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The Veterinary record2023; 192(9); e2732; doi: 10.1002/vetr.2732

Benefits of cyanoacrylate mesh closure following exploratory laparotomy in horses.

Abstract: Skin closure of laparotomy incisions using topical 2-octyl cyanoacrylate (2-OCA) mesh provides a secure bactericidal barrier in humans, which may reduce the risk of postoperative incisional complications. However, the benefits of using this mesh have not been objectively assessed in horses. Methods: From 2009 to 2020, three methods of skin closure were used following laparotomy for acute colic, including metallic staples (MS), suture (ST) and cyanoacrylate mesh (DP). The closure method was not randomised. Owners were contacted 3 months or more after the surgery to record any postoperative complications that occurred. For each method of closure, the rates of surgical site infection (SSI) and herniation were recorded, as well as surgical time and treatment costs, including those for incisional complications. Chi-square testing and logistic regression modelling were used to assess differences between the groups. Results: A total of 110 horses were recruited (45 in the DP group, 49 in the MS group and 16 in the ST group) The overall rate of SSI was 15.5%, with rates of 8.9%, 18.4% and 25% for the DP, MS and ST groups, respectively (p = 0.23). In addition, incisional hernias developed in 21.8% of cases, with 8.9%, 34.7% and 18.8% of horses in the DP, MS and ST groups, respectively, being affected (p = 0.009). The median total treatment cost did not differ significantly between groups (p = 0.47). Conclusions: This was a retrospective study with non-randomised choice of closure method. Conclusions: No significant differences in the rate of SSI or overall cost wwere demonstrated between treatment groups. However, MS was associated with a higher rate of hernia formation than DP or ST. Despite increased capital cost, 2-OCA proved to be a safe skin closure method in horses and was no more expensive than DP or ST by the time visits to remove sutures/staples and treat infections were factored in.
Publication Date: 2023-02-21 PubMed ID: 36809672DOI: 10.1002/vetr.2732Google Scholar: Lookup
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  • Journal Article

Summary

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The study investigates the use of a topical adhesive mesh for closing incisions after surgery in horses, suggesting it’s a safe, cost-effective method compared to traditional sutures or staples, notably with a lesser association with hernia formation despite higher initial cost.

Methods Used

  • The study was conducted over a span of 11 years (2009-2020).
  • Three methods of skin closure were utilized after horse laparotomy surgery: metallic staples (MS), suture (ST), and a cyanoacrylate adhesive mesh (DP).
  • Choice of closure method was not randomized.
  • Owners of the horses were followed up with three or more months after surgery to document postoperative complications.
  • The rates of surgical site infection (SSI) and herniation (bulging of an organ or tissue through an abnormal opening), surgical time, and treatment costs were tracked for each closure method.
  • Data was analyzed using chi-square testing and logistic regression modelling.

Research Findings

  • A total of 110 horses were recruited for the study with varying numbers in each group (45 in the DP group, 49 in the MS group, and 16 in the ST group).
  • The overall rate of SSI across all groups was 15.5% – with lower rate in DP group (8.9%) than MS (18.4%) and ST (25%) groups.
  • Incisional hernias were found in 21.8% of total cases. Again, the DP group (8.9%) had lower rates than the MS (34.7%) and ST (18.8%) groups.
  • There was no significant difference in total treatment costs between the three groups.

Study Conclusion

  • Despite being a retrospective study with non-randomized selection of closure method, the research provides valuable insights.
  • No significant difference was found in the rate of SSI incidents or overall treatment cost among the three groups.
  • However, the use of metallic staples (MS) was linked to a higher rate of hernia formation than either DP or ST.
  • Although 2-octyl cyanoacrylate (2-OCA) adhesive mesh has a higher initial cost, it’s proven to be a safe, eventually cost-effective skin closure method in horses, particularly when the costs associated with follow-up visits to remove sutures or staples and treating infections are factored in.

Cite This Article

APA
Terschuur JA, Coomer RPC, Handel I, Pressanto MC, McKane SA. (2023). Benefits of cyanoacrylate mesh closure following exploratory laparotomy in horses. Vet Rec, 192(9), e2732. https://doi.org/10.1002/vetr.2732

Publication

ISSN: 2042-7670
NlmUniqueID: 0031164
Country: England
Language: English
Volume: 192
Issue: 9
Pages: e2732

Researcher Affiliations

Terschuur, Janine Astrid
  • Cotts Equine Hospital, Robeston Wathen, Narberth, Wales, UK.
Coomer, Richard P C
  • Cotts Equine Hospital, Robeston Wathen, Narberth, Wales, UK.
Handel, Ian
  • The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Roslin, Midlothian, UK.
Pressanto, Maria Chiara
  • Cotts Equine Hospital, Robeston Wathen, Narberth, Wales, UK.
McKane, Shaun A
  • Cotts Equine Hospital, Robeston Wathen, Narberth, Wales, UK.

MeSH Terms

  • Humans
  • Horses
  • Animals
  • Laparotomy / adverse effects
  • Laparotomy / veterinary
  • Retrospective Studies
  • Surgical Mesh / veterinary
  • Surgical Mesh / adverse effects
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / prevention & control
  • Surgical Wound Infection / veterinary
  • Cyanoacrylates / therapeutic use
  • Horse Diseases / surgery

References

This article includes 25 references
  1. Proudman CJ, Smith JE, Edwards GB, French NP. Long-term survival of equine surgical colic cases. Part 1: patterns of mortality and morbidity.. Equine Vet J 2002;34(5):432-7.
  2. Freeman KD, Southwood LL, Lane J, Lindborg S, Aceto HW. Post-operative infection, pyrexia and perioperative antimicrobial drug use in surgical colic patients.. Equine Vet J 2012;44(4):476-81.
  3. Mair TS, Smith LJ. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 2: short-term complications.. Equine Vet J 2005;37(4):303-9.
  4. Isgren CM, Salem SE, Archer DC, Worsman FCF, Townsend NB. Risk factors for surgical site infection following laparotomy: effect of season and perioperative variables and reporting of bacterial isolates in 287 horses.. Equine Vet J 2017;49(1):39-44.
  5. Ingle-Fehr JE, Baxter GM, Howard RD, Trotter GW, Stashak TS. Bacterial culturing of ventral midline celiotomies for prediction of postoperative incisional complications in horses.. Vet Surg 1997;26:7-13.
  6. Gibson KT, Curtis CR, Turner As, McIlwraith CW, Aanes WA, Stashak TS. Incisional hernias in the horse. Incidence and predisposing factors.. Vet Surg 1989;18:360-6.
  7. Honnas CM, Cohen ND. Risk factors for wound infection following celiotomy in horses.. J Am Vet Med Assoc 1997;210(1):78-81.
  8. Bischofberger AS, Brauer T, Gugelchuk G, Klohnen A. Difference in incisional complications following exploratory celiotomies using antibacterial-coated suture material for subcutaneous closure: prospective randomised study in 100 horses.. Equine Vet J 2010;42(4):304-9.
  9. Coomer RPC, Mair TS, Edwards GB, Proudman CJ. Do subcutaneous sutures increase risk of laparotomy wound suppuration?. Equine Vet J 2007;39(5):396-9.
  10. Colbath AC, Patipa L, Berghaus RD, Parks AH. The influence of suture pattern on the incidence of incisional drainage following exploratory laparotomy.. Equine Vet J 2014;46(2):156-60.
  11. 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.
  12. Smith LJ, Mellor DJ, Marr CM, Reid SW, Mair TS. Incisional complications following exploratory celiotomy: does an abdominal bandage reduce the risk?. Equine Vet J 2007;39:277-83.
  13. Kilcoyne I, Nieto JE, Dechant JE. A comparative study of the effect of different stent bandages on the likelihood of incisional complications following exploratory laparotomy in horses with colic.. Equine Vet Educ 2017;29:38.
  14. Tnibar A, Grubbe Lin K, Thuroe Nielsen K, Christophersen MT, Lindegaard C, Martinussen T. Effect of incisional infection following exploratory celiotomy for colic in horses: a comparative retrospective study.. Equine Vet J 2013;45(5):564-9.
  15. Kitshoff AM, Louwagie J, Or M, Devriendt N, Dehuisser V, Koenraadt A. Biomechanical properties of celiotomy wounds closed with tape and cyanoacrylate versus intradermal sutures.. Vet Surg 2018;47(8):1087-93.
  16. Gristina AG, Price JL, Hobgood CD, Webb LX, Costerton JW. Bacterial colonization of percutaneous sutures.. Surgery 1985;98:12-8.
  17. Nitsch A, Pabyk A, Honig JF, Verheggen R, Merten HA. Cellular, histomorphologic, and clinical characteristics of a new octyl-2-cyanoacrylate skin adhesive.. Aesthetic Plast Surg 2005;29:53-8.
  18. Singer AJ, Quinn JV, Hollander JE. The cyanoacrylate topical skin adhesives.. Am J Emerg Med 2008;26(4):490-6.
  19. Narang U, Maiwaring L, Spath G, Barefoot J. In vitro analysis for microbial barrier properties of 2-octylcyanoacrylate-derived wound treatment films.. J Cutan Med Surg 2003;7(1):13-9.
  20. Rushbrook JL, White G, Kidger L, Marsh P, Taggart TF. The antibacterial effect of 2-octylcyanoacrylate (Dermabond) skin adhesive.. J Infect Prevent 2014;15(6):236-9.
  21. Lepage OM, Moulin N, Francois I, Gangi M. Topical skin adhesive and knotless barbed absorbable material for ventral equine abdominoplasty: a comparative clinical study.. In: Proceedings of the short communications soft tissue, ECVS Annual Scientific Meeting, Budapest. 2019.
  22. Martinez-Lopez J, Brown JA, Werre SR. Incisional complications after skin closure with n-butyl cyanoacrylate or stainless-steel skin staples in horses undergoing colic surgery.. Vet Surg 2021;50(1):186-95.
  23. Aristizabal FA, Lopes MA, Silva A, Avanza MF, Nieto JE. Evaluation of the effect of onlay mesenteric flaps on end-to-end jejunojejunostomy healing in horses.. Vet Surg 2014;43:479-86.
  24. Mair TS, Smith LJ. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 3: long-term complications and survival.. Equine Vet J 2005;37(4):310-4.
  25. Marshall JF, Blikslager AT. Colic: diagnosis, surgical decision, preoperative management, and surgical approaches to the abdomen.. In: Auer JA, Stick JA, Kummerle JM, Prange T, editors. Equine surgery. 5th ed. (2020). Elsevier; 2019. p. 256.

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