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

Equine colic outcomes and prognostic factors at a South African academic hospital (2019-2021)

BACKGROUND

Colic is a common equine emergency requiring medical or surgical intervention. These interventions can be costly, making outcomes data and prognostic indicators essential for guiding referral and treatment decisions.

OBJECTIVE

To determine survival rates to hospital discharge and evaluate prognostic indicators in equine colic cases treated at a referral hospital (Onderstepoort Veterinary Academic Hospital [OVAH], South Africa).

METHODS

This retrospective observational cohort study analysed records from horses with colic that were presented to the OVAH from January 2019 to August 2021. Data included signalment, admission heart rate (HR) and packed cell volume (PCV), treatment type (medical vs. surgical), surgical diagnosis, postoperative complications, and survival to discharge.

RESULTS

Of 415 cases, 375 were treated (292 medically, 83 surgically). 91% of medically, 77% of surgically treated, and 88% overall survived. Compared to a previous study, overall survival to discharge improved by 5% (p = 0.025), mainly due to improved surgical outcomes. Survival was associated with treatment type and surgical lesion site (lower for small intestinal than large intestinal lesions). Medically treated cases with an increased HR and surgical cases with a high PCV had lower survival rates. Signalment showed no association with outcomes.

CONCLUSION

Survival rates to discharge were comparable to previously published international reports and showed significant improvement to previous results from the same institution, due to improved surgical outcomes. These findings can assist veterinarians in referral and treatment decisions. Further research on long-term survival and additional prognostic indicators is required to improve outcome predictions for equine colic treatment.

Ex vivo biomechanical evaluation of tissue construct strength in an equine colopexy model

OBJECTIVE

To compare strength of left paramedian colopexies using various techniques in equine ex vivo models.

STUDY DESIGN

Experimental study.

SAMPLE POPULATION

Equine cadavers euthanized for nongastrointestinal pathology (36 specimens derived from 9 horses).

METHODS

Colopexies were performed after euthanasia. Suture pattern (horizontal mattress vs. cruciate) and incorporation of dorsal sheath of the rectus abdominis (partial-thickness) versus incorporation of dorsal and ventral sheath of the rectus abdominis (full-thickness) were evaluated. Single cycle load to failure, work to peak load, stiffness, and mode of failure of colopexy tissue constructs were assessed.

RESULTS

Mean load to failure of all constructs ranged from 102.26 to 166.38 N. Partial-thickness bites demonstrated a mean load to failure and standard deviation (SD) of 111.91 (35.88) N and 102.26 (30.06) N (p < .05) which was significantly lower than the mean and SD of full-thickness bites (166.3 [72.42] N and 163.21 [51.40 N]), respectively. All full-thickness bites regardless of suture pattern and over half of partial-thickness bites failed at the colonic wall. There was no significant difference in load to failure compared to mode of failure.

CONCLUSION

A stronger colopexy was achieved with a full-thickness bite regardless of the suture pattern. The most common mode of failure was the colon wall.

CLINICAL SIGNIFICANCE

Incorporating ventral and dorsal fascia of the rectus abdominus provided a stronger colopexy structure, which may necessitate a second incision or subcutaneous palpation of the needle when performing a colopexy. The lateral band of the colon failed in most constructs (77%) regardless of technique, which could weaken the colonic wall and risk colonic rupture.

Comparison of incisional bursting strength of a bidirectional absorbable knotless suture material versus a standard continuous absorbable suture material for closure of the equine linea alba

OBJECTIVE

To evaluate the use of bidirectional knotless barbed suture material for closure of the equine linea alba.

STUDY DESIGN

Laboratory study.

ANIMAL OR SAMPLE POPULATION

Adult light horse cadavers (n = 24).

METHODS

A 25 cm incision was made through the linea alba, and a 200 L polyurethane bladder was positioned within the abdomen. The linea alba was closed either using USP2/EP5 bidirectional polydioxanone barbed suture or USP2/EP5 standard polydioxanone suture in a simple continuous pattern. Closure time was recorded for each suture type. The bladder was air-insufflated at 40 L/min, and the pressure at body wall failure recorded. The length of suture used for wound closure and wound failure modes were recorded. Suture length, closure time, bursting pressure, and failure modes were compared using Welch-Aspin t-tests.

RESULTS

The incisional bursting pressure was comparable between the two groups (p > .05). Less suture material (p < .01) was required with the barbed suture than the standard suture. Closure time was less for the barbed suture than the standard suture (p < .01). Suture failure was the main failure mode in both groups (83% cases).

CONCLUSIONS

Closure of the equine linea alba using bidirectional barbed suture material reduced the amount of foreign material in the wound and decreased closure time without compromising incisional strength.

CLINICAL RELEVANCE

Bidirectional barbed suture material could be considered as an alternative to standard suture materials for closure of the equine line alba.