Comparison of incisional complications between skin closures using a simple continuous or intradermal pattern: a pilot study in horses undergoing ventral median celiotomy

Scharner, D; Gittel, Claudia; Winter, Karsten; Blaue, Dominique; Schedlbauer, Carola; Vervuert, Ingrid; Brehm, Walter

doi:10.7717/peerj.5772

Cited by 9 publications

(17 citation statements)

References 39 publications

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“…25 Wound dehiscence concerns have caused some surgeons to recommend a subcuticular layer that is then overlaid with cyanoacrylates to provide a waterproof sealant, similarly to what is reported in our study. 25 Furthermore, authors from previous equine laparotomy studies 30,31 have reported lower prevalence of incisional complications when avoiding a percutaneous pattern. 28,29 Even though an intradermal or subcutaneous layer may provide sufficient apposition, additional strength is provided by incorporating cyanoacrylate to the closure, without compromising the skin barrier.…”

Section: Discussionmentioning

confidence: 97%

Incisional complications after skin closure with n‐butyl cyanoacrylate or stainless‐steel skin staples in horses undergoing colic surgery

2020

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Objective: To compare the prevalence of incisional complications after skin closure with n-butyl cyanoacrylate (NBC) or stainless-steel skin staples (SS) after ventral midline celiotomy for colic surgery in the horse. Study design: Retrospective study (2014-2018). Animals: Two hundred eighteen horses. Methods: Medical records of horses that underwent exploratory celiotomy for colic were included when the skin was closed with NBC or SS and the horse survived ≥15 days after surgery. Records and a follow-up questionnaire were used to determine in-hospital and posthospital discharge incisional complications. Associations between variables were assessed by using bivariable and multivariable analysis. Results: The cutaneous incision was closed with SS in 113 of 218 (51.8%) horses and with NBC in 105 of 218 (48.2%) horses. Follow-up information was available in 166 of 218 horses. Five horses with incisional complications prior to discharge but without follow-up were included in the overall analysis. Incisional complications were recorded in 17.5% (30/171) of horses, including 19.1% (17/89) of closures with SS and 15.9% (12/82) of closures with NBC (P = .54). Complications occurred before discharge in 14 of 218 (6.4%) horses and after discharge in 16 of 166 (9.6%) horses. Four horses with in-hospital incisional complications (surgical site infection) developed a second complication after discharge (hernia). Packed cell volume was a risk factor for in-hospital incisional complications (P = .04), and in-hospital incisional complications were associated with posthospital discharge incisional complications (P = .01).

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Section: Discussionmentioning

confidence: 97%

Incisional complications after skin closure with n‐butyl cyanoacrylate or stainless‐steel skin staples in horses undergoing colic surgery

2020

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“…The effect of abdominal closure technique on incisional complications has been extensively studied (Anderson et al, 2015; Biedrzycki & Brounts, 2016; Bischofberger et al, 2010; Colbath et al, 2014; Coomer et al, 2007; Darnaud et al, 2016; Isgren et al, 2017; Kilcoyne et al, 2019; Magee & Galuppo, 1999; Mair & Smith, 2005; Rinnovati et al, 2016; Salem et al, 2016; Scharner et al, 2017, 2018; Smith et al, 2007; Torfs et al, 2010; Verkade et al, 2020). The standard abdominal wall closing technique includes 3 layers, linea alba (LA), subcutaneous (SC) and skin.…”

Section: Surgical Site Infectionmentioning

confidence: 99%

“…However, by the commonly used strict definition, any surgical abdominal wound draining over 24 h after colic surgery is considered infected (Colbath et al, 2014;Kilcoyne et al, 2019;Scharner et al, 2018, Torfs et al, 2010. It has been postulated that there is a marked underestimation of the prevalence of SSIs after colic surgery.…”

Section: Surg Ic Al S Ite Infec Tionmentioning

confidence: 99%

“…Other studies found that suturing the peritoneum, prior to linea alba closure, reduced the incidence of SSI (Scharner et al, 2017; Torfs et al, 2010). Using intradermal sutures instead of suturing the skin, resulted in no SSI at all in one study (Scharner et al, 2018). Similarly, when absorbable subcuticular staples, were used, none of the horses developed SSI (Biedrzycki & Brounts, 2016).…”

Section: Surgical Site Infectionmentioning

confidence: 99%

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What do we currently know about incisional complications of colic surgery?

Kelmer

2023

Equine Veterinary Education

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Summary It is common for horses to suffer from incisional complications after colic surgery. The complications encountered are oedema, infection, hernia and dehiscence. Oedema is a natural response to surgical trauma but when it is severe it can be associated with additional complications such as infection, hernia and dehiscence. Thus, it is worthwhile preventing marked oedema, and an abdominal bandage is an effective method for that. Infection of the incision is common, but mostly it is mild and does not require significant intervention. Many of the infections manifest after the horse is discharged from the hospital; thus, these infections are markedly underreported. Since multidrug resistance in bacteria are becoming a major problem in equine medicine, sampling the incision for monitoring is important. Hernia formation is typically preceded by incisional infection. Most hernias do not require intervention but some warrant surgical correction. The most simple and effective method to repair them is primary closure of the hernial ring followed by subcutaneous mesh implantation. By this method, one achieves both a strong body wall and a good cosmetic outlook. Complete body wall dehiscence is fortunately uncommon and is often associated with incisional infection and pregnancy. Complete body wall dehiscence usually occurs in about 5 days after surgery and is the most fatal complication. If dehiscence is noticed prior to any evisceration, conservative therapy with close monitoring and a supportive bandage is indicated and has a good chance of success. Once evisceration is noted, emergency secondary body wall closure is indicated, and the prognosis is guarded. To conclude, incisional complications are commonly encountered after colic surgery, most of them have clinically mild implications. Occasionally, these complications may become significant and even fatal. Careful attention to surgical technique and protecting the incision in the immediate post‐operative period can significantly decrease the risk of these complications.

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“…The occurrence of hernias can be associated with injuries. Often the occurrence of hernias can be associated with anatomical conditions that most often occur in the navel, groin or perineum (Shnjakina and Shherbakov, 2008;Gimranov andLjukovec, 2010, 2011;Safonov, 2018), or they may arise as a result of unsuccessful operations or their complications (Scharner et al, 2018;Winter et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Morphological indicators of subcutaneous implantation of monofilament mesh

et al. 2020

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Hernias are a significant, non-infectious animal condition. In productive animals, failure to provide surgical treatment leads to premature rejection and potential loss of their productive longevity. In small pets, this becomes a social problem for pet owners related to the keeping and death of affected animals. The aim of this study was to study the histological parameters of tissues during implantation of monofilament mesh in cattle for periods up to four months. The study was conducted on eight bulls of the Black Motley breed, divided into two groups of four animals. In the first group, four bulls received a subcutaneous implant of hernioplasty mesh made of polypropylene monofilament (Herniamesh S.R.I. Via CiRie 22 / A, San Maruro Torinese, Torino, Italy) in the area of the lateral soft abdominal wall on the right and left sides. In the second group, four bulls received implants in the middle third of the neck to the right and left sides. Thus, the subject of research was 16 wounds with implanted mesh. A sterile piece monofilament mesh, 1x2 cm in size and folded in half along the longitudinal side, was inserted vertically into the formed hypodermic pocket on the right side of the wound, in which it was possible to freely place the specified mesh. During the course of the study, Polycon No. 4 thread with intermittent knotted seams was used, and three sutures were applied. To ensure fixation of the mesh, it was stitched centrally. The material for histological studies was taken by biopsy at one, two, three and four months after implantation. Tissue was embedded in paraffin blocks, and sections were stained with haematoxylin-eosin and picrofuchsin according to Van Gieson. The results indicated that after subcutaneous implantation of monofilament mesh in the neck and abdominal wall in cattle, wound healing occurs by primary intention. It was revealed that from the beginning of the histological study to one month, the monofilament mesh is first overgrown with loose connective tissue. By the end of the study, after four months, this is sequentially differentiated into dense connective tissue. No significant differences were observed between the abdominal wall and neck area as sites of implantation, and morphological processes in both sites proceeded in the same way. Thus, the conducted studies allow us to conclude that monofilament mesh is a suitable material for closing the hernial ring in cattle, where it is not possible to use their own tissues for these purposes.

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Comparison of incisional complications between skin closures using a simple continuous or intradermal pattern: a pilot study in horses undergoing ventral median celiotomy

Cited by 9 publications

References 39 publications

Incisional complications after skin closure with n‐butyl cyanoacrylate or stainless‐steel skin staples in horses undergoing colic surgery

Incisional complications after skin closure with n‐butyl cyanoacrylate or stainless‐steel skin staples in horses undergoing colic surgery

What do we currently know about incisional complications of colic surgery?

Morphological indicators of subcutaneous implantation of monofilament mesh

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