Comparison of incisional complications between skin closures using a simple continuous or intradermal pattern: a pilot study in horses undergoing ventral median celiotomy

Doreen Scharner; Claudia Gittel; Karsten Winter; Dominique Blaue; Carola Schedlbauer; Ingrid Vervuert; Walter Brehm

doi:10.7717/peerj.5772

Comparison of incisional complications between skin closures using a simple continuous or intradermal pattern: a pilot study in horses undergoing ventral median celiotomy

PeerJ. 2018 Nov 9:6:e5772. doi: 10.7717/peerj.5772. eCollection 2018.

Authors

Doreen Scharner¹, Claudia Gittel¹, Karsten Winter², Dominique Blaue³, Carola Schedlbauer³, Ingrid Vervuert³, Walter Brehm¹

Affiliations

¹ Department for Horses, University of Leipzig, Leipzig, Germany.
² Institute of Anatomy, Faculty of Medicine, University of Leipzig, Leipzig, Germany.
³ Institute of Animal Nutrition, Nutrition Diseases and Dietetics, University of Leipzig, Leipzig, Germany.

Abstract

Background: Development of incisional complications following ventral median celiotomy might depend on suture pattern for skin closure.

Methods: In this prospective study, 21 healthy male horses underwent celiotomy. Skin closure was either performed via a continuous percutaneous pattern (CO group; 5 warmbloods/5 ponies) or an intradermal pattern (ID group; 5 warmbloods/6 ponies). Follow-up examination of the incisional site included daily monitoring for edema, dehiscence, and drainage. Transcutaneous ultrasound was performed at Days 3, 6, and 10 as well as on Week 8 and 12 to evaluate size of edema and presence or absence of sinus formation, and hernia formation. Prevalence of incisional infection on base of positive microbiological analysis at any time up to Day 10 was evaluated and compared between ID and CO group. Furthermore, edema size was analysed by a linear mixed-effect model for group and time dependency.

Results: Observed incisional complications included edema (9/10 in CO, 10/11 in ID), suture sinus formation (2/10 in CO, 1/11 in ID), surgical site infection (2/10 in CO, 0/11 in ID), and incisional hernia (1/10 in CO, 0/11 in ID). The overall prevalence of incisional infection was 9.5% without significant differences between both groups (20% in CO, 0% in ID; p = 0.214). Edema size was not dependent on time or group (p = 0.545 and p = 0.627, respectively).

Discussion: CO and ID suture pattern are appropriate for skin closure following ventral median celiotomy in horses. None of the animals in the continuous ID group developed surgical site infections, even without the use of antibiotics.

Keywords: Complications; Exploratory laparotomy; Incision; Surgical site infection; Suture pattern.

Grants and funding

The study was funded by the German Research Foundation (Deutsche Forschungsgemeinschaft [DFG], project number: VE 225/9-1) and was also supported by the University of Leipzig. We received support from the German Research Foundation (DFG) and Leipzig University within the program of Open Access Publishing. There was no additional external funding received for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.