The influence of suture pattern on the incidence of incisional drainage following exploratory laparotomy.
Abstract: Incisional complications following exploratory celiotomy increase morbidity, extend hospitalisation and increase cost. Retrospective studies seek to identify risk factors and measures for prevention of surgical site infection. The relatively high incidence of incisional complications following exploratory laparotomy necessitates identification of ideal surgical closure methods. Objective: The study sought to identify the incidence of incisional drainage within our hospital population, and to identify risk factors for incisional complications while determining surgical practices that reduce the incidence of incisional drainage. Methods: Retrospective cohort study. Methods: A retrospective study, with telephone follow-up, was performed on 199 horses that underwent exploratory laparotomy at the University of Georgia from 2 January 2008 to 31 December 2010, examining associations between case background, lesion type, access to the lumen of the bowel, and closure methods and incisional draining. The linea alba incisions were closed by the primary surgeon and junior house officers closed the subcutaneous tissues and skin. Results: The incidence of purulent or persistent serosanguinous incisional drainage in 142 horses with complete follow-up information was 21.8%. Background, lesion type, and enterotomy or enterectomy were not associated with a significantly increased likelihood of incisional drainage. However, closure of the subcutaneous tissues and skin in a 2-layer, modified subcuticular pattern was associated with a significantly lower incidence of post operative incisional drainage. Follow-up information identified subsequent episodes of colic in 28.9% of horses. However, 80.3% of horses had returned to their previous level of work. Conclusions: Incisional drainage is common following ventral midline laparotomy. The use of a 2-layer, modified subcuticular closure was associated with a significant reduction in the incidence of incisional drainage compared with closure performed with skin sutures, but not closure performed with staples.
© 2013 EVJ Ltd.
Publication Date: 2013-07-08 PubMed ID: 23663132DOI: 10.1111/evj.12091Google Scholar: Lookup
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- Journal Article
Summary
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The research examines the impact of different suture patterns on the occurrence of drainage after exploratory laparotomy surgeries in horses, with findings suggesting that a 2-layer, modified subcuticular closure pattern significantly reduces the incidence of post-operative incisional drainage.
Objective and Methods
- The primary objective of this study was to isolate potential risk factors for incisional complications following exploratory laparotomy surgeries in horses and to identify surgical procedures that may help limit these complications.
- The research took the form of a retrospective cohort study, involving data from 199 horses that underwent exploratory laparotomy at the University of Georgia between 2008 and 2010.
- A variety of factors were considered in the study, including the background of each case, the type of lesion, whether or not the bowel lumen was accessed, and the method used for surgical closure.
Results
- Of the 142 horses that were followed up on post-surgery, 21.8% experienced purulent or persistent serosanguinous incisional drainage.
- Upon analysis, it was found that factors like background, lesion type, and whether an enterotomy or enterectomy was performed did not significantly influence the likelihood of incisional drainage.
- The research revealed that when a 2-layer, modified subcuticular closure was used to close the subcutaneous tissues and skin, the incidence of post-operative incisional drainage was significantly lower.
- In the long-term follow-up, it was found that 28.9% of horses experienced further episodes of colic, but 80.3% had returned to their previous level of work.
Conclusions
- The research concludes that while incisional drainage is a common issue following ventral midline laparotomy surgeries, the use of a 2-layer, modified subcuticular closure can significantly reduce the incidence of such a complication.
- This method proved more effective than using traditional skin sutures, but not significantly more effective than using staples for closure.
Cite This Article
APA
Colbath AC, Patipa L, Berghaus RD, Parks AH.
(2013).
The influence of suture pattern on the incidence of incisional drainage following exploratory laparotomy.
Equine Vet J, 46(2), 156-160.
https://doi.org/10.1111/evj.12091 Publication
Researcher Affiliations
- Department of Clinical Sciences, Colorado State University College of Veterinary Medicine, USA.
MeSH Terms
- Animals
- Horse Diseases / etiology
- Horse Diseases / prevention & control
- Horses
- Laparotomy / veterinary
- Retrospective Studies
- Surgical Wound Infection / etiology
- Surgical Wound Infection / veterinary
- Suture Techniques / adverse effects
- Suture Techniques / veterinary
- Sutures / veterinary
Citations
This article has been cited 8 times.- Gehlen H, Klein KS, Merle R, Lübke-Becker A, Stoeckle SD. Does colonization with MRSA, ESBL - producing Enterobacteriaceae, and/or Acinetobacter baumannii - increase the risk for postoperative surgical site infection?. Vet Med Sci 2023 Mar;9(2):729-737.
- Gandini M, Cerullo A, Franci P, Giusto G. Changes in Perioperative Antimicrobial and Anti-Inflammatory Drugs Regimens for Colic Surgery in Horses: A Single Center Report. Vet Sci 2022 Oct 4;9(10).
- Stöckle SD, Kannapin DA, Kauter AML, Lübke-Becker A, Walther B, Merle R, Gehlen H. A Pilot Randomised Clinical Trial Comparing a Short-Term Perioperative Prophylaxis Regimen to a Long-Term Standard Protocol in Equine Colic Surgery. Antibiotics (Basel) 2021 May 16;10(5).
- Crosa AT, Katzman SA, Kelleher ME, Nieto JE, Kilcoyne I, Dechant JE. Incidence of incisional complications after exploratory celiotomy in equids affected with enterolithiasis. Can Vet J 2020 Oct;61(10):1085-1091.
- Scharner D, Gittel C, Winter K, Blaue D, Schedlbauer C, Vervuert I, Brehm W. Comparison of incisional complications between skin closures using a simple continuous or intradermal pattern: a pilot study in horses undergoing ventral median celiotomy. PeerJ 2018;6:e5772.
- Manneveau GB, Robert MP, Tessier C, Bizon-Mercier C. Surgical removal of a gastric trichophytobezoar in a foal. Can Vet J 2017 Sep;58(9):926-930.
- Cerullo A, Di Nicola MR, Scilimati N, Bertoletti A, Pollicino G, Moroni B, Pepe M, Nannarone S, Gialletti R, Passamonti F. Intra- and Post-Operative Bacteriological Surveys of Surgical Site in Horses: A Single-Centre Study. Microorganisms 2025 Apr 17;13(4).
- 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.
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