Comparison of suture materials and suture patterns for inverting intestinal anastomosis of the jejunum in the horse.

The research article discusses the efficacy of different suture materials and patterns in inverting intestinal anastomosis operations for horses, evaluating outcomes such as adhesion formation, post-operative obstruction, and lumen diameter reduction.

Research Methodology

• The study was conducted on seven horses, each of which underwent four intestinal anastomosis surgeries using various combinations of synthetic absorbable monofilament and multifilament suture materials in conjunction with continuous and interrupted suture patterns.
• The operations involved the serosubmucosal layer of a 2-layer inverting-suture technique.
• Post-operative conditions of the horses were evaluated after 30 days, with a focus on adhesion formation, lumen diameter, evidence of chronic obstruction, and suture tract inflammation at the anastomosis site.

Results and Observations

• Five out of the seven horses experienced postoperative obstruction, while total of six horses survived past the study period.
• One horse had to be euthanized on the 6th postoperative day due to 48 hours of ileus and obstruction. This horse’s necropsy revealed a partial intussusception involving anastomosis done with continuous multifilament suture material.
• Two more horses experienced obstruction between postoperative days 3 and 5 and exhibited prolonged ileus and gastric reflux up till 48 hours, but still survived. Horses that suffered obstruction after the 6th postoperative day recovered within 4 hours.

Impact of Suture Material and Pattern

• Use of the continuous inverting-suture pattern in the serosubmucosal layer resulted in significantly fewer adhesions compared to the interrupted pattern. The type of suture material did not have an effect on adhesion formation.
• No significant difference was found in terms of reduction of lumen diameter between the various techniques employed. There was also no evidence of chronic obstruction related to any type of anastomosis.
• Suture tract inflammation was found to be moderate in anastomoses using continuous-multifilament suture, with neutrophils being the most common cell type. Those with continuous-monofilament suture observed milder inflammation with focal accumulations of neutrophils. Minimal inflammation was associated with both types in the interrupted pattern.