Incisional Hernias in the Horse Incidence and Predisposing Factors

Abstract

Medical records of 210 horses that survived ventral midline celiotomy for at least 4 months were examined and owners were queried to determine factors contributing to incisional hernia formation. The incidence rate of incisional hernias within 4 months was 16%. Factors significantly associated with occurrence of incisional hernias were incisional drainage, closure of the linea alba with chromic gut suture material, previous midline celiotomy, excessive incisional edema, castrated male sex, postoperative leukopenia, and postoperative pain (colic). Factors not significantly associated with occurrence of incisional hernias were suture pattern used for linea alba closure, concurrent enterotomy or intestinal resection, postoperative bandage or stent, postoperative fever, hypoproteinemia, diarrhea, respiratory disease (coughing), and peritonitis. Hernias developed in horses within 12 weeks of surgery, with the earliest hernia recognized at week 2. Of 30 horses for which information was available, only one hernia developed in 24 (80%) and two or more hernias developed in 6 (20%) along the incision. Multiple hernias tended to be smaller than single hernias.

Abdominal bandage after colic surgery – sense or nonsense?

“…The occurrence of incisional drainage (20.2 %) was comparable to other authors (16-38%) (Kobluk et al 1988, Gibson et al 1989, Honnas and Cohen 1997, Ingle-Fehr et al 1997, Bartmann et al 2003, Smith et al 2007). Partial wound dehiscence occurred only in those horses that showed purulent discharge.…”

“…Although in literature a higher incidence of herniation has been reported in male horses (Gibson et al 1989), the obtained results from this prospective study could not confirm these findings.…”

“…This might be a matter of definition, while other authors report a 2.8% (Turner et al 1988), 5.7% (Kobluk et al 1988), 6% (Wilson et al 1995) and a 16% herniation rate (Gibson et al 1989). In the literature no reference was made to the size of the hernias or whether they include only visible hernias or also palpable hernias.…”

Indications, complications, and outcome of horses undergoing repeated celiotomy within 14 days after the first colic surgery: 95 cases (2005–2013)

“…A significantly higher number of horses with incisional infection developed incisional hernias, compared with hernia formation in horses with an incisional infection after a single celiotomy (19.3% vs 2.6% without wound infection). 4 Incisional infection and a second celiotomy have both been identified as risk factors for incisional hernia formation, 4,26,27 and it is likely that their effects are additive. The high rate of incisional complications and the potential requirement for additional surgical treatment should be factored into the discussion with horse owners opting for a second celiotomy.…”

Fatores predisponentes das complicações incisionaisde laparotomias medianas em eqüinos

“…A leucopenia em eqüinos aumenta em 2,3 vezes a chance de ocorrer drenagem pela ferida operatória abdominal (GIBSON et al, 1989), a qual constitui importante fator predisponente à hérnia incisional, uma vez que aumenta em até dezessete vezes sua incidência (HONNAS & COHEN, 1997;FRENCH et al, 2002).…”