Abstract
Experimental and human studies have reported the advantages of a suture length to wound length (SL:WL) ratio greater than 4:1 in midline abdominal closure. This is achieved when the tissue bite (TB) is equal to or larger than the stitch interval (SI). Although TB and SI values are recommended in some textbooks, SL:WL ratios are rarely reported in veterinary textbooks. Additionally, no clinical data regarding these parameters could be found in small animals. Therefore, the aim of this study was to evaluate the SL:WL ratio of midline laparotomy closure in dogs and cats performed by surgeons with different levels of expertise and to compare the findings with current textbook recommendations. Midline laparotomy incisions of 100 dogs and 75 cats were closed in continuous pattern by diplomates and residents of both the European College of Veterinary Surgeons (ECVS) and the European College of Animal Reproduction (ECAR). The mean SL:WL ratio was 2.5 ± 0.7:1. The surgeons´ level of experience and the species and body weights of the animals did not have any significant influence on the SL:WL ratio. A moderate negative correlation was observed between the mean SI to mean TB (SI:TB) ratio and the SL:WL ratio. In this study, the mean SI matched the textbook recommendations both in feline and canine species, whereas the TB in cats was different. In this study, the SL:WL ratio was less than 4:1 without apparent complications. Because of the low prevalence of incisional hernia in dogs and cats larger studies are necessary to evaluate clinical significance of the presented data.
Highlights
In human surgery, a ventral midline incision is a frequently used approach to the abdominal cavity [1,2]
Our results showed a positive correlation between mean stitch interval (SI) and mean tissue bite (TB) values and weight categories
These findings suggest that applying the current textbook recommendations without specifying the TB to SI ratio cannot help surgeons reach the recommended 4:1 ratio
Summary
A ventral midline incision is a frequently used approach to the abdominal cavity [1,2]. Because complications of abdominal closure generate pain and morbidity and cause a substantial financial burden to the healthcare system, experimental and clinical trials have been conducted to reduce the risk of incisional hernias [3,4,5,6]. The five-year incidence of incisional hernia after vascular repair of abdominal aortic occlusive and aneurysmal disease is 69.1% [11]. With this risk in mind, recommendations for abdominal incision closure have been revised in human surgery. The European Hernia Society recommends that elective midline abdominal incisions be closed
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