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.
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 ...
Entrapment of the small colon through a mesocolic rent in a mare. A 6-year-old mare was presented for acute abdominal pain unresponsive to analgesics. Exploratory laparotomy revealed entrapment of the small colon through a 12 cm rent in the mesocolon. The incarcerated small colon was manually reduced and the rent in the mesocolon was sutured closed. The mare made excellent postoperative recovery and was discharged from the hospital 4 days later. The cause of the rent, which was chronic in appearance, is unknown.
Ligature slippage during standing laparoscopic ovariectomy in a mare. Suture ligature failure is a potential complication during laparoscopic ovariectomy techniques utilizing ligatures as a means of hemostasis. This complication in the standing mare and the successful use of laparoscopic electrosurgical instrumentation as the sole means of providing hemostasis to the mesovarium of a mare are described.
Comparison of incisional bursting strength of simple continuous and inverted cruciate suture patterns in the equine linea alba. To determine the bursting strength of ventral median abdominal incisions closed by either simple continuous or inverted cruciate suture patterns. Methods: Experimental. Methods: Twelve equine cadavers. Methods: A 25 cm ventral median incision was made through the linea alba and a 200 L polyurethane bladder was placed within the abdomen. Either a simple continuous or an inverted cruciate pattern using 3 polyglactin 910 with a bite size and suture interval of 1.5 cm was used to close linea incisions. Closure time was recorded for each pattern. The bladder was inflated with air at 40 L/min, and t...
An evaluation of the haemostatic suture in hysterotomy closure in the mare. This study was designed to evaluate the haemostatic suture as a means of preventing haemorrhage from the hysterotomy in mares after caesarean section. At 2 university hospitals 1982-1994, 48 mares had caesarean section for dystocia, 10 as an elective, and 8 mares concurrently with colic surgery. The haemostatic suture was used in 31 of 66 mares (47%) and surgery period was significantly (P<0.05) shorter when it was not applied. Anaemia (PCV<30%) was recorded in 13 (22%) of 58 mares, excluding the colic group, and the haemostatic suture did not after this proportion of mares that had anae...
Standing surgical repair of cystorrhexis in two mares. Two surgical techniques were used to evert the bladder into the vagina for observation and repair of bladder tears that were associated with parturition. One technique involved an incision through the vaginal floor into the peritoneal cavity just caudal to the cervix, and prolapse of the bladder into the vagina. The second technique involved a 3-cm incision through the urethra, 5 cm cranial to the urethral orifice, and digital exploration of the tear and finger traction to evert the bladder through the urethral incision. In both mares, the bladder defects were repaired in two layers, with use ...
Parotid duct laceration repair in two horses. Repair of parotid duct lacerations in 2 horses is described using intraluminal silastic tubing as a stent. The duct was lacerated traumatically at the facial vessel notch (incisura vasorum facialium) in the 1st horse, and iatrogenically after removal of an intraluminal sialolith after development of infection within the duct in the 2nd horse. In both cases, a silastic tube was passed retrograde into the duct via the salivary papilla, past the wound until the end lay rostroventral to the parotid salivary gland. The severed salivary ducts and the wounds were sutured. The external portion of the ...
Laparoscopic cryptorchid castration in standing horses. This article describes a new technique for laparoscopic cryptorchid castration in standing horses. Methods: Prospective study. Methods: Eight horses aged 11 months to 3 years and weighing between 300 and 643 kg. Methods: Food was withheld for 24 to 36 hours, and then horses were sedated with detomidine HCl (0.02 to 0.03 mg/kg) and butorphanol tartrate (0.02 mg/kg). The paralumbar fossa region was desensitized with 2% mepivacaine in an inverted "L" pattern and caudal epidural anesthesia was administered with either xylazine (0.18 mg/kg diluted to 10 to 15 mL with 0.9% sodium chloride) or a comb...
Diaphragmatic hernia repair in three young horses. This clinical report describes surgical correction of diaphragmatic hernia in three young horses. Methods: Retrospective investigation of medical records and subsequent racing performance. Methods: Three young horses with diaphragmatic hernia. Results: Three young horses with signs of abdominal pain had diaphragmatic hernia causing small intestinal strangulation. The strangulated small intestine was resected and an end-to-end jejuno-jejunal (two horses) or a side-to-side jejuno-cecal anastomosis (one horse) was performed. Diaphragmatic hernias were closed with a continuous suture pattern. All ...
[How to manage a rectal lesion in horses in clinical practice]. The most feared complication after a rectal examination of horses and ponies is to cause a tear of all the layers in the intraperitoneal part of the rectum. The description of the anatomy is an attempt to explain that the rectal tear is mostly located in the dorsal or dorsolateral part of the rectum. This article describes a relatively simple suture technique for the rectal tear by using the needle of Deschamp which is modified by Professor B. Huskamp. Furthermore there is a description of this method as treatment of two horses in practice circumstances. The issue whether causing a rectal tear...
Surgical materials and wound closure techniques. Recent innovations in surgical materials have helped to enhance wound healing and protect surgical wounds from infection. Materials such as polyglyconate have been evaluated in equine tissues and found efficacious. Other materials, such as poliglecaprone 25, appear to have qualities useful to equine surgery but are untested in equine tissues. Care must be taken to fully evaluate a new surgical material because its usefulness in equine tissues may not match that in human or laboratory animal tissues. Furthermore, use of disposable materials in surgery, although considered ideal for maintenance ...
Suture sinus formation following closure of ventral midline incisions with polypropylene in three horses. Suture sinuses formed in 3 horses following closure of ventral midline incisions with size-2 polypropylene. Suture sinuses healed after the suture material was removed. Suture sinus formation following closure with polypropylene may be related to the suture material's mechanical, rather than its chemical, properties. If polypropylene is used to close the linea alba in horses, the amount of tissue incorporated in the suture loops, suture tension, and knot volume should be minimized to decrease the risk of suture sinus formation.
[Suture material and suturing of the laparotomy wound in horses and cattle]. Wound healing is discussed in the introduction. Subsequently in a review of the suture materials used in large animal laparotomies is presented. In the discussion examples are given of the suture materials that are used at the Department of General and Large Animal Surgery.
Primary closure of equine laryngotomy incisions: a review of 42 cases. Laryngotomy incisions for either staphylectomy, ventriculectomy, cordectomy, resection of the palatopharyngeal arch, or subepiglottal cyst removal, were closed primarily in 42 horses. Incisional complications were subcutaneous emphysema (11 horses, 26%), incisional discharge (4 horses, 10%), postoperative fever (4 horses, 10%), incisional abscessation (3 horses, 7%), incisional seroma (2 horses, 5%), and subcutaneous edema (2 horses, 5%). Incisional complications were identified in 22 horses, but only 8 horses (19%) required intervention for incisional healing to occur. Factors such as preoper...
A study of the biomechanical properties of the adult equine linea alba: relationship of tissue bite size and suture material to breaking strength. The purposes of this study were to mechanically determine the optimal tissue bite size and to evaluate seven suture materials at their largest commercially available size for breaking strength and stiffness using cadaveric adult equine linea alba. Soft tissues were removed from the abdominal fascia of 16 adult horses. Individual test sections were created from the entire linea alba and labeled (1 through 6) starting at the umbilicus and extending craniad. A single biomechanical test was performed on each test section. Tissue bite size (3, 6, 9, 12, 15, 18, and 21 mm) significantly altered brea...
Technique for long-term ileal cannulation in ponies. A T-cannula was fitted permanently into the ileum of ten mature ponies to quantify the role of the prececal and postileal segments of the digestive tract in equine nutrition studies. The ponies were anesthetized, positioned in left lateral recumbency, and the distal small intestine was exteriorized through a right paralumbar incision. A silastic T-cannula was inserted through a 2-cm longitudinal incision into the lumen of the ileum, on the antimesenteric surface, and sutured to the ileum. The stem of the cannula was exteriorized through a 2-cm circular skin incision, 6 cm caudal to the 16th ri...
Open drainage, intra-articular and systemic antibiotics in the treatment of septic arthritis/tenosynovitis in horses. Open drainage was used to treat 26 horses with persistent or severe septic arthritis/tenosynovitis. Infected synovial structures were drained through a small (3 cm) arthrotomy incision that was left open and protected by a sterile bandage. Joint lavage was performed in all 26 horses. In addition to systemic antibiotics, 23 of these horses were also treated with intra-articular antibiotics; amikacin (17 horses), gentamycin (2 horses), cefazolin (2 horses), and 2 horses were injected at different times with gentamycin and amikacin. The infection was eliminated from the involved synovial structur...
Mechanical properties of suture materials in vitro and after in vivo implantation in horses. Tensile testing of reproducible loops of size 5 braided polyester, size 2 polyglycolic acid, size 2 monofilament nylon, and size 2 polydioxanone sutures was performed in vitro and after subcutaneous implantation in horses for 7, 14, and 28 days. Maximum breaking strength, energy absorption, and percentage elongation to breakage point were measured. Size 5 braided polyester had the highest maximum breaking strength and energy absorption over 28 days. Polydioxanone had better mechanical performance over 28 days than did polyglycolic acid. On day 28, none of these parameters was measurable in pol...
Postpartum partial cystectomy through the vagina in a mare with everted partially necrotic bladder. The bladder of a 750-kg Clydesdale mare had everted through the urethra into the vagina immediately after parturition. The bladder was reinverted into the peritoneal cavity by an attending veterinarian, but 4 days later, the bladder was everted again in the vagina. The mare was able to void urine through both ureters, which could be seen in the mucosal surface of the bladder. The everted bladder had become edematous and could not be reinverted through the urethra. A considerable portion of the fundus was necrotic. The mare was administered xylazine epidurally to induce perineal analgesia, and ...
Healing of transected equine superficial digital flexor tendons with and without tenorrhaphy. Healing of transected superficial digital flexor tendons was evaluated mechanically and histologically in eight horses. Tendons sutured with polyglyconate had higher loads at failure than nonsutured tendons at weeks 5 and 9. The tendon stress at failure (force per unit area) was higher in the sutured tendons at week 5 but not at week 9, reflecting the increased size of the scar at week 9. Histologically, scars after tenorrhaphy were consistently more mature than nonsutured tenotomy scars. The mean maturity score for sutured tendons was higher than for nonsutured tendons at weeks 5 and 9. Overa...
Resection and anastomosis of the small colon in four horses. Resection and anastomosis of the small colon was performed on 4 horses with vascular lesions (strangulating lipoma, mesenteric tear, dissecting haematoma) or functional obstruction (stricture) of this area of the bowel. The anastomoses were performed using a variety of suture materials in 2 layers. An appositional, full-thickness, simple, interrupted pattern was used in the first layer in all cases and oversewn with either a Cushing pattern (3 cases) or a Utrecht pattern (1 case). Post-operative complications associated with suture material and surgical technique were not seen. All horses were...
Sutured end-to-end and stapled side-to-side jejunal anastomoses in the horse. Hand sutured end-to-end (EE) and stapled side-to-side (SS) small intestinal anastomoses were performed in 10 healthy adult horses. In five SS anastomoses, staple lines on the blind ends of the jejunum were inverted (SSI) and in five they were not (SSNI). Five EE anastomoses were sutured with polydioxanone and five were sutured with polyglyconate. All horses were euthanatized on day 30. Intra-abdominal adhesions were graded (0-4), and stomal areas were calculated from contrast radiographs made with the bowel distended. Histopathology scores for the anastomoses were based on the degree of inflam...
Presuturing as a means of reducing skin tension in excisional biopsy wounds in four horses. Excisional biopsy of a skin lesion was performed in 4 horses after stretching the surrounding skin with mattress sutures. The technique of presuturing allowed all biopsy wounds to be closed without excessive tension on the suture lines.
A comparison of three techniques for closure of pelvic flexure enterotomies in normal equine colon. Six enterotomies 3 cm long, spaced at 3 cm intervals, were made in the antimesenteric border of the pelvic flexure of the ascending colon in five adult horses. Ten incisions each were sutured with a Utrecht pattern (single layer), a full-thickness simple continuous oversewn with a Cushing pattern (two layer), and a mucosal simple continuous with a seromuscular simple continuous oversewn with a Cushing pattern (three layer). In all horses, chromic gut and polyglactin 910 were each used once for each pattern. On day 6, the pelvic flexure was excised and the colonic vessels were injected with a r...
Modification of the cutting thread technique for intestinal anastomoses using diathermy. The author has modified a surgical technique, which was originally developed at the turn of the century, for the aseptic establishment of an intestinal anastomosis. The principle of this technique, known as the "cutting thread" principle, was that a loop of thread was introduced into the lumen of each of two approximated loops of intestine. After suturing the two loops of intestine together around the intraluminal parts of the thread, the latter was used as a "wire-saw" to create a stoma between the two intestinal loops. The author modified the method in such a way that the cutting could be pe...
[Rupture of the bladder and of the urachus in foals. A literature review]. It is well documented that the incidence of rupture of the urinary bladder or urachus is highest in newborn male foals and occurs during the (usually uncomplicated) parturition. Important clinical symptoms include frequent passing of small quantities of urine, abdominal distention and positive abdominal undulation. Hyperkalaemia, hyponatraemia, hypochloraemia and an elevated serum creatinine level are often present. The serum blood urea nitrogen concentration may be normal or only slightly elevated. The creatinine concentration in the peritoneal fluid is invariably higher than that in serum, a...
Evaluation of sodium carboxymethylcellulose for prevention of experimentally induced abdominal adhesions in ponies. Twelve ponies were used to evaluate the reliability of an abdominal adhesion model and the efficacy of intraperitoneal infusion of sodium carboxymethylcellulose in preventing abdominal adhesions. A celiotomy was performed on each of the 12 ponies and the serosa of the distal portion of the jejunum was abraded with a dry gauze sponge at 5 locations. In addition to the serosal damage, a single 2-0 chromic gut suture was placed through the seromuscular layer of the jejunum in the center of the abraded area. After closure of the celiotomy, a 1% solution of sodium carboxymethylcellulose (7 ml/kg of...
Surgical stapling for repair of a rectal tear in a horse. A grade-4 rectal tear in a mare was successfully repaired per rectum, using a surgical stapling device. The mare had only minor postoperative complications. This technique has some advantages over previously described procedures, but should be reserved for use in selected cases.
A comparison of repair methods for gap healing in equine flexor tendon. In nine horses (18 forelimbs), a 3 cm section of superficial digital flexor tendon was removed and the tendons were repaired with immobilization for 6 weeks and (1) no suture (n = 6); (2) a double locking loop tenorrhaphy with carbon fiber (n = 6); or (3) a double locking loop tenorrhaphy with size 2 nylon suture (n = 6). Clinical assessment, gross evaluation, morphometry, histology, and mechanical testing were performed on two limbs from each treatment group at weeks 6, 12, and 24. At weeks 6 and 12, the unsutured tissue was less mature than the tissue sutured with nylon. By week 24, the carb...