Incisional complications following ventral median coeliotomy in horses. Does suturing of the peritoneum reduce the risk?

This research aimed to examine how often surgical complications occur after abdominal surgery in horses and if there are any associated risk factors. The study found that suturing the peritoneum, a membrane that covers abdominal organs, can reduce the risk of surgical complications.

Research Methodology

• The study is retrospective and involved studying patient records at the Large Animal Clinic for Surgery of the University of Leipzig from the years 2010-2015.
• The horses included in the study underwent ventral midline laparotomy, which is a surgical incision into the abdominal cavity, carried out due to colic.
• The researchers measured various parameters including the breed, sex, age of the horse, location of the colic disease, the intensity of the surgical procedure, duration of general anaesthesia, how the surgical incision was sutured, and postoperative signs such as fever or a decrease in white blood cell count (leukopenia).
• Surgeons’ observations of surgical complications, including the tearing of sutures, fluid seeping from the wound, swelling of the surgical incision, or the development of an incisional hernia where the contents of the abdomen protrude through the surgical wound were also recorded.

Research Findings

• Of the 202 horses in the study, 8.9% developed complications such as fluid seeping from the wound or the tearing of sutures. Postoperative hernia development was seen in 5.2% of the 173 patients studied.
• The risk for these complications was not affected by the breed, sex, location of the colic disease, the intensity of the surgical procedure, or the duration of general anaesthesia.
• The age of horse, presence of postoperative fever, and whether or not the peritoneum was sutured significantly affected the risk of surgical complications. Specifically, horses aged 20 years and older, those with postoperative fever, and those with unsutured peritoneum had an increased risk for complications.
• Patients with moderate to severe swelling of the surgical wound also had a significantly higher risk of developing surgical complications.

Conclusions

• The study concluded that a surgeon’s control over the suturing pattern can directly influence the risk of surgical complications. Specifically, the practice of suturing the peritoneum can reduce such risks and should be made a part of the standard procedure during wound closure in the horse.