Occurrence of Incisional Complications After Closure of Equine Celiotomies With USP 7 Polydioxanone

Anderson, Stacy; Devick, Ian F; Bracamonte, José L.; Hendrick, S.; Barber, Spencer M.; Carmalt, James L.; Wilson, David G.

doi:10.1111/j.1532-950x.2014.12275.x

Cited by 28 publications

(44 citation statements)

References 22 publications

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“…Incisional complications after ventral midline celiotomy in horses include infection, herniation, acute dehiscence, suture sinus formation, swelling, drainage, and abscess formation . Incisional herniation occurs frequently, affecting 16% of horses undergoing celiotomy, resulting in significant patient morbidity .…”

Section: Introductionmentioning

confidence: 99%

Bursting strength of surgeon's and self‐locking knots for closure of ventral midline celiotomy in horses

et al. 2018

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Objective To compare the bursting strength and failure mode of ventral midline celiotomy closed with a simple continuous suture pattern with 1 of 2 knot combinations, a novel self‐locking knot combination of a forwarder start with an Aberdeen end knot (F‐A) and a traditional combination of a surgeon's start with a surgeon's end knot (S‐S). Study design Ex vivo experimental. Sample population Equine cadavers (n = 14). Methods A 20‐cm ventral midline celiotomy was created in 14 equine cadavers. Horses were assigned to celiotomy closure with an F‐A or S‐S knot combination. Prior to closure, a 200‐L inflatable bladder was placed in the abdomen and then insufflated until failure of the celiotomy closure. The horses’ signalment, weight, breed, and age, as well as knot combination type, mode of failure, closure time, and bursting strength (mm Hg) were recorded. Results The median bursting strength was significantly greater when incisions were closed with the F‐A knot combination (388 mm Hg) compared with the S‐S knot combination (290 mm Hg) (P = .035). Most incisions failed along the fascia when closed with F‐A combinations and at the knot when closed with S‐S combinations. Conclusion The bursting strength of ventral midline incisions in equine cadavers was increased by an average of 25% when closed with the self‐locking F‐A knot combination. Clinical significance Closing ventral midline celiotomies with an F‐A knot combination may provide a more secure closure than the traditional S‐S knot combination. Additional in vivo investigation is required prior to recommending this closure in clinical cases.

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Section: Introductionmentioning

confidence: 99%

Bursting strength of surgeon's and self‐locking knots for closure of ventral midline celiotomy in horses

et al. 2018

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“…Braided 6 polyglactin 910 and 7 polydioxanone are produced in other countries, but are not available in the United States. While a recent study reported that use of 7 polydioxanone does not increase the incidence of incisional complications, a prospective case controlled study is required to fully evaluate both KHC and size of square and surgeon's knots using this material …”

Section: Discussionmentioning

confidence: 99%

In vitro evaluation of square and surgeon's knots in large gauge suture

et al. 2017

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Objective: To investigate the strength and size of surgeon's and square knots for starting and ending continuous suture lines using large gauge suture. Study Design:In vitro mechanical study. Study Population: Knotted suture.Methods: Surgeon's and square knots were tested using 2 and 3 USP polyglactin 910 and 2 USP polydioxanone under linear tension on a universal testing machine. Failure mode and knot holding capacity (KHC) were recorded, and relative knot security (RKS) was calculated as a percentage of KHC. Comparisons were made between number of throws, suture size, suture type, and knot types. Knot volume and weight were assessed by a digital micrometer and balance, respectively.Results: There were no significant differences in KHC (P 5 .295), RKS (P 5 .307), volume (P 5 .128), or weight (P 5 .310) between square and surgeon's knots at the start or end of suture lines with the same number of throws and suture type. A minimum of 6 throws were required for start knots and 7 throws at end knots to prevent unraveling. Knots tied with 3 polyglactin 910 were strongest (P < .001) and 2 polyglactin 910 produced knots with higher KHC and RKS than 2 polydioxanone (P < .001).Conclusion: No consistent differences were detected between knots types tied with the same suture material; however, number of throws affected KHC and RKS up to 6 throws in start or 7 throws in end knots. The configuration of square and surgeon's knots performed at the end of a continuous line alters their KHC, supporting the use of additional throws for knot security.

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“…Despite advances in surgical technique and anaesthesia, improvements as measured by the frequency of wound healing problems cannot be seen. Wound healing rates reported up until year 2000 ranged between 7.4% and 61.4% (12,16,19,26,30,39) and after year 2000 between 16% and 62% (4,5,13,27,29,31).…”

Section: Introductionmentioning

confidence: 94%

“…Postoperative risk factors are fever (4,13), leukopenia and postoperative colic (4,17). Smith et al (33) claim an important reduction in wound healing complications when using an abdominal bandage, while other studies do not confirm this finding (17,36).…”

Section: Introductionmentioning

confidence: 99%

“…Anatomical localisation plays a role in that there is an enhanced risk when large intestinal problems are present (30). Some authors describe elevated wound healing rates together with prolonged times of surgery and anaesthesia (4,13,33,39). Suture material and suture technique are predisposing factors for wound healing problems: Near-far-far-near-technique (26), closure of the linea alba using chromic catgut (17) as well as the use of suture staples for skin closure (36) were mentioned.…”

Section: Introductionmentioning

confidence: 99%

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Wundheilungsstörungen nach ventraler medianer Laparotomie beim Pferd

Scharner¹,

Winter²,

Brehm³

et al. 2017

Tierarztl Prax Ausg G

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Occurrence of Incisional Complications After Closure of Equine Celiotomies With USP 7 Polydioxanone

Abstract: Overall occurrence of incisional herniation after closure of ventral celiotomies with 7PD was low.

Cited by 28 publications

References 22 publications

Bursting strength of surgeon's and self‐locking knots for closure of ventral midline celiotomy in horses

Bursting strength of surgeon's and self‐locking knots for closure of ventral midline celiotomy in horses

In vitro evaluation of square and surgeon's knots in large gauge suture

Wundheilungsstörungen nach ventraler medianer Laparotomie beim Pferd

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