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Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)2020; 30(2); 136-148; doi: 10.1111/vec.12936

Incisional infections associated with ventral midline celiotomy in horses.

Abstract: To review the veterinary literature regarding healing and complications associated with equine celiotomy including anatomy and physiology, risk factors for incisional infection and hernia, and treatment. Background: Celiotomy is the most common approach to treat horses with surgical colic. Incision through the linea alba provides exposure to most of the abdomen for exploration, exteriorization, and correction of surgical lesions. Incisional apposition relies on suture strength during anesthetic recovery and for the first 30 days postoperatively. Factors associated with the patient, surgical lesion and procedures, anesthesia, and recovery put the horse at risk for surgical site infection. Infection is the most important risk factor for incisional hernia formation. Methods: A presumptive diagnosis of surgical site infection is made based on the presence of fever and incisional swelling, pain, and discharge. Ultrasonography can be used to identify areas of fluid accumulation prior to the appearance of incisional drainage. Definitive diagnosis is based on positive bacteriologic culture of the incisional discharge. Incisional hernia is diagnosed by palpation of the incision, usually 30-60 days after surgery. Ultrasound of the incision may aide in early diagnosis of incisional hernia if gaps along the incision in the linea alba are apparent. Methods: No objective data exist to assess the efficacy of specific therapies for surgical site infections following celiotomy. Principles of treatment include the establishment of drainage, bandaging, antimicrobial therapy based on culture and sensitivity, and extended rest in an attempt to avoid incisional hernia or dehiscence. Treatment for incisional hernia includes prolonged circumferential bandaging, open or minimally invasive hernia repair, or no treatment. Conclusions: Incisional complications are associated with prolonged convalescence and diminished prognosis for return to athleticism. Limiting risk factors for surgical site infections, prompt treatment, and incisional support may optimize celiotomy healing and timely return to function. Horses compete in many disciplines with incisional hernias.
© Veterinary Emergency and Critical Care Society 2020.
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Publication Date: 2020-02-25 PubMed ID: 32100465DOI: 10.1111/vec.12936Google Scholar: Lookup
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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.

This research article is a comprehensive review of the veterinary literature related to the healing and complications of ventral midline celiotomy in horses, a common surgical procedure particularly in colic cases.

Background

  • According to the research, celiotomy is a type of surgical incision often made in horses to treat surgical colic
  • The incisional site, also known as the linea alba, provides exposure to most of the abdomen, aiding in the exploration, exteriorization, and correction of surgical lesions.
  • The healing process of this incision majorly depends on the suture strength during anesthetic recovery and for the first 30 days after surgery.
  • The study also highlights various risk factors that can result in surgical site infections in horses that undergo a celiotomy. These risk factors can be associated with the patient, the surgical procedures used, the anesthesia applied, and the recovery process.
  • Notably, infection in the initial incision is a significant risk factor in the formation of incisional hernias.

Methods

  • In diagnosing surgical site infections, practitioners rely on visible symptomology, such as fever, swelling, pain, and discharge at the incisional site. Ultrasonography may also assist this process by identifying fluid accumulation before the onset of incisional drainage.
  • A definitive diagnosis is reached once a positive bacteriologic culture of the incisional discharge is recorded.
  • Incisional hernias are typically diagnosed by palpating the surgical incision, around 30-60 days after the surgery. Ultrasound techniques can also reveal early signs of incisional hernia by identifying gaps along the incision in the linea alba.
  • The research points out that there is no objective data to evaluate the efficacy of specific therapies following incisional infections after celiotomy.

Treatment and Conclusions

  • Treatment for surgical site infections involve draining the infected area, bandaging, and antimicrobial therapy as per the culture and sensitivity results. Extended rest periods are included to avoid incisional hernia or dehiscence.
  • Hernias are treated using a combination of prolonged bandaging, open or minimally invasive hernia repairs, or in some cases, no treatment is offered.
  • From the research, it is apparent that incisional complications can result in a longer recovery period and a lower chance of the horse returning to peak physical performance.
  • To maximize the healing process and speedy return to function, the research suggests minimizing the risk factors for surgical site infections, prompt treatment for any arising complications, and providing proper incisional support.
  • Even with incisional hernias, it is noted that horses can still compete in various disciplines.

Cite This Article

APA
Shearer TR, Holcombe SJ, Valberg SJ. (2020). Incisional infections associated with ventral midline celiotomy in horses. J Vet Emerg Crit Care (San Antonio), 30(2), 136-148. https://doi.org/10.1111/vec.12936

Publication

Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)
ISSN: 1476-4431
NlmUniqueID: 101152804
Country: United States
Language: English
Volume: 30
Issue: 2
Pages: 136-148

Researcher Affiliations

Shearer, Tara R
  • Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI.
Holcombe, Susan J
  • Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI.
Valberg, Stephanie J
  • Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI.

MeSH Terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Horse Diseases / etiology
  • Horse Diseases / pathology
  • Horses
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / therapy
  • Surgical Wound Infection / veterinary
  • Wound Healing

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Citations

This article has been cited 4 times.
  1. Gozalo-Marcilla M, Ringer SK. Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature. Animals (Basel) 2021 Jun 14;11(6).
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  2. Crabtree NE, Capper AM, McKinnon LH, Epstein KL. Perioperative factors and outcomes associated with antimicrobial therapy duration in horses undergoing exploratory celiotomy. Can Vet J 2025 Jun;66(6):653-662.
    pubmed: 40510283
  3. Griessel TS, Muñoz Morán JA, Byaruhanga C, Smit Y. A single-centre retrospective study of surgical site infection following equine colic surgery (2013‒2021). Vet Rec 2025 May 17;196(10):e5227.
    doi: 10.1002/vetr.5227pubmed: 40123113google scholar: lookup
  4. Isgren CM, Pinchbeck GL, Salem SE, Hann MJ, Townsend NB, Cullen MD, Archer DC. Evaluation of a stent dressing and abdominal bandage on surgical site infection following emergency equine laparotomy: A randomised controlled trial. Equine Vet J 2025 Nov;57(6):1466-1477.
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