Abdominal hernia as a rare manifestation of feline mammary gland carcinoma: a case report.

A 15-year-old, spayed female, Scottish Straight cat without any traumatic history was presented with swollen abdomen and diagnosed as an abdominal wall hernia. Abdominal ultrasound revealed thickened, irregular, and hypoechoic change of abdominal wall muscle adjacent to defect. During the herniorrhaphy, multiple nodules were identified in the subcutaneous tissue around the defect. Histological examination of the nodular tissue was performed, and it was confirmed as mammary gland tumor. After the surgery, metastatic changes of the pancreas were identified, and pleural effusion and ascites were also confirmed. The patient deteriorated rapidly and died 78 days after the surgery. This is the first case presenting abdominal wall hernia induced by malignant tumor in veterinary medicine.

Lateral abdominal hernia associated with thin abdominal musculature in a calf.

This study aimed to evaluate the clinical utility of ultrasonography in the diagnosis of a newborn calf presenting with extended swelling within its right flank, in addition to its therapeutic planning. Ultrasonograms of the bilateral flanks identified thinning of the external and internal oblique abdominal muscles in whole areas of the abdominal walls. A right lateral abdominal hernia associated with thin abdominal muscular structures was diagnosed ultrasonographically. The right flank abdominal hernia was successfully reconstructed through a modified Mayo mattress suture. This allowed the overlapping of the two very thin structures of the abdominal walls, resulting in the creation of a thicker structure of the right lateral abdominal walls. Reconstruction of the abdominal walls using this method could prevent re-protrusion of the viscera during calf growth.

Abdominal Hernia in Equine: Animal Level Risk Factors and Repair Using Polypropylene Mesh.

There is a paucity of information regarding the frequency and risk factors associated with the occurrence of an abdominal hernia in different equine species especially donkeys, and mules. In addition, the effectiveness of using polypropylene mesh for the surgical management of abdominal hernia in donkeys and mules is still unknown. The purpose of the present study was to evaluate the efficacy of using polypropylene mesh for the surgical treatment of abdominal hernia in horses, donkeys, and mules and to address the occurrence and risk factors associated with an abdominal hernia in the selected animal species. Based on clinical and ultrasound proof of abdominal hernia, 48 animals were included in the current study. A questionnaire was created to imply the assumed risk factors associated with occurence and clinical findings of abdominal hernia. Hernioplasty using polypropylene mesh was used for the surgical treatment. The abdominal hernia was prevalent (P < .05) in foals followed by adult horses, donkeys, and mules (25, 15, 6, and 2), respectively. Ages from 3 to 5 years exhibited more abdominal hernias in donkeys, mules, and horses (12.5%, 4.2%, and 31.3%, P < .05), respectively. In all studied animals, females were more prevalent than males (70.8%, n = 34 vs. 29.2%, n = 14) respectively. The complication of abdominal wall hernia was positively affected by the time to repair admitted cases (P = .000). The majority of the animals (36 cases) recovered without complications, however, 10 cases had mild difficulties such as suture abscess, wound infection, serous fluid accumulation, and hematoma postsurgery. In addition, two cases of postoperative recurrence were documented. The results herein indicated that polypropylene mesh hernioplasty may be an alternative to the treatment of equine abdominal hernia. Recognizing the potential risk factors associated with an abdominal hernia in different equine species may be helpful to construct the best preventive measures.

Genes and SNPs Involved with Scrotal and Umbilical Hernia in Pigs.

Hernia is one of the most common defects in pigs. The most prevalent are the scrotal (SH), inguinal (IH) and umbilical (UH) hernias. We compared the inguinal ring transcriptome of normal and SH-affected pigs with the umbilical ring transcriptome of normal and UH-affected pigs to discover genes and pathways involved with the development of both types of hernia. A total of 13,307 transcripts was expressed in the inguinal and 13,302 in the umbilical ring tissues with 94.91% of them present in both tissues. From those, 35 genes were differentially expressed in both groups, participating in 108 biological processes. A total of 67 polymorphisms was identified in the inguinal ring and 76 in the umbilical ring tissue, of which 11 and 14 were novel, respectively. A single nucleotide polymorphism (SNP) with deleterious function was identified in the integrin α M (ITGAM) gene. The microtubule associated protein 1 light chain 3 γ (MAP1LC3C), vitrin (VIT), aggrecan (ACAN), alkaline ceramidase 2 (ACER2), potassium calcium-activated channel subfamily M α 1 (KCNMA1) and synaptopodin 2 (SYNPO2) genes are highlighted as candidates to trigger both types of hernia. We generated the first comparative study of the pig umbilical and inguinal ring transcriptomes, contributing to the understanding of the genetic mechanism involved with these two types of hernia in pigs and probably in other mammals.

Use of bilateral superficial gluteal muscle flaps for the repair of ventral perineal hernia in dogs: A cadaveric study and short case series.

OBJECTIVE: To describe bilateral mobilization of the superficial gluteal muscle (SGM) to treat ventral perineal hernias in dogs. STUDY DESIGN: Cadaveric study and short case series. SAMPLE POPULATION: Male dog cadavers (n = 10) weighing between 5 and 42 kg and three dogs treated for ventral perineal hernia. METHODS: Cadavers were positioned in right and left lateral recumbency to free the origin and insertion of the ipsilateral SGM except for muscle fibers originating on the first tail vertebra and sacrotuberous ligament. The dogs were placed in ventral recumbency to approach the perineum and rotate the muscle flaps. The insertions of the SGM were sutured together ventral to the anal sphincter muscle. The dorsal border of the overlapping tendons was sutured to the anal sphincter muscle, and the ventral border was sutured to the ischiourethralis muscle. The amount of overlap between bilateral flaps was measured. The SGM flaps were used to revise recurrent perineal hernias in three dogs. RESULTS: Superficial gluteal muscle flaps were created without damage to the blood supply in all dogs. The overlap between the bilateral flaps ventral to the anal sphincter measured 0 to 2.4 cm. No recurrence was detected at follow-up (6-12 months) in the three dogs treated with these flaps. CONCLUSION: Superficial gluteal muscle flaps were mobilized without damage to the blood supply and crossed the midline ventral to the anal sphincter. Flaps were used successfully to repair ventral perineal hernias in three dogs. CLINICAL SIGNIFICANCE: Bilateral SGM flaps can be considered to repair ventral perineal hernias.

Repair of a Large Ventral Hernia in a Rhesus Macaque (Macaca mulatta) by Using an Abdominal Component Separation Technique.

Here we present a 32-y-old rhesus macaque (Macaca mulatta) with a large recurrent ventral incisional hernia. The initial surgery included midline celiotomy for treatment of endometriosis, in which the animal developed a hernia that was repaired with interposition of mesh. Hernia recurrence at 1 y resulted in a defect measuring 7 × 13 cm, with loss of abdominal domain. Skin breakdown was noted with areas of exposed mesh through the skin with associated acute on chronic infection. Clinically, the animal was lethargic, not eating, and failing to thrive. The present surgical treatment included midline celiotomy, removal of mesh, and attempted primary fascial closure. Due to the large defect and high tension, the fascia could not be closed. To facilitate closure, abdominal component separation technique was used and consisted of skin and subcutaneous dissection, external oblique muscle release, and dissection between the external and internal oblique musculature. This technique allowed for primary fascial closure and resection of excess diseased skin. A piece of polypropylene mesh was placed in a sublay fashion to reinforce the primary fascial closure. The animal tolerated the procedure well and has demonstrated steady weight gain, with no recurrence at 12 mo. Large ventral abdominal hernia defects in after surgery or trauma in NHP can present reconstructive challenges to veterinary surgeons. Failure to achieve a dynamic, low-tension closure can result in hernia recurrence, necessitating additional operations. Abdominal component separation is not commonly used in veterinary surgery and may be a helpful tool in cases of difficult abdominal reconstructions.

Prosthetic mesh repair of abdominal wall hernias in horses.

Repair of hernias of the abdominal wall of horses is often augmented by inserting a prosthetic mesh. In this review, we describe the various characteristics of prosthetic meshes used for hernia repair and present 2 systems that are used by surgeons in the human medical field to classify techniques of prosthetic mesh herniorrhaphy. Both of these classification systems distinguish between onlay, inlay, sublay, and underlay placements of mesh, based on the location within the abdominal wall in which the prosthetic mesh is inserted. We separate the published techniques of prosthetic mesh herniorrhaphy of horses using this classification system, ascribing names to the techniques of herniorrhaphy where none existed, and report the success rates and complications associated with each technique. By introducing a classification system widely used in the human medical field and illustrating each technique in a figure, we hope to clarify inconsistent nomenclature associated with prosthetic mesh herniorrhaphy performed by veterinary surgeons.

Radiographic and ultrasonographic characteristics of ventral abdominal hernia in pigeons (Columba livia).

Five female egg-laying pigeons presented with painless, reducible, ventral abdominal swellings located between the keel and the pubis, or close to the cloaca. Based on clinical, radiographic, and ultrasonographic examination, these pigeons were diagnosed with ventral abdominal hernia requiring surgical interference. Reduction was successfully performed under general anesthesia. Radiographic and ultrasonographic examinations were beneficial for confirming the diagnosis and visualizing the hernial content for surgical planning. Lateral radiographs were more helpful than ventrodorsal radiographs for identification of the hernial content and its continuation with the abdominal muscles. Ultrasonographic examination offered a non-invasive diagnostic tool that allowed for the differentiation of hernia from other abdominal swellings. In addition, it played a beneficial role in identification of the hernial content and follow up after surgical interference. In conclusion, radiographic and ultrasonographic examinations were beneficial in the diagnosis, surgical planning, and follow up after surgical interference of ventral abdominal hernia in pigeons.

Modified semitendinosus muscle transposition to repair ventral perineal hernia in 14 dogs.

OBJECTIVES: To describe a modified technique of semitendinosus muscle transposition for the repair of ventral perineal hernia. MATERIALS AND METHODS: Retrospective review of case records of dogs with ventral perineal hernia that were treated by transposing the medial half of the longitudinally split semitendinosus muscle of one limb. The transposition of the internal obturator muscle was used when uni- or bilateral rectal sacculation was also present in addition to ventral perineal hernia; colopexy and vas deferens pexy were also performed. RESULTS: Fourteen dogs were included. In addition to ventral perineal hernia, unilateral and bilateral perineal hernia was also present in five and six of the dogs, respectively. The mean follow-up time was 890 days. Ventral perineal hernia was successfully managed by the modified semitendinosus muscle transposition with minor complications in all the dogs included in the study. CLINICAL SIGNIFICANCE: Despite the small number of dogs included, the unilateral transposition of the medial half of the longitudinally split semitendinosus muscle consistently supported the ventral rectal enlargement in perineal hernia without obvious adverse effects.

Surgical repair of a congenital sternal cleft in a cat.

OBJECTIVE: To describe the clinical findings, diagnosis, and treatment of an incomplete cleft of the 5th-8th sternebra and a cranioventral abdominal wall hernia in a 2 month old Ragdoll kitten and to evaluate the short- and long-term outcome. STUDY DESIGN: Clinical report. ANIMALS: Ragdoll cat (n = 1), 2 months old. METHODS: Sternal cleft was confirmed by thoracic radiographs. Computed tomography (CT) was used to plan an optimal surgical approach. A ventral median incision was made, starting at the 3rd sternebra and extended into the abdomen. Ostectomy of the proximal part of the 5th left sternebra was performed. Lateral periosteal flaps were created, unfolded, and absorbable monofilament sutures preplaced to facilitate closure and the repair was reinforced by 2 peristernal sutures. A bone graft was applied, and the free margin of the omentum was sutured to the cranial aspect of the wound. RESULTS: No major complications occurred. At 3 weeks, CT scan confirmed approximation of the hemisternebrae and at 10 months, complete fusion of the hemisternebrae had not occurred, but a strong connection of the sternal bars was present. CONCLUSION: Sternal cleft is a rare congenital abnormality that can be corrected surgically with favorable outcome.

Incisional hernia repair in horses: a cadaveric study of endoscopic component separation.

OBJECTIVE: To report a technique for endoscopic component separation in horses and quantify the amount of body wall advancement obtained. STUDY DESIGN: Descriptive study. ANIMALS: Fresh cadaveric horses (n = 14). METHODS: After a preliminary anatomic study, 7 horses had unilateral endoscopic component separation involving transection of the external abdominal oblique fascia lateral to the rectus abdominis muscle. A laparoscope, placed using a balloon dissector, was used to create an intermuscular working space between the external abdominal oblique fascia and internal abdominal oblique muscle. A single instrument portal was created 10-12 cm medial to the laparoscope portal. Laparoscopic scissors were used to transect the external abdominal oblique fascia, lateral to its insertion to the external rectus sheath, from ≈ 20 cm cranial to the costochondral junction to the level of the superficial inguinal ring. Subsequently, a 30 cm ventral median celiotomy was created and the myofascial advancement was quantified at points 10 and 20 cm cranial to the umbilicus. RESULTS: Endoscopic component separation was successfully completed in all horses. Component separation provided a net mean (± SD) abdominal wall advancement of 3.5 ± 1.3 cm and 3.4 ± 0.5 cm, 10 cm, and 20 cm cranial to the umbilicus, respectively. CONCLUSION: Endoscopic component separation in horses is technically feasible but, as conducted, results in modest abdominal wall advancement.

Rectus abdominis muscle flap for repair of prepubic tendon rupture in 8 dogs.

The clinical use and outcome of the rectus abdominis muscle flap to repair prepubic hernias were evaluated retrospectively. Medical records (2002-2007) of 8 dogs that had a rectus abdominis muscle flap to repair traumatic prepubic tendon rupture were reviewed. Only minor donor site complications were noted, including self-limiting ventral and hind-limb swelling. No long-term complications including recurrence of hernia were noted. The results of this study indicate that the rectus abdominis muscle flap is a clinically useful option for repairing prepubic tendon rupture in dogs.

Clinical anatomy and surgical repair of prepubic hernia in dogs and cats.

Prepubic hernia is a traumatic hernia in small animals, most often associated with severe trauma to the caudal abdomen. Common causes include vehicular trauma, dog fights, and kicks by large animals. Rupture of the prepubic tendon in dogs and of its equivalent in cats results in a ventral abdominal hernia. Due to the traumatic nature of the injury, concurrent injuries are frequently seen. Clinical signs of herniation are often nonspecific, and the resultant hernia may not be readily apparent during routine physical examination. This being so, diagnosis is often based on a thorough physical examination in conjunction with abdominal radiography and, possibly, abdominal ultrasonography. Multiple methods of repair of prepubic hernia have been reported, and survival rates are quite good if concurrent injuries are not severe.

Hernioplastia experimental em coelhos por meio de cartilagem auricular bovina conservada em glutaraldeído / Rabbits experimental hernioplasty by means of bovine auricular cartilage preserved in glutaraldehyde

Avaliou-se a viabilidade do emprego da cartilagem auricular bovina conservada em glutaraldeído a 4 por cento na hernioplastia experimental, empregando-se seis coelhos adultos, machos, da raça Nova Zelândia. Para obtenção da hérnia incisional, removeu-se um segmento elíptico de 3cm de comprimento por 1cm de largura, no ponto central à primeira incisão, envolvendo fáscia e tecido muscular, na região da cicatriz umbilical. Dois animais de cada vez foram sacrificados aos 15, 30 e 45 dias após a cirurgia. Nos sacrificados aos 15 dias, observaram-se áreas focais de inflamação, caracterizadas por abscesso e fístula. À microscopia, observou-se área de inflamação e necrose próxima à periferia do implante. Nas amostras colhidas dos animais sacrificados aos 30 dias, não foram evidenciadas alterações clínicas relevantes. Desses, um animal apresentou à microscopia intensa proliferação fibroblástica, moderada neovascularização e células inflamatórias predominantemente mononucleares. Dos sacrificados aos 45 dias, em um ocorreu aderência de alça intestinal ao implante. É possível inferir que o material implantado apresentou satisfatória compatibilidade com o tecido receptor. Conclui-se que o implante de cartilagem auricular bovina conservada na hernioplastia experimental em coelhos apresentou evidências de boa integração tecidual e cicatrização, não havendo eliminação do material implantado.

The auricular cartilage preserved in 4 percent glutaraldehyde was used for experimental hernioplasty in six male, adult, New Zealand rabbits. To create an incision hernia, an elliptic tissue fragment three centimeter-long and one-centimeter wide was removed at a point centrally located from the first incision, embracing fascia and muscle tissue, from the area of umbilical scar. Animals were euthanized, two at a time, 15, 30, or 45 days after surgery. In the animals euthanized after 15 days focal areas of inflammation were observed, characterized by abscesses and fistulas. The histological section showed areas of inflammation and necrosis next to the periphery of the graft. In the animals euthanized after 30 days, there was no evidence of clinical alterations. Microscopic diagnosis of one of these animals showed intense fibroblastic proliferation, moderate neovascularization and inflammatory cells, predominantly mononuclear. One of the animals submitted to euthanasia at 45 days presented at necropsy adherence of bowel to the graft and impaired reconstitution of the parietal peritoneum. It is possible to infer that the grafted material presented satisfactory compatibility with the receptor tissue. Thus, it may be concluded that auricular bovine cartilage grafts preserved in 4 percent glutaraldehyde in experimental hernioplasty in rabbits presented evidence of good tissue integration and healing, with no elimination of the grafted material.

Evaluation of common vaginal tunic ligation during field castration in draught colts.

The objective of this study was to determine if ligation of the common vaginal tunic could prevent or reduce the incidence of omental herniation and eventration in draught colts undergoing routine field castration. It was found that common vaginal tunic ligation, while not completely preventing omental herniation and evisceration, significantly reduced the incidence of these complications and should be considered in those males deemed at increased risk of significant post castration complications.

Seguimiento del comportamiento peritoneal de diferentes biomateriales empleando laparoscopia secuencial. Aplicabilidad en la reparación de hernias ventrales / Real-time monitoring of the peritoneal behavior of composite prostheses by sequential laparoscopy: applicability in ventral hernia repair

Introducción. A pesar de las ventajas que ofrecen los materiales protésicos en la reparación de defectos de pared abdominal, éstos pueden inducir la formación de adherencias y fístulas intestinales, o producir obstrucciones intestinales. El objetivo de este trabajo fue realizar un estudio secuencial por laparoscopia del comportamiento de diferentes biomateriales en la interfaz prótesis-peritoneo visceral. Material y métodos. Se emplearon 24 conejos blancos de Nueva Zelanda en los que se crearon defectos de 7 x 5 cm en la pared anterior del abdomen. Los defectos se repararon con 3 prótesis de tipo compuesto: Parietex Composite (n = 8), Sepramesh (n = 8) y PL-PU 99 (n = 8). El porcentaje de adherencias a los 3, 7 y 14 días fue evaluado a partir de imágenes obtenidas mediante laparoscopia secuencial; su contorno se trasladó a plantillas de polietileno y se las sometió a análisis de imagen. A los 14 días, se obtuvieron secciones que incluían la prótesis y el tejido receptor para su estudio histológico y morfométrico. Resultados. La estabilización en la formación de adherencias se producía entre los 7 y los 14 días postimplante. El porcentaje de adherencias a los 14 días fue significativamente menor en los implantes realizados con Parietex y PL-PU99 (0,55 ± 0,06% y 0,27 ± 0,20%, respectivamente) respecto al Sepramesh (18,55 ± 1,96%). El proceso de integración tisular y la mesotelización fue similar en los 3 grupos. Conclusiones. a) Los 3 biomateriales mostraron un comportamiento óptimo en la interfaz peritoneal; b) el período crítico de formación adherencial se produce durante la primera semana; c) los 3 biomateriales podrían ser aptos para ser empleados en la reparación de hernias ventrales mediante laparoscopia (AU)

Introduction. Despite the advantages offered by meshes, their use in abdominal wall repair can promote adhesions and damage the intra-abdominal viscera. This study was designed to assess the behavior at the peritoneal interface of several composite prostheses using sequential laparoscopy to monitor the real-time adhesion formation process. Materials and methods. Three composite prostheses, Parietex Composite (n=8), Sepramesh (n=8) and PL-PU 99 (n=8), were used to repair 7 x 5 cm defects created in the abdominal wall of 24 New Zealand white rabbits. The area occupied by adhesions at 3, 7 and 14 days after prosthesis placement was established by tracing the adhesions onto a polyethylene template, using images obtained from sequential laparoscopy, and subjecting it to image analysis. At 14 days, the animals were sacrificed and specimens of the prostheses plus adjacent host tissue were obtained for histological and morphometric tests. Results. Adhesion formation was laparoscopically observed to stabilize between 7 and 14 days post-implant, with no increase in adhesions produced at 14 days. The Parietex and PL-PU99 meshes showed significantly lower proportions of adhesions (0.55 ± 0.06% and 0.27 ± 0.20% respectively) than Sepramesh (18.55 ± 1.96%). All three composites induced similar host tissue ingrowth and mesothelialization of the peritoneal prosthetic surface. Conclusions. a) The three prostheses tested showed optimal behavior at the peritoneal interface; b) the critical period when most adhesions form is the first week after implant; c) these biomaterials are suitable for use in laparoscopic ventral hernia repair (AU)

Prevención de adherencias peritoneales a las prótesis intraperitoneales. Estudio experimental en cerdos / Prevention of peritoneal adhesions to intraperitoneal prostheses. An experimental study in pigs

Introducción. El objetivo de este estudio es investigar el efecto de la cola de fibrina y del gel de hialuronidasa en la prevención de adherencias peritoneales a las prótesis intraperitoneales. Material y método. En este estudio hemos utilizado 20 cerdos, divididos en 2 grupos: en todos los animales se procedió a colocar implantes de 4 x 4 cm: 2 de malla de polipropileno en una posición más cefálica, y otros dos de politetrafluoroetileno (Dualmesh® Plus Corduroy) en una posición más caudal. Los implantes situados en el lado derecho del animal se impregnaron de inhibidores de la producción de adherencias (en 10 animales se utilizó cola de fibrina, serie A, y en otros 10 se utilizó gel de hialuronidasa, serie B). Después de 5 semanas, se procedió al sacrificio de los animales y se evaluaron los resultados (cantidad y calidad de las adherencias formadas, así como datos histológicos de integración de las prótesis, como mesotelización infiltración por fibroblastos, vasos neoformados, etc.). Resultados. Al cabo de 5 semanas se apreciaba que los implantes impregnados de sustancias inhibidoras de la producción de adherencias presentaban menos adherencias, éstas (cuando existían) eran más laxas, e incluso en muchos casos los implantes estaban perfectamente peritonizados. La integración de las prótesis no estaba afectada por la presencia de los inhibidores. Conclusiones. La formación de adherencias puede disminuirse tras la cirugía abdominal. La disminución conseguida es mayor en la cantidad que en la consistencia de adherencias. Los resultados son algo mejores en la serie en la que se utilizó hialuronidasa que en la que se utilizó cola de fibrina. La hialuronidasa tiene la ventaja de tener un menor coste (AU)

Introduction. The aim of this study was to investigate the effect of fibrin glue and hyaluronidase gel on the prevention of postoperative peritoneal adhesions to intraperitoneal prostheses. Material and method. Twenty pigs, divided in two groups, were included. In all animals, four implants (4 x 4 cm) were placed: two polypropylene mesh implants were placed in an upper location and two polytetrafluoroethylene (PTFE) implants (Dualmesh Plus Corduroy) were placed in a lower position. Implants located in the right side of the animals were painted with fibrin glue (group A, n = 10) or with hyaluronidase gel (group B, n = 10). After 5 weeks, the animals were sacrificed and the results (number and grade of intraperitoneal adhesions, histological data on prosthesis integration, such as mesothelialization, fibroblast infiltration, vessel neoformation, etc.) were evaluated. Results. Intraperitoneal adhesions decreased in implants painted with fibrin glue and hyaluronidase gel compared with untreated implants. When right-sided adhesions formed, they were looser and in many animals, the implants were completely peritonized. Integration of the prostheses was not affected by either fibrin glue or hyaluronidase gel. Conclusions. Adhesion formation can be reduced after abdominal surgery. The reduction achieved in this study was greater in the quantity than in the consistency of the adhesions. The results with hyaluronidase gel were moderately superior to those obtained with fibrin glue. Hyaluronidase gel has the advantage of being inexpensive (AU)

Polipropileno frente a polidioxanona: igual eficacia biomecánica en cierres de la línea media / Polypropylene and polydioxanone show similar biomechanical efficacy in midline closure

Introducción. La incidencia de hernia incisional tras laparotomías es elevada, especialmente cuando la apertura del abdomen se efectúa siguiendo la línea alba, una zona débil de la pared abdominal. El objetivo del presente trabajo ha sido evaluar desde un punto de vista biomecánico el cierre de la línea media, empleando la misma técnica quirúrgica y dos suturas diferentes (absorbible a largo plazo frente a no absorbible). Material y métodos. Se realizó una laparotomía media sobre la línea alba de 7,5 cm a 48 conejos blancos Nueva Zelanda. El defecto se reparó con una sutura continua en masa utilizando polipropileno 4/0 o polidioxanona 4/0. Como grupo control, se emplearon animales no sometidos a cirugía. A las 3, a las 6 semanas y a los 6 meses se realizaron estudios morfológicos, inmunohistoquímicos y biomecánicos. Resultados. Ambas suturas generaron un tejido cicatrizal compuesto por fibras de colágeno en torno a los filamentos de la sutura. A los 6 meses la biodegradación de la sutura de polidioxanona era casi completa. La respuesta macrofágica disminuía progresivamente, aunque era significativamente mayor en los cierres con polidioxanona. No hubo diferencias significativas en la resistencia biomecánica entre las 2 suturas. Conclusiones. En cierres de laparotomía en la línea media, ambas suturas presentaron un comportamiento biológico óptimo, y su composición no influyó en la resistencia biomecánica (AU)

Introduction. After laparotomy, the incidence of incisional hernia is high, especially when the abdomen in opened along the linea alba, a weak structure of the abdominal wall. This study was designed to evaluate the biomechanical resistance of midline closure using the same surgical technique but two different types of suture material, a long-lasting absorbable material and a non-absorbable material. Material and methods. A 7.5 cm midline laparotomy was performed in 48 New Zealand White rabbits. The surgical wound was then repaired with an en masse running suture using polypropylene 4/0 or polydioxanone 4/0. Animals not subjected to surgery were used as controls. Morphological, immunohistochemical and biomechanical tests were undertaken 3 weeks, 6 weeks and 6 months after surgery. Results. Both types of suture gave rise to scar tissue composed of collagen fibers concentrically arranged around the suture filaments. Six months after surgery, the polydioxanone suture had almost completely degraded. The macrophage response steadily diminished over time, although it was significantly greater in wounds closed by polydioxanone suture. No significant differences were found in the biomechanical strength provided by the two types of suture. Conclusions. After laparotomy closure at the linea alba, both suture materials showed optimal biological behavior. The composition of the suture material did not affect the tensile strength of the repair zone (AU)

Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 3: Long-term complications and survival.

REASONS FOR PERFORMING STUDY: Few studies have evaluated long-term survival and complication rates in horses following surgical treatment of colic, making it difficult to offer realistic advice concerning long-term prognosis. OBJECTIVE: To review the complications occurring after discharge from hospital and survival to >12 months after surgery of 300 horses undergoing exploratory laparotomy for acute colic. Pre-, intra- and post operative factors that affected long-term complications and long-term survival were assessed. METHODS: History, clinical findings, surgical findings and procedures and post operative treatments of 300 consecutive surgical colic cases (1994-2001) were reviewed. Long-term follow-up information was retrieved from case records and telephone enquiries from owners. RESULTS: The long-term (>12 months) survival rate for 204 horses discharged after colic surgery and for which follow-up information was available was 84%. The most common complication after discharge was colic, affecting 35.1% of horses following a single laparotomy. Colic was most common in horses that had had small intestinal obstructions, bowel resection or post operative ileus. Abdominal adhesions were most common in horses that presented with severe colic due to strangulation of small intestine. Ventral hernia formation occurred in 8% of horses, and was most common in horses that had had post operative wound drainage or infection. CONCLUSIONS: This study identified various factors that appear to predispose horses to long-term complications after colic surgery. POTENTIAL RELEVANCE: Further evaluation of strategies that might reduce the incidence of such complications are needed; in particular, the value of intraperitoneal heparin should be evaluated, and procedures designed to reduce the rates of wound drainage and infection assessed.