FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Equine Vet J / Acute abdominal dehiscence following laparotomy: A multicent...
Equine veterinary journal2021; doi: 10.1111/evj.13498

Acute abdominal dehiscence following laparotomy: A multicentre, international retrospective study.

Abstract: Incisional complications are a common cause of morbidity following laparotomy. Although uncommon, acute abdominal dehiscence (AAD) is a potentially fatal post-operative complication. However, few AAD cases are described in the literature. Objective: To describe common features of cases of AAD following ventral midline laparotomy, management and outcomes. Methods: Retrospective case series. Methods: Hospital records of horses that underwent a ventral midline laparotomy at nine hospitals in the UK, Ireland and USA over a 10-year period (2009-2019) were reviewed. Data were collected for pre-, intra- and post-operative factors that were considered relevant. Descriptive statistical analysis was performed. Results: A total of 63 cases of AAD were identified. AAD occurred due to tearing of sutures through the linea alba or rupture of the body wall adjacent to the suture line in 46 horses (73%). AAD occurred at a median of 5 days (0.5-70 days) post-operatively and broodmares accounted for 25% of the cases (n = 16). Surgical site infection developed prior to AAD in 28 horses (44%); leakage of peritoneal fluid occurred in 5% of horses prior to AAD being identified. Surgical repair was performed in 27 horses (43%), 10 (16%) were treated conservatively and 26 (41%) were euthanised immediately. Repair was most frequently performed using suture (n = 14), wire (n = 5) or a combination (n = 5). Overall survival to hospital discharge was 39% (24/63). Where surgical repair was performed, 15 horses (56%) survived to hospital discharge; 9 horses (90%) managed conservatively survived to hospital discharge. Conclusions: Follow-up was not performed for all cases following hospital discharge and some data were incompletely recorded in hospital files. Conclusions: Previously stated causative factors for AAD were not consistent features in the present study. Surgical site infection following laparotomy and pregnant or early post-partum mares may be important risk factors for AAD and warrant further investigation.
© 2021 EVJ Ltd.
Get Full Text
Publication Date: 2021-08-21 PubMed ID: 34418125DOI: 10.1111/evj.13498Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research article explores the issue of Acute Abdominal Dehiscence (AAD) following an abdominal surgery known as a laparotomy in horses. The research also investigates the common reasons for this complication and the outcomes when such incidents occur.

Objective and Methodology

The research aimed to outline the frequent characteristics of AAD incidents following laparotomies, as well as the varying treatment methods and their outcomes.

To achieve this, the research team carried out a retrospective review of hospital records of horses that had undergone ventral midline laparotomies (a type of abdominal surgery) at nine different hospitals within the UK, Ireland, and USA, over a 10-year span from 2009 to 2019. Data was collected concerning:

  • Preoperative factors
  • Intraoperative factors
  • Postoperative factors

The data was then subjected to descriptive statistical analysis.

Results

The review identified 63 cases of AAD in horses. This occurred chiefly as a result of sutures tearing through the linea alba (abdominal midline) or rupture of the body wall close to the suture line, which was seen in 73% of the cases.

In the majority of cases, AAD was noticed five days post operation, though this ranged from half a day to 70 days. A significant proportion of these cases (25%) were on broodmares – mares used for breeding.

44% of cases had a surgical site infection before AAD was detected. Further, leakage of peritoneal fluid, which is the fluid from the abdominal cavity, was noticed in 5% of horses before identification of AAD.

Treatments and Outcomes

In terms of treatment strategies, surgical repair was carried out in 43% of the cases, whereas conservative treatment and immediate euthanisation were utilised in 16% and 41% of cases, respectively. Methods of repair that were noted included using sutures or wires, or a combination of these.

The general survival rate to hospital discharge was 39%. Of the horses that underwent surgical repair, 56% survived to hospital discharge, while 90% of those managed conservatively survived to hospital discharge.

Conclusions

Although follow-up was not conducted for all cases post their discharge and some data were incompletely recorded, the research suggests that earlier identified causative factors for AAD were not consistently present as features in this study. It also reveals that surgical site infection post-laparotomy and the condition of horses being pregnant or in the early post-partum period may be important risk factors for AAD. More investigation on this front is recommended by the researchers.

Cite This Article

APA
Hann MJ, Mair TS, Gardner A, Mudge M, Southwood LL, Dechant JE, Barton MH, Garcia-Macias J, Parker RA, Hassel D, Archer DC. (2021). Acute abdominal dehiscence following laparotomy: A multicentre, international retrospective study. Equine Vet J. https://doi.org/10.1111/evj.13498

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Hann, Michelle J
  • Department of Equine Clinical Science, Institute of Veterinary Science, University of Liverpool, Leahurst Campus, Neston, UK.
Mair, Tim S
  • Bell Equine Veterinary Clinic, Maidstone, UK.
Gardner, Alison
  • Department of Veterinary Clinical Sciences, Ohio State University, Columbus, Ohio, USA.
Mudge, Margaret
  • Department of Veterinary Clinical Sciences, Ohio State University, Columbus, Ohio, USA.
Southwood, Louise L
  • Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania, USA.
Dechant, Julie E
  • Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA.
Barton, Michelle H
  • University of Georgia College of Veterinary Medicine, Athens, Georgia, USA.
Garcia-Macias, Jesus
  • Troytown Greyabbey Equine Veterinary Services, Kildare, Ireland.
Parker, Russell A
  • Liphook Equine Hospital, Liphook, UK.
Hassel, Diana
  • Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Archer, Debbie C
  • Department of Equine Clinical Science, Institute of Veterinary Science, University of Liverpool, Leahurst Campus, Neston, UK.

References

This article includes 28 references
  1. Marshall JF, Blikslager AT. Surgical approaches to the abdomen.. In: Auer JA, Stick JA, Kummerle J, Prange T, editors. Equine Surgery. 5th ed. St Louis, Missouri: Elsevier Inc., 2018; p. 521-8.
  2. Salem SE, Proudman CJ, Archer DC. Prevention of post operative complications following surgical treatment of equine colic: current evidence.. Equine Vet J 2016;48:143-51.
  3. Toth F, Schumacher J. Abdominal Hernias.. In: Auer JA, Stick JA, Kummerle J, Prange T, editors. Equine Surgery. 5th edn. St Louis, Missouri: Elsevier Inc., 2018; p. 645-59.
  4. Kobluk CN, Ducharme NG, Lumsden JH, Pascoe PJ, Livesey MA, Hurtig M. Factors affecting incisional complication rates associated with colic surgery in horses: 78 cases (1983-1985).. J Am Vet Med Assoc 1989;195:639-42.
  5. Stone WC, Lindsay WA, Mason ED, Wilson DG. Factors associated with acute wound dehiscence following equine abdominal surgery.. In: Proceedings of the 4th Equine Colic Research Symposium. 1990; p. 52.
  6. Tulleners EP, Donawick WJ. Secondary closure of infected abdominal incisions in cattle and horses.. J Am Vet Med Assoc 1983;182:1377.
  7. McIlwraith CW. Complications of laparatomy incisions in the horse [Sheath, suture sinuses and peritonitis].. Proc Am Assoc Equine Practnrs 1978.
  8. McGlinchey L, Hanson RR, Boone LH, Rosanowski SM, Coleridge M, Souza C. Bursting strength of surgeon’s and self-locking knots for closure of ventral midline celiotomy in horses.. Vet Surg 2018;47:1080-6.
  9. Mäkelä JT, Kiviniemi H, Juvonen T, Laitinen S. Factors influencing wound dehiscence after midline laparotomy.. Am J Surg 1995;170:387-90.
  10. Trostle SS, Wilson DG, Stone WC, Markel MD. A study of the biomechanical properties of the adult equine linea alba: relationship of tissue bite size and suture material to breaking strength.. Vet Surg 1994;23:435-41.
  11. Verkade ME, Ugahary F, Martens A, Wiemer P. Clinical and ultrasonographic evaluation of three suture techniques for closure of the equine linea alba.. Equine Vet Educ 2020;32:646-53.
  12. Fierheller EE, Wilson DG. 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.. Vet Surg 2005;34:18-23.
  13. Rinnovati R, Romagnoli N, Stancampiano L, Spadari A. Occurrence of incisional complications after closure of equine ventral midline celiotomies with 2 polyglycolic acid in simple interrupted suture pattern.. J Equine Vet Sci 2016;47:80-3.
  14. Salciccia A, de la Rebière de Pouyade G, Gougnard A, Detilleux J, Caudron I, Verwilghen D. Complications associated with closure of the linea alba using a combination of interrupted vertical mattress and simple interrupted sutures in equine laparotomies.. Vet Rec 2020;187:e94.
  15. Salem SE, Proudman CJ, Archer DC. Prevention of post operative complications following surgical treatment of equine colic: current evidence.. Equine Vet J 2016;48:143-51.
  16. Riou J-PA, Cohen JR, Johnson H Jr. Factors influencing wound dehiscence.. Am J Surg 1992;163:324-30.
  17. Pavlidis TE, Galatianos IN, Papaziogas BT, Lazaridis CN, Atmatzidis KS, Makris JG. Complete dehiscence of the abdominal wound and incriminating factors.. Eur J Surg 2001;167:351-4.
  18. van Ramshorst GH, Nieuwenhuizen J, Hop WCJ, Arends P, Boom J, Jeekel J. Abdominal wound dehiscence in adults: development and validation of a risk model.. World J Surg 2009;34:20.
  19. George Broughton II, Janis JE, Attinger CE. Wound healing: an overview.. Plast Reconstr Surg 2006;117.
  20. Ross J, Palmer JE, Wilkins PA. Body wall tears during late pregnancy in mares: 13 cases (1995-2006).. J Am Vet Med Assoc 2008;232:257-61.
  21. Roberts SJ. Rupture of the prepubic tendon or prepubic desmorrhexis of pregnancy.. In: Roberts SJ, ed. Veterirur Obstet Genit Dis. 2nd ed. Ann Arbor, Michigan: Edwards Brothers Inc., 1971; pp 184-6.
  22. Mota P, Pascoal AG, Vieira F. Changes in superficial abdominal muscles morphology during pregnancy: a case study.. Int Soc Biomech XXIII Congress 2011;3-7.
  23. Gilleard WL, Brown JMM. Structure and function of the abdominal muscles in primigravid subjects during pregnancy and the immediate postbirth period.. Phys Ther 1996;76:750-62.
  24. Weatherall KM, Boone LH, Munsterman A, Hanson RR. Ex vivo comparison of the bursting strength of an equine ventral midline celiotomy covered by two standard abdominal bandages.. Vet Surg 2021;50:615-21.
  25. Fuchs F, Bruyere M, Senat M-V, Purenne E, Benhamou D, Fernandez H. Are standard intra-abdominal pressure values different during pregnancy?. PLoS One 2013;8(10):e77324.
  26. de Paula VB, Canola PA, Rivera GG, Bonacin YS, Del Rio LA, Canola JC. Intra-abdominal pressure screening of horses with colic.. J Equine Vet Sci 2020;90:102998.
  27. Cullen MD, Archer DC, Mair TS. Clinical audit in equine practice, and the international colic surgery audit.. Equine Vet Educ 2020;32(4):172-4.
  28. Anderson SL, Bracamonte JL, Hendrick S, Carmalt JL, Wilson DG. Ex vivo comparison of bursting strength of ventral median and right ventral paramedian celiotomies in horses.. Vet Surg 2013;42:468-72.

Citations

This article has been cited 1 times.
  1. Gaitan HM, Mudge MC, Litsky AS, Arruda AG, Gardner AK. Ex vivo biomechanical evaluation of tissue construct strength in an equine colopexy model. Vet Surg 2025 Jan;54(1):189-198.
    doi: 10.1111/vsu.14117pubmed: 38975740google scholar: lookup
Subscribe to our newsletter
Join 99,316 horse owners like you who receive our email updates on horse health and nutrition.