Comparison of 3 suture closure techniques for pelvic flexure enterotomy in equine cadaveric large colon.

This research article discusses a comparison of three different methods of closing a surgical incision in the large colon of an equine cadaver. It was found that a two-layer closure with suture line reversal could be a potential alternative to traditional closure methods based on resistance to bursting pressure and closure time.

Research Methods

• The study was carried out ex vivo, meaning it was conducted outside of the normal biological context, utilising large colon segments from adult horses (a total of 18 specimens).
• The pelvic flexures, which are parts of the colon, were removed from 18 horses and were randomly selected to undergo one of three closure techniques, ensuring six trials for each technique.
• A 10-centimeter surgical cut (enterotomy) was then made in each pelvic flexure and closed using the assigned technique. The researchers then recorded various data for each specimen like the time it took to close the incision, the inner diameter of the colon via contrast radiographs, and the pressure at which the closure would burst.
• The results of all three techniques were compared using a statistical test known as 1-way ANOVA with post-hoc testing (Duncan post hoc test) and a significance level of less than 0.05.

Research Findings

• Differences were found in the time it took to close the incision, with the one-layer closure technique being faster than both the traditional two-layer closure and the two-layer closure with reversed suture line.
• However, they found no significant difference in the diameter of the colon lumen or the bursting pressure, implying that the strength of the closures were comparable across all three techniques.
• Therefore, they concluded that a two-layer closure with a reversed suture line could potentially be an alternative to the traditional two-layer closure, given its similar performance in terms of strength (bursting pressure) and slightly longer closure time.
• Interestingly, the one-layer closure method was also found to resist bursting pressure at levels not significantly different to the two-layer techniques, while offering a quicker closure time.
• The authors suggested that further in vivo (within the living organism) studies could prove useful to confirm these findings.