Reduction of complications of the wound healing following ventral median celiotomy in horses

Complications of the ventral midline incision can develop in a high percentage in horses following intestinal surgery. Wound healing complications of celiotomy incisions were evaluated in two groups of each 74 horses that underwent intestinal surgery. Surgery in horses of group 1 was performed by different surgeons with different suture patterns of the abdominal incision. The subcutaneous tissue was not closed in those horses. Antibiotics were given but time of induction and duration of administration were not uniform. In contrast to horses of group 1, incisional length was no longer than 20 cm in horses of group 2. Surgery of all horses of group 2 was performed by the same surgeon with the aim of uniform surgical technique and perioperative treatment. The peritoneum was closed in a simple continuous pattern and the linea alba was adapted with interrupted cruciate pattern. The skin was closed with an interrupted vertical suture pattern including the subcutaneous tissue to prevent dead space formation and subcutaneous fluid accumulation. Antibiotic prohylaxis was induced before surgery and treatment was maintained for three to five days. In case of uncomplicated wound healing, work of the horses was resumed gradually at eight weeks following surgery. Incisional complications included wound infection with incisional drainage, acute dehiscence, hernia formation and suture sinus with suture fistula formation. Incidence of incisional complications was significantly (p < 0.001) lower in horses of group 2 with 25.% than in horses of group 1 with 62.2%. Severe edema developed in a significantly (p < 0.001) lower number of horses of group 2 than in horses of group 1. Hernia formation and dehiscence of the skin was present in 18.9% rs. 16.2% of the horses of group 1 but could not be registered in horses of group 2. Duration of hospitalization was significantly (p < 0.001) longer in horses of group 1 (24.6 +/- 11.29) than was in horses of group 2 (15.8 +/- 5.9 days). The results indicate, that incisional complications may be reduced essentially by the efforts in perioperative treatment that have been described here.