Comparison of tensile strength and early healing of acute repeat celiotomy through a ventral median or a right ventral paramedian approach.

This study compares the tensile strength and healing process of acute repeat abdominal surgery (celiotomy) performed through a ventral median (middle) or a right ventral side approach on horses. The findings suggest both surgical approaches result in similar levels of wound healing and strength.

Research Methodology

• The researchers conducted an experimental study ex vivo (outside a living organism) on 18 adult horses.
• 12 of these horses initially underwent a ventral median celiotomy. A repeat celiotomy was performed 72 hours later either through the original ventral median or the right ventral paramedian incision.
• The celiotomies were scored daily for swelling (edema), fluid leakage (drainage), and wound separation (dehiscence).
• After 14 days post the second surgery, the animals were euthanized and their abdominal wall tissue, containing the celiotomy incisions, were collected for biomechanical and histological evaluation.
• The abdominal wall of the control horses, which did not undergo any surgery, was also collected for biomechanical testing.

Data Analysis and Results

• Various variables, including vital signs, incisional edema, and histologic scores, were compared using a Wilcoxon signed-rank test, which is used for comparing paired populations.
• Incisional fibrotic depth (thickness of fibrous tissue in the incision) and tensile strength (ability to withstand pulling force) were compared using repeated measures ANOVA, a statistical test often used in clinical trials.
• The horses with the ventral median and right ventral paramedian repeat celiotomies had significantly less tensile strength than the control group, which hadn’t undergone any surgery.
• However, there was no observed difference between the tensile strengths of the two surgical approaches.
• Similarly, the healing process, inflammation, infection rates, and tissue death (necrosis) of the repeat celiotomies were comparable for the two incision methods.
• However, the right ventral paramedian group had higher fibrin and hemorrhage within the incision and showed more swelling (edema).

Conclusion

• Overall, this research concludes that an acute repeat celiotomy (abdominal surgery) in horses, whether performed through a traditional ventral median incision or a right ventral side approach, results in similar wound healing and tensile strength of the tissue.