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Incidence of incisional complications after exploratory celiotomy in equids affected with enterolithiasis.

Abstract: This study reports the prevalence of and risk factors for incisional complications in equids after ventral midline celiotomy for enterolithiasis. This study covered the years 2008 to 2015 and included 72 equids. Enteroliths were removed from the ascending or descending colon through 1 or more enterotomies. Complications were defined as surgical site infection and/or incisional hernia formation. Follow-up by telephone questionnaire or medical records determined that 10/72 (13.9%) equids experienced complications, with 6/72 (8.3%) developing a surgical site infection and 5/72 (6.9%) a hernia. Seven of ten were presented for chronic abdominal discomfort (> 24 hours), and 8/10 had right dorsal colon and pelvic flexure enterotomies. All equids that developed an incisional hernia and 4 with surgical site infection had enteroliths > 15 cm diameter removed from the right dorsal colon. Antimicrobial powder applied to the ventral midline incision during closure significantly reduced incisional complications. Removal of > 15 cm diameter enteroliths from the right dorsal colon may predispose to postoperative incisional complications. . Cette étude rapporte la prévalence et les facteurs de risque des complications incisionnelles chez les équidés opérés pour l’entérolithiase en utilisant une celiotomie médiane ventrale de 2008 à 2015. Soixantedouze équidés ont été inclus. Les entérolithes ont été retirés du côlon ascendant ou descendant par ≥ 1 entérotomies. Les complications étaient définies comme une infection du site opératoire et/ou la formation d’une hernie incisionnelle. Le suivi a été obtenu par questionnaire téléphonique ou par dossiers médicaux. Dix des 72 (13,9 %) des équidés ont eu des complications, dont 6/72 (8,3 %) ont développé une infection du site opératoire et 5/72 (6,9 %) une hernie. Sept sur 10 ont été présentés pour un malaise abdominal chronique (> 24 heures) et 8/10 avaient des entérotomies du côlon dorsal droit et de la flexion pelvienne. Tous les équidés ayant développé une hernie incisionnelle et quatre avec une infection du site opératoire avaient des entérolithes > 15 cm de diamètre prélevés du côlon dorsal droit. La poudre antimicrobienne appliquée sur l’incision médiane ventrale lors de la fermeture réduisait significativement les complications incisionnelles. Le retrait d’entolithes de > 15 cm de diamètre du côlon dorsal droit peut prédisposer aux complications incisionnelles postopératoires.(Traduit par les auteurs).
Publication Date: 2020-10-06 PubMed ID: 33012825PubMed Central: PMC7488371
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  • Journal Article

Summary

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The research article discusses the occurrence and risk factors of incisional complications in equids (horses, donkeys, etc) after undergoing a surgical procedure called ventral midline celiotomy for the condition of enterolithiasis, which involves the formation of stone-like structures in the gut. According to the study, complications predominantly occurred in cases where the stone-like structures or “enteroliths” that had been removed were greater than 15 cm in diameter.

Research Methodology

  • The study was conducted between 2008 and 2015 and included 72 equids.
  • Enteroliths, stone-like structures formed in the gut, were removed from either the ascending or descending colon, through one or more surgical cuts (enterotomies).
  • There were two primary forms of complications considered for the study – surgical site infection and the formation of an incisional hernia.
  • A follow-up was conducted via phone questionnaires or through a review of medical records.

Findings of the Study

  • Out of the 72 cases considered, complications arose in 10 i.e., 13.9%, cases.
  • 8.3% developed a surgical site infection while 6.9% went on to form an incisional hernia.
  • Most cases that experienced complications, seven out of ten, reported chronic abdominal discomfort, lasting more than 24 hours, before coming in for the procedure.
  • Eight out of the ten experiencing complications had undergone surgical cuts in the right dorsal colon and the pelvic flexure regions of their gut.
  • All cases that developed an incisional hernia and a majority, four out of six, that experienced a surgical site infection, had enteroliths larger than 15 cm diameter removed from their right dorsal colon.

Conclusions and Recommendations

  • The application of an antimicrobial powder on the incision during closure significantly reduced the chance of incisional complications.
  • It was observed that the removal of enteroliths with a diameter greater than 15 cm from the right dorsal colon potentially increases the risk of postoperative complications. Therefore, such cases may need to be handled with additional care and precautionary measures.

Cite This Article

APA
Crosa AT, Katzman SA, Kelleher ME, Nieto JE, Kilcoyne I, Dechant JE. (2020). Incidence of incisional complications after exploratory celiotomy in equids affected with enterolithiasis. Can Vet J, 61(10), 1085-1091.

Publication

ISSN: 0008-5286
NlmUniqueID: 0004653
Country: Canada
Language: English
Volume: 61
Issue: 10
Pages: 1085-1091

Researcher Affiliations

Crosa, Albert Torrent
  • William R. Pritchard Veterinary Medical Teaching Hospital (Torrent), Department of Surgical and Radiological Sciences (Katzman, Nieto, Kilcoyne, Dechant), School of Veterinary Medicine, University of California, Davis, California 95616, USA; Virginia-Maryland College of Veterinary Medicine, Marion duPont Scott Equine Medical Center, Leesburg, Virginia, USA (Kelleher).
Katzman, Scott A
  • William R. Pritchard Veterinary Medical Teaching Hospital (Torrent), Department of Surgical and Radiological Sciences (Katzman, Nieto, Kilcoyne, Dechant), School of Veterinary Medicine, University of California, Davis, California 95616, USA; Virginia-Maryland College of Veterinary Medicine, Marion duPont Scott Equine Medical Center, Leesburg, Virginia, USA (Kelleher).
Kelleher, Maureen E
  • William R. Pritchard Veterinary Medical Teaching Hospital (Torrent), Department of Surgical and Radiological Sciences (Katzman, Nieto, Kilcoyne, Dechant), School of Veterinary Medicine, University of California, Davis, California 95616, USA; Virginia-Maryland College of Veterinary Medicine, Marion duPont Scott Equine Medical Center, Leesburg, Virginia, USA (Kelleher).
Nieto, Jorge E
  • William R. Pritchard Veterinary Medical Teaching Hospital (Torrent), Department of Surgical and Radiological Sciences (Katzman, Nieto, Kilcoyne, Dechant), School of Veterinary Medicine, University of California, Davis, California 95616, USA; Virginia-Maryland College of Veterinary Medicine, Marion duPont Scott Equine Medical Center, Leesburg, Virginia, USA (Kelleher).
Kilcoyne, Isabelle
  • William R. Pritchard Veterinary Medical Teaching Hospital (Torrent), Department of Surgical and Radiological Sciences (Katzman, Nieto, Kilcoyne, Dechant), School of Veterinary Medicine, University of California, Davis, California 95616, USA; Virginia-Maryland College of Veterinary Medicine, Marion duPont Scott Equine Medical Center, Leesburg, Virginia, USA (Kelleher).
Dechant, Julie E
  • William R. Pritchard Veterinary Medical Teaching Hospital (Torrent), Department of Surgical and Radiological Sciences (Katzman, Nieto, Kilcoyne, Dechant), School of Veterinary Medicine, University of California, Davis, California 95616, USA; Virginia-Maryland College of Veterinary Medicine, Marion duPont Scott Equine Medical Center, Leesburg, Virginia, USA (Kelleher).

MeSH Terms

  • Animals
  • Horse Diseases / epidemiology
  • Horse Diseases / surgery
  • Horses
  • Incidence
  • Laparotomy / veterinary
  • Postoperative Complications / epidemiology
  • Postoperative Complications / veterinary
  • Surgical Wound / veterinary
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / veterinary

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Citations

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