Surgical Closure of Equine Abdomen, Prevention, and Management of Incisional Complications.

The research article explores various techniques to reduce the occurrence and expedite the resolution of incisional complications from ventral midline laparotomy surgery in horses. A method of incision closure characterized by the use of specific types of sutures on the linea alba shows promising results, although repeat surgeries had a higher occurrence of complications.

Surgical Technique and Results

• The study presents a specific way of closing the incision made for celiotomy, a surgical operation involving the opening of the abdominal cavity. This method involves stitching the linea alba, a vertical band of fibrous tissue in the abdomen, with tension sutures made of polyglactin 910, which are then supported by additional polyglactin 910 sutures in a simple continuous pattern. An elastic bandage is also applied to the wound post-surgery.
• In terms of results, this technique has yielded positive figures. Incisional infections were confirmed in a relatively small percentage of cases, both after a single surgery and after repeated ones, albeit the rate was higher for the latter.
• The overall occurrence of incisional complications, which include various forms of discharge, hematoma, infection, hernia development, and complete wound breakdown, also had wider results. There was a significant increase in the rate of these complications following repeat surgeries.

Negative Pressure Therapy

• For incisions considered more vulnerable to infection – specifically, those resulting from early relaparotomy, or laparotomy incisions longer than 30 cm – the study explores the use of negative pressure therapy. This treatment was found easy to apply to closed incisions, and resulted in no observed negative effects.
• However, this part of the research lacks concrete evidence backing the prophylactic benefits of negative pressure therapy, indicating a need for further investigation using a larger subject group.
• In cases where a laparotomy wound was infected and required drainage, using negative pressure therapy appeared to have a positive impact on the formation of granulation tissue, necessary for wound healing. However, due to the lack of a control group, this result could not be statistically confirmed.

Case of Complete Breakdown

• One case of complete breakdown of the incision post-laparotomy was dealt with using stainless steel retention sutures, negative pressure therapy, and a hernia belt.
• This approach resulted in some smaller hernias forming, but the horse regained its previous level of sporting performance and did not experience any colic, thus demonstrating a successful recovery process.