Rectal tear repair using barbed suture in the horse.

The research investigates the effectiveness of using barbed sutures to repair rectal tears in horses. Three cases with varying severity of injury were studied, with mostly positive results; however, additional surgical procedures may be required for complex tears.

Methodology

• The study made use of 3 horses aged between 3 and 10 years old, with grade 3 to 4 rectal tears. These horses were referred for surgical repair after their injuries from iatrogenic tears or tearing during childbirth.
• The selected suture was the integral-anchor barbed suture (Stratafix Symmetric PDS Plus, size 1, 18″ CT-1), and it was placed with either long-handled instruments or by hand closure, depending on how easy it was to access and see the tear.
• The closure of grade 3 tears was done with a continuous appositional pattern, and a horizontal mattress pattern was used for the grade 4 tear. Apart from these procedures, no other surgical operations were performed.

Results

• Among the three cases, two horses with grade 3 tears healed successfully without postoperative complications, and the horses were discharged from hospital.
• One horse with a grade 4 tear was also repaired successfully, but a complication arose – a partial dehiscence (splitting open or breaking down) of the suture site four days after the operation. This led to the horse being euthanized.

Conclusions

• The findings suggest that grade 3 rectal tears can be successfully repaired using the integral-anchor barbed suture, and no post-op issues were recorded in these cases.
• The procedure could be carried out blind in cranial locations when visibility was poor.
• However, the procedure was not fully successful in the case of the grade 4 tear. This suggests that more complex rectal tear grades might require additional surgical procedures beyond the barbed suture closure approach.