Comparison of suture materials and suture patterns for inverting intestinal anastomosis of the jejunum in the horse.
In 7 horses, 4 anastomoses were done in the small intestine in each, using the combinations of synthetic absorbable monofilament and multifilament suture materials with continuous- and interrupted-suture patterns in the serosubmucosal layer of a 2-layer inverting-suture technique. Horses were evaluated 30 days after the operation for adhesion formation, lumen diameter, evidence of chronic obstruction, and suture tract inflammation at the anastomosis. Postoperative obstruction occurred in 5 of the 7 horses, and 6 horses survived. One horse was euthanatized on postoperative day 6 after 48 hours of ileus and obstruction; necropsy revealed a partial intussusception involving the anastomosis done with continuous multifilament-suture material. Two other horses that became obstructed between postoperative days 3 and 5 had protracted ileus and gastric reflux up to 48 hours' duration, but survived. Horses that had obstruction after the 6th postoperative day recovered within 4 hours of onset. The continuous inverting-suture pattern in the serosubmucosal layer resulted in significantly (P less than 0.05) fewer adhesions than did the interrupted pattern, and suture material had no effect on adhesion formation. There was no significant difference in the percentage of reduction of lumen diameter between the variations of the 2-layer technique, and there was no evidence of chronic obstruction related to any of the anastomoses. Suture tract inflammation was moderate in the anastomoses, using continuous-multifilament suture, with neutrophils being the predominant cell type. The anastomoses with continuous-monofilament suture had mild inflammation with focal accumulations of neutrophils. Minimal inflammation was associated with both types of suture in the interrupted pattern.
D000818:Animals; D005260:Female; D006734:Horse Diseases / Q000473:pathology; D006736:Horses / Q000601:surgery*; D007249:Inflammation / Q000473:pathology / Q000662:veterinary; D007579:Jejunal Diseases / Q000473:pathology / Q000662:veterinary; D007583:Jejunum / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000473:pathology / Q000662:veterinary; D013536:Suture Techniques / Q000662:veterinary*; D013537:Sutures / Q000662:veterinary*