasculature of the superficial digital flexor tendon (SDFT) of horses in vitro after surgery. Methods: 16 forelimbs obtained from 8 mature horses. Methods: Tenotomy and subsequent tenorrhaphy was performed in anesthetized horses. Following systemic administration of heparin, horses were euthanatized and the limbs were removed and placed under tension to load the flexor tendons. The intrinsic vasculature was then perfused with a mixture of barium sulfate and water....
Evaluation of a vessel-sealing device for small intestinal resection and anastomosis in normal horses. To compare arterial bursting pressure after vessel closure using a vessel-sealing device (LigaSure Atlas Laparoscopic Sealer/Divider Instrument; Valleylab, Boulder, CO), a ligate-and-divide stapling device (LDS), and 2-0 polydioxanone suture. To evaluate the LigaSure Atlas as a method for ligation of the mesenteric vasculature during small intestinal resection in normal horses. Methods: Experimental study. Methods: Part A: jejunal segments from 19 horses. Part B: 6 horses, aged 1 to 18 years, weighing 330 to 509 kg. Methods: Part A: Jejunal segments with mesenteric vessels were collected from ...
A comparison of ultra-high-molecular weight polyethylene cable and stainless steel wire using two fixation techniques for repair of equine midbody sesamoid fractures: an in vitro biomechanical study. To compare the monotonic tensile and fatigue strength of 16-gauge stainless steel wire (SSW) to ultra-high-molecular weight polyethylene (UHMWPE) cable using a transfixed cerclage technique in an in vitro midbody sesamoid osteotomy model. Endoscopic modifications to Martins transfixed cerclage technique were developed. A new suture technique of fixation was compared with the transfixed cerclage technique by measuring gap formation after cyclic testing. Methods: An in vitro biomechanical paired equine cadaver limb study. Methods: Twenty-one paired cadaveric adult equine forelimbs. Methods: Unia...
Laparoscopic surgical technique for repair of rectal and colonic tears in horses: an experimental study. To determine the efficacy of laparoscopic surgical techniques for repair of rectal lacerations in horses. Methods: Experimental study. Methods: Thirty-two segments of equine bowel placed in an equine pelvitrainer, 8 equine cadavers, and 3 normal horses. Methods: In experiment 1, 3 laparoscopic intestinal-repair techniques were evaluated in an equine pelvitrainer: suturing with needle holders, with an automatic suture device, and stapling with a hernia stapler. In experiment 2, descending colon lacerations were sutured laparoscopically using needle holders in a pelvitrainer and in equine cadave...
Repair of collateral ligament instability in 2 foals by using suture anchors. Instability of the collateral ligaments of the carpal or metacarpophalangeal joint occurred in 2 foals. The instability was repaired using commercial suture anchors. In foals, commercial suture anchors combined with external coaptation can be used successfully to repair collateral ligament instability of the carpus or the metacarpophalangeal joint.
Celiotomy closure via permanent implantation of polyamide in horses. Permanent implantation of nonabsorbable materials is appropriate in many surgical circumstances but is not commonly used to close equine celiotomies. This paper describes a simple method of continuous nonabsorbable implantation of polyamide suture used successfully to close 48 equine celiotomies. Forty-eight clean or clean-contaminated celiotomies were successfully performed over 5 years using this technique. The postsurgical survival observation period ranged from 1-6 years (median 3.5 years). There were 45 long-term survivors (93.75%). Only 2 minor implant complications (4.4%) were observed ...