A scoping review on intraoperative and postoperative surgical castration complications in domesticated equids.
Authors: Rodden Elise B K, Suthers Joanna M, Busschers Evita, Burford John H, Freeman Sarah L
Journal: Equine veterinary journal
Summary
# Editorial Summary: Surgical Castration Complications in Equids Castration remains the most commonly performed surgical procedure in horses and donkeys, yet considerable variation exists in surgical technique and perioperative management across practitioners—a gap that prompted Rodden and colleagues to systematically review the current evidence on intraoperative and postoperative complications. Through a rigorous scoping review of three major databases, the authors analysed 71 peer-reviewed studies encompassing 76,734 castrations, categorising surgical approaches by technique (open, closed, or half-closed) and whether the parietal tunic was left open or closed. Swelling and oedema represented the most frequently reported complications across all methods, whilst evisceration—though uncommon overall—occurred more frequently in draught breeds and Standardbreds, with closure of the parietal tunic appearing protective. Critical to practice, the review revealed substantial inconsistency in how complications are defined and reported, alongside notable variation in analgesia and antimicrobial protocols, with some studies failing to meet current recommendations for pain management and infection control. The authors advocate strongly for standardised definitions of surgical techniques and complications in future research, which would enable practitioners to make better-informed decisions about method selection and perioperative management tailored to individual horse risk factors.
Read the full abstract on PubMed
Practical Takeaways
- •Closing the parietal tunic at the end of castration significantly reduces evisceration risk, particularly important when operating on draught breeds and Standardbreds
- •Follow current evidence-based recommendations for perioperative analgesia and antimicrobial use; many practitioners are not implementing these standards
- •Standardize how you document and communicate surgical technique details and post-operative complications to enable meaningful comparison of outcomes with peers and the literature
Key Findings
- •Analysis of 71 studies covering 76,734 castrations identified 18 different complications, with swelling/oedema being most common across all surgical techniques
- •Evisceration risk was significantly higher in draught breeds and Standardbreds, but substantially reduced when the parietal tunic was closed at the end of surgery
- •Perioperative management including analgesia and antimicrobial protocols varied widely between studies, with many not following current recommendations
- •Lack of standardized definitions for complications and surgical techniques across studies made evidence consolidation and comparison of complication rates problematic