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Acta sci. vet. (Impr.); 40(4): Pub. 1086, 2012. ilus

Artigo em Português | VETINDEX | ID: biblio-1377770

Resumo

Background: Routine neutering of bitches is typically carried out by ovariohysterectomy (OVH) in Veterinary Medicine, seen by many as a simple procedure. During the conventional approach the points of attachment of the uterus and ovaries are double ligated with absorbable or non-absorbable sutures or even with titanium clamps. It has been described the use of non-surgical polyamide tie-raps as a hemostatic closure method by some authors but there are few papers describing the consequenses of such use. The aim of this study is to report four cases of surgical complications associated with nylon tie-raps use on OVHs on bitches referred to the Veterinary Teaching Hospitals of the Federal University of Rio Grande do Sul (HCV-UFRGS) and Passo Fundo University (HV-UPF), both at the State of Rio Grande do Sul. Cases: 1- An eleven-month-old bitch was admitted at the HV-UPF nine days after OVH performed elsewhere, with omentum evisceration due to suture dehiscence. During emergency surgery both ovaries were found surrounded by nylon tie-raps and fibrous tissue adherence. Peritonitis signs were recognizable. Bilateral ovariectomy with nylon 2-0 was performed and the remaining uterus was removed. 2- A five-years-old bitch was referred to the HV-UPF ten days after OVH performed elsewhere, with apathy and suture dehiscence. Free liquid was identifi ed around the bladder and kidneys using the ultrasound exam. Intense hemorrhage from uterine vessels was found during celiotomy. A nylon tie-rap was found loose on the abdominal cavity and another couple were found at both ovaries surrounded by fibrous tissue adherence. Bilateral ovariectomy with nylon 2-0 was performed and a blood transfusion was necessary. 3- A three-years-old bitch was admitted at the HCV-UFRGS six days after OVH performed at another institution, presenting suture dehiscence and evisceration. During emergency surgery, bladder, intestine and musculature necrosis due to the contact with sharp edged nylon tie-raps (prior placed as hemostatic devices), intense fibrous tissue adherence and peritonitis were identified. 4- A two-years-old bitch was referred to the HCV-UFRGS one year after OVH performed elsewhere, with a four-month persistent sinus tract on the right flank unsuccessfully treated by another veterinarian. Abdominal communication was suspected and therefore the patient was submitted to exploratory celiotomy. During surgery intense fibrous tissue adherence were found on both mesovarium. Stump granuloma and a sinus tract were also identified in the right side. Sharped nylon tie-raps were found among the fibrous tissue and were then replaced by non-absorbable suture. Discussion: OVH complications such as suture dehiscence, evisceration, peritonitis and loosen tie-raps, all seen on cases 1, 2 and 3 are usual when there is trans-operatory contamination and can probably be associated with technique failure, as described by other authors. Self-trauma must be avoided throughout the use of Elizabethan collar, but this recommendation was not followed by the patients' owners on any of the cases even though it had been prescribed by the veterinarian. Fibrous tissue and granulomas were found on all cases due to the tie-raps, what brings the question about its real effects to the animal organism. All the patients had satisfiable recovery after the emergency surgeries. There is urgent need of scientific investigations about the grave consequences of the inadequate use of poliamide tie-raps before assigning it as a hemostatic material.

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