Clinical audit in equine practice, and the International Colic Surgery Audit

Cullen, Matthew D.; Archer, Debra; Mair, T. S.

doi:10.1111/eve.13134

Cited by 3 publications

(3 citation statements)

References 31 publications

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“…A case‐control study would have been ideal to confirm and quantify risk factors for AAD but it was not possible to reliably select appropriate controls due to differences in collection of data and recording systems used by collaborating clinics. It is hoped that a newly developed international colic audit tool 27 will assist clinics in recording relevant clinical data, including short‐ and long‐term post‐operative outcomes following laparotomy. In addition to providing benchmarks for post‐operative complications and outcomes, this tool may assist future investigation of complications such as AAD, facilitating selection of appropriate cases and controls where case‐control studies are indicated.…”

Section: Discussionmentioning

confidence: 99%

Acute abdominal dehiscence following laparotomy: A multicentre, international retrospective study

Hann

Mair

Gardner

et al. 2021

Equine Veterinary Journal

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Background: Incisional complications are a common cause of morbidity following laparotomy. Although uncommon, acute abdominal dehiscence (AAD) is a potentially fatal post-operative complication. However, few AAD cases are described in the literature. Objectives:To describe common features of cases of AAD following ventral midline laparotomy, management and outcomes. Study design: Retrospective case series.Methods: Hospital records of horses that underwent a ventral midline laparotomy at nine hospitals in the UK, Ireland and USA over a 10-year period (2009-2019) were reviewed. Data were collected for pre-, intra-and post-operative factors that were considered relevant. Descriptive statistical analysis was performed.Results: A total of 63 cases of AAD were identified. AAD occurred due to tearing of sutures through the linea alba or rupture of the body wall adjacent to the suture line in 46 horses (73%). AAD occurred at a median of 5 days (0.5-70 days) postoperatively and broodmares accounted for 25% of the cases (n = 16). Surgical site infection developed prior to AAD in 28 horses (44%); leakage of peritoneal fluid occurred in 5% of horses prior to AAD being identified. Surgical repair was performed in 27 horses (43%), 10 (16%) were treated conservatively and 26 (41%) were euthanised immediately. Repair was most frequently performed using suture (n = 14), wire (n = 5) or a combination (n = 5). Overall survival to hospital discharge was 39% (24/63). Where surgical repair was performed, 15 horses (56%) survived to hospital discharge; 9 horses (90%) managed conservatively survived to hospital discharge.Main limitations: Follow-up was not performed for all cases following hospital discharge and some data were incompletely recorded in hospital files.

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Section: Discussionmentioning

confidence: 99%

Acute abdominal dehiscence following laparotomy: A multicentre, international retrospective study

Hann

Mair

Gardner

et al. 2021

Equine Veterinary Journal

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“…Pedicle grafting may be performed in regions where there is enough skin close to the wound defect to rotate skin into the area while leaving some vascular supply intact. Recently, the use of self‐inflating tissue expanders has been described in 20 surgical cases with 75% of cases reaching an excellent clinical outcome (Cullen et al., 2023). The distal limbs do not have enough excess skin to rotate tissue in most cases.…”

Section: Grafting Techniquesmentioning

confidence: 99%

Review of skin grafting in equine wounds: Indications and techniques

Williams,

Pezzanite,

Hendrickson

2024

Equine Veterinary Education

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SummarySkin grafting is a simple technique that can be performed by equine practitioners to improve cosmetic outcomes in wounds with large skin defects that would not heal functionally or cosmetically with standard wound therapy interventions. Successful skin grafting is not difficult but relies upon appropriate preparation of the wound bed and effective immobilisation of the grafted area after skin graft placement. Prior to grafting, the wound bed should be treated with a moist wound healing dressing to prepare the granulation tissue bed to receive the graft. For best results, skin grafts should be placed in wounds free of infection with healthy granulation tissue, and motion should be reduced in the graft region in the early postoperative period. When successful, skin grafts cover granulation tissue and encourage wound contraction and epithelialisation while decreasing exuberant granulation tissue resulting in a more cosmetic result. This review will advance practitioners' understanding of skin grafting in horses, including graft classification and techniques, donor site selection, recipient site preparation and postoperative management strategies to optimise graft retention and ongoing research in this field.

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“…11 While colic surgery may not be the right or best option for all horses and horse owners, providing afordable options for treatment of more severe forms of colic has important consequences for equine health and welfare. Those in equine hospitals treating colic have a responsibility to use clinical audit to monitor outcomes and identify areas for improvements in care, 12 as well as appraising the evidence to justify the use of therapies that may substantially add to treatment costs.…”

Section: What You Need To Knowmentioning

confidence: 99%