Comparison of the zip skin closure system with conventional suture for skin closure of ventral midline incisions in horses.

OBJECTIVE: To compare the application and healing of the zip skin closure system (ZSCS) with sutured closure by use of a split-scar model of ventral midline incisions in horses in a prospective, randomized experimental study. ANIMALS: 8 adult horses. PROCEDURES: All horses underwent an exploratory ventral midline celiotomy with a standardized 30-cm skin incision. Each horse was randomized to have either the cranial 15 cm closed with suture and caudal 15 cm with the ZSCS or vice versa (split-scar model). Skin closure time was recorded and compared. Photography and skin biopsies were taken preoperatively and 14 days postoperatively. Cosmetic appearance was assessed by use of a proposed equine celiotomy incision score. Healing at 14 days was assessed by histopathology. RESULTS: Skin closure times were faster with the ZSCS compared to sutured incisions. At 14 days postoperatively, the cosmetic appearance (equine celiotomy incision scores) for ZSCS incisions were better than sutured closure and histologic healing scores were not different between methods of closure. Subcuticular sutures were associated with deep dermal inflammation and necrosis independent of epidermal closure methods. CLINICAL RELEVANCE: While limitations to the utility of the ZSCS are recognized, the potential benefits of expedient closure, good cosmetic outcome, and satisfactory healing make this method viable for closure of linear wounds or incisions in horses.

Use of Polyamide (Nylon) Cable Ties for Vascular Ligation of Healthy Equine Jejunal Mesentery.

Jejunal vascular ligation is an essential step in performing jejunojejunostomy. Hand sewn ligation is typically used and can increase operative time with long sections of bowel to be removed. Nylon cable ties (NCT) have been used for vascular ligation in horses but are yet to be investigated for application on the mesenteric vasculature of the gastrointestinal tract. Our objective was to evaluate the efficacy and short-term safety of NCT jejunal mesenteric vessel ligation in healthy horses. Eight healthy adult horses underwent midline celiotomy. A segment of jejunal mesentery was identified (≥4 arcades). Briefly, three fenestrations (proximal, middle, distal) were made 5-10 mm apart adjacent to the first and last vascular arcade to be ligated. Two sterilized NCT were passed to encircle the mesentery through the proximal and middle fenestrations, separated by intact mesentery. NCT were closed tightly and the vascular pedicle transected with Mayo scissors through the distal fenestration. Jejunojejunostomy was then performed and the mesentery sutured closed. The number of vascular arcades and time to ligate using NCT were recorded. At 2 weeks, horses underwent repeat celiotomy to assess the healing of the NCT ligation site and an equal number of vascular arcades were hand sewn double ligated using 2-0 Polyglactin 910 as a timed comparison. NCT mesenteric ligation was significantly faster than hand sewn methods (P < 0.01). Effective hemostasis was achieved in all cases. There was no evidence of local infection or adhesions at 14 days post-operatively. Further investigation in the long-term effects in horses as well as horses with strangulating jejunal lesions are needed for clinical application.

Comparison of one-layer Utrecht pattern with two-layer (simple continuous/Cushing) pattern for jejunojejunostomy in healthy horses in vivo.

OBJECTIVE: To compare end-to-end jejunal anastomoses with a one-layer (Utrecht) and two-layer (simple continuous/Cushing) patterns. STUDY DESIGN: Experimental study. ANIMALS: Eight healthy adult horses. METHODS: Jejunal end-to-end anastomoses were performed in randomly assigned one-layer or two-layer patterns. Horses were recovered from surgery and monitored for complications. At 14 days, the opposite pattern was performed (cross-over design) prior to euthanasia. Duration of closures was compared between patterns. Serosal width was measured before harvesting anastomotic sites from the first procedure. Luminal diameter was measured, and sections were collected for histological evaluation of heating after routine and immunohistochemical staining. RESULTS: One-layer closure was faster (716 ± 86 s) than two-layer closures (1136 ± 111 s). Postoperative complications were minimal. No difference was detected in lumen size between groups. The lumen was reduced by 18% after one-layer and 15% after two-layer closures (p = .34). Serosal adhesions to the mesentery without clinical evidence of obstruction were observed in two horses with two-layer closure. Histopathological scores for inflammation, infection, and healing did not differ between groups. CONCLUSION: Jejunal anastomosis with one-layer Utrecht technique was about 7 min faster and led to similar luminal reduction and histological healing scores as two-layer jejunojejunostomies. CLINICAL SIGNIFICANCE: The outcomes of one-layer Utrecht jejunojejunostomies in healthy horses justify clinical evaluation of this technique.

Use of polyamide cable ties during experimental omentectomy in adult horses with histopathological assessment.

OBJECTIVE: To report the use of nylon cable ties (NCT) for omentectomy in the horse. STUDY DESIGN: Experimental study. ANIMALS: Eight healthy adult horses. METHODS: Horses underwent nylon cable tie (NCT) ligation of the greater omentum after ventral midline celiotomy. The time required to complete the omentectomy was recorded. Horses were recovered for 14 days before repeat celiotomy, adhesions assessment, and histological examination of the omentectomy site using a proposed histologic grading scheme. The total time for omentectomy procedure and histologic score was assessed for normality. Data are expressed as mean ± standard deviation. RESULTS: NCT ligation provided sufficient hemostasis to complete the omentectomy (28 ± 15 s), without rescue ligation. No gross evidence of intra-abdominal adhesion or morbidity was associated with the omentectomy site 14 days after surgery. NCT were intact at the site of application, covered with smooth fibrous connective tissue. Adiponecrosis with minimal inflammation and fibrovascular occlusion of omental vessels was present at the surgical site. Mild inflammation was present at the NCT-tissue interface. CONCLUSION: The use of NCT resulted in fast and effective omentectomy in healthy horses without short-term evidence of inflammatory reaction or intra-abdominal adhesion. CLINICAL SIGNIFICANCE: The described technique provides an alternative for omentectomy in healthy adult horses.