Suture Material Matters for Abdominal Incisions (AAEP 2011)

Your horse has just recovered from anesthesia after a successful colic surgery, however, you can’t help but eye that incision site and wonder if you’ll face complications as it heals. Rightfully so: at least one study has shown that 30% of horses undergoing abdominal surgery had incision-related complications such as swelling, abscess formation, drainage, and the incision bursting open (Wilson, 19951).  Stacy Anderson, DVM, of the Western Veterinary College at the University of Saskatoon, in Saskatchewan, Canada, recently described a study in which she and colleagues compared different suture materials’ integrity.

“There are a number of suture materials available, each with its own set of characteristics that make one more suitable than another for certain surgical procedures,” said Anderson, during her presentation at the 2011 American Association of Equine Practitioners convention, held Nov. 18–22 in San Antonio, Texas. “In closing the equine abdomen during colic surgery, many surgeons in North America use 0.5-mm or 0.6-mm diameter suture. At our hospital, we use a 1-mm diameter braided polydioxone (7 PDS) that is much larger. We were interested in comparing this large suture to smaller suture, 2 Vicryl, which my co-authors and I have used at other practices to close abdomens during colic surgery.”

Anderson and colleagues put the sutures to the test using equine cadavers and a large 200 L “bladder.” They created a surgical incision in either the ventral abdomen (in the middle of the abdomen from the sternum to umbilicus, or belly button) or at the side of the abdomen (called a paramedian incision). The team closed the incisions in a simple continuous pattern using either the 7 PDS or 2 Vicryl. Then they inflated the bladder (Anderson explained, "There were stab incision in the lateral abdominal wall  to allow for ingress and egress tubing.  The ingress was attached to an air compressor and the egress was attached to pressure measurement equipment.") until the incisions or the abdominal wall burst open was referred to as the bursting strength, BS (Anderson noted that the team inflated at 30 L/min, and the time it took and pressure varied by the horse).

The team’s key findings were:

  • They noted no overall difference in BS between ventral and paramedian incisions, regardless of the suture material used;
  • Older horses had significantly decreased BS measurements as compared to younger horses;
  • When the incisions burst open, the suture material itself broke in 60% of the 2 Vicryl group, whereas the body wall adjacent to the sutured incision failed (the suture and knots remained intact but the tissue tore) in the 7 PDS group.

“These data show that 7 PDS is a superior suture material for closing all types of abdominal incisions because it never failed before the abdominal wall.  Also, equine surgeons should be aware that older horses may have weaker abdominal walls, although further research is needed to confirm this finding,” concluded Anderson.

1 Wilson DA, Baker GJ, Boero MJ. Complications of celiotomy incisions in horses. Vet Surg. 1995;24(6):506-14

About the Author

Stacey Oke, DVM, MSc

Stacey Oke, MSc, DVM, is a practicing veterinarian and freelance medical writer and editor. She is interested in both large and small animals, as well as complementary and alternative medicine. Since 2005, she's worked as a research consultant for nutritional supplement companies, assisted physicians and veterinarians in publishing research articles and textbooks, and written for a number of educational magazines and websites.

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