Use of Polyamide Cable-ties for the management of incisional hernia repair and acute celiotomy dehiscence in horses
Ansoleaga N1, Menarim BC2, Verocay JA3
1Escuela de Medicina Veterinaria, Facultad de Medicina y Ciencias de la Salud, Universidad Mayor, Santiago, Chile, 2Gluck Equine Research Center, Martin-Gatton College of Agriculture, Food & Environment, University of Kentucky, Lexington, USA, 3Servicio de Diagnóstico y Tratamiento Especializado Equino, Montevideo, Uruguay.
Objectives:
To describe a novel, low-cost technique for the surgical management of large-sized abdominal hernias and acute celiotomy dehiscence, that is associated with low complications rate
Methods:
A retrospective study of 49 cases was performed. All horses with incisional hernias (n=43) and acute total dehiscence after celiotomy (n=6) that were treated with polyamide cable-ties were included. The abdominal defect was repaired with primary closure of the linea alba and reinforced with gas sterilized polyamide cable-ties. Five mm wide 40 cm long polyamide cable-ties were applied in a Lambert pattern each 5 cm apart, passing through the skin, subcutaneous, fascia, muscle and fascia of the rectus abdominal muscle, subcutaneous and skin of each incisional side. A stent bandage was placed under and within the cable-tie loop. the skin was sutured only in patients that had no infection of the surgical wound.
Results:
Forty-three of the cases were repaired 4 weeks after the first surgery. In 6 other cases, the technique was used at the time of a recurring laparotomy due to acute dehiscence.
Forty-five out of 49 horses (91,8%) were discharged and survived a follow-up of 12 months. Three out of 45 (6,6%) developed an infection of the linea alba that was treated with drainage and systemic antibiotics. None of the horses discharged had recurrence of the herniation or any other complications.
Conclusions:
This approach represents an alternative measure for the treatment of abdominal hernia repair and for acute total celiotomy dehiscence, giving extra surface to withstand the tension at the surgical wound.