An evaluation of the haemostatic suture in hysterotomy closure in the mare.

The research examined the efficacy of a hemostatic suture in mitigating hemorrhaging after a cesarean section in horse mares. Despite the use of the hemostatic suture, the researchers found no significant reduction in post-operative bleeding or severe uterine hemorrhage.

Methodology & Data Collection

• The study gathered data from two university hospitals between 1982 and 1994. A total of 48 mares who underwent C-section due to dystocia, another 10 who had elective C-sections, and 8 who had C-sections along with colic surgery were included in the study.
• Researchers used a hemostatic suture in 31 of 66 mares, which accounted for 47% of all cases.

Findings

• The study revealed that the surgery period was significantly shorter when the hemostatic suture was not used.
• Anemia, identified as packed cell volume less than 30%, was observed in 13 (22%) of the 58 mares, excluding the group that underwent colic surgery. The incidence of anemia was not altered by the use of the hemostatic suture.
• Post-delivery anemia was more likely following a C-section compared to a vaginal birth, indicating that bleeding from the uterine incision (hysterotomy) is a common and severe complication of C-sections in mares.
• Severe uterine bleeding was recorded in 3 mares that had the haemostatic suture (10%) and in 2 mares that did not (6%). Tragically, the two mares without the suture died due to haemorrhage.

Implications & Recommendations

• The use of the hemostatic suture did not eliminate the risk or incidence of post-operative anaemia and severe uterine bleeding. As such, it does not improve outcomes significantly for mares undergoing a caesarean section.
• Without the use of a hemostatic suture, the researchers suggested that a full thickness suture pattern, tight enough to compress blood vessels in the uterine wall, should be used to close the uterus after surgery.