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Home / Equine Research Bank / Vet Surg / Ex vivo biomechanical evaluation of tissue construct strengt...
Veterinary surgery : VS2024; 54(1); 189-198; doi: 10.1111/vsu.14117

Ex vivo biomechanical evaluation of tissue construct strength in an equine colopexy model.

Abstract: To compare strength of left paramedian colopexies using various techniques in equine ex vivo models. Methods: Experimental study. Methods: Equine cadavers euthanized for nongastrointestinal pathology (36 specimens derived from 9 horses). Methods: Colopexies were performed after euthanasia. Suture pattern (horizontal mattress vs. cruciate) and incorporation of dorsal sheath of the rectus abdominis (partial-thickness) versus incorporation of dorsal and ventral sheath of the rectus abdominis (full-thickness) were evaluated. Single cycle load to failure, work to peak load, stiffness, and mode of failure of colopexy tissue constructs were assessed. Results: Mean load to failure of all constructs ranged from 102.26 to 166.38 N. Partial-thickness bites demonstrated a mean load to failure and standard deviation (SD) of 111.91 (35.88) N and 102.26 (30.06) N (p < .05) which was significantly lower than the mean and SD of full-thickness bites (166.3 [72.42] N and 163.21 [51.40 N]), respectively. All full-thickness bites regardless of suture pattern and over half of partial-thickness bites failed at the colonic wall. There was no significant difference in load to failure compared to mode of failure. Conclusions: A stronger colopexy was achieved with a full-thickness bite regardless of the suture pattern. The most common mode of failure was the colon wall. Conclusions: Incorporating ventral and dorsal fascia of the rectus abdominus provided a stronger colopexy structure, which may necessitate a second incision or subcutaneous palpation of the needle when performing a colopexy. The lateral band of the colon failed in most constructs (77%) regardless of technique, which could weaken the colonic wall and risk colonic rupture.
© 2024 The Author(s). Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
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Publication Date: 2024-07-08 PubMed ID: 38975740PubMed Central: PMC11734877DOI: 10.1111/vsu.14117Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

  • This study evaluated the strength of different surgical techniques for attaching the colon to the abdominal wall (colopexy) in horse cadaver models.
  • The goal was to identify which technique provides the strongest attachment to help inform surgical practices and avoid complications such as colon rupture.

Study Purpose and Background

  • The researchers wanted to compare the biomechanical strength of left paramedian colopexies performed using various suture patterns and techniques in horses.
  • Colopexy is a surgical procedure where the colon is attached to the abdominal wall to prevent displacement or torsion, important in equine abdominal surgeries.
  • Understanding which suture technique offers the best strength can reduce the risk of post-surgical complications like colonic rupture.

Materials and Methods

  • Subjects: 9 horses euthanized for reasons unrelated to gastrointestinal disease provided 36 abdominal specimens.
  • Procedure: Various colopexy techniques were performed on these equine cadaver specimens post-euthanasia.
  • Surgical Techniques:
    • Suture Patterns Tested: horizontal mattress vs. cruciate patterns.
    • Incorporation of abdominal wall layers:
      • Partial-thickness: only the dorsal sheath of the rectus abdominis muscle incorporated.
      • Full-thickness: both dorsal and ventral sheaths of the rectus abdominis muscle incorporated.
  • Biomechanical Testing:
    • Single cycle load to failure (maximum force before the construct fails).
    • Work to peak load (energy absorbed up to failure).
    • Stiffness (resistance to deformation before failure).
    • Mode of failure (where or how the construct failed, e.g., colon wall or suture tissue).

Results

  • Load to Failure:
    • All constructs showed load to failure ranging from approximately 102 to 166 Newtons.
    • Partial-thickness bites had significantly lower mean load to failure (around 102-112 N) compared to full-thickness bites (around 163-166 N), indicating they were weaker.
  • Mode of Failure:
    • More than half of partial-thickness constructs and all full-thickness constructs failed at the colonic wall rather than the suture or fascial tissues.
    • MOST commonly, failure occurred through the lateral band of the colon (77% of constructs), indicating this is a weaker point in the colonic wall.
  • Suture Pattern:
    • No significant difference found between horizontal mattress and cruciate suture patterns in terms of load to failure.

Conclusions and Clinical Implications

  • Full-thickness colopexy bites (incorporating both ventral and dorsal fascial layers) provide stronger tissue constructs than partial-thickness bites (incorporating only dorsal fascia), regardless of suture pattern used.
  • Stronger colopexy may require more comprehensive surgical technique, potentially necessitating:
    • A second surgical incision, or
    • Careful subcutaneous palpation during needle placement to properly engage both fascial layers.
  • The predominant failure site being the lateral band of the colon suggests that this area is vulnerable and may predispose to colonic rupture post-colopexy.
  • Choosing techniques that optimize colonic wall integrity and fascial incorporation may reduce postoperative complications in equine colopexy surgeries.

Cite This Article

APA
Gaitan HM, Mudge MC, Litsky AS, Arruda AG, Gardner AK. (2024). Ex vivo biomechanical evaluation of tissue construct strength in an equine colopexy model. Vet Surg, 54(1), 189-198. https://doi.org/10.1111/vsu.14117

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 54
Issue: 1
Pages: 189-198

Researcher Affiliations

Gaitan, Hannah M
  • Department of Veterinary Clinical Sciences College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
Mudge, Margaret C
  • Department of Veterinary Clinical Sciences College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
Litsky, Alan S
  • Departments of Orthopedics and Engineering, College of Medicine, The Ohio State University, Columbus, USA.
Arruda, Andreia G
  • Department of Veterinary Preventive Medicine College of Veterinary Medicine, The Ohio State University, Columbus, USA.
Gardner, Alison K
  • Department of Veterinary Clinical Sciences College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.

MeSH Terms

  • Animals
  • Horses / surgery
  • Cadaver
  • Biomechanical Phenomena
  • Suture Techniques / veterinary
  • Colon / surgery

Conflict of Interest Statement

The authors declare no conflicts of interest related to this report.

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