Use of an active intra-abdominal drain in 67 horses.
Authors: Nieto Jorge E, Snyder Jack R, Vatistas Nicholas J, Spier Sharon J, Van Hoogmoed Linda
Journal: Veterinary surgery : VS
Summary
# Active Abdominal Drainage in Horses: Technical Efficacy and Clinical Trade-offs Closed-suction abdominal drains offer a practical approach to managing equine peritonitis and contamination following colic surgery, yet their routine use requires careful consideration of complication rates. This retrospective review of 68 drains placed in 67 horses between 1989 and 1996 examined insertion technique, fluid retrieval efficiency, and associated complications during treatment with intermittent lavage every 4–12 hours. Encouragingly, the system functioned reliably with approximately 83% peritoneal fluid recovery; however, minor complications occurred in 49% of horses, most frequently including drain obstruction or sluggish flow (26%), fluid leakage around the drain site (16%), and subcutaneous accumulation (12%), with incisional suppuration developing in 32% and herniation in 11% of cases. The drain could be placed under general anaesthesia or in standing horses, demonstrating technical versatility valuable in acute peritoneal disease or as prophylaxis against post-operative adhesion formation. Practitioners should weigh the genuine benefits of active drainage—particularly in severe contamination or confirmed septic peritonitis—against the substantive risk of incisional complications, and implement meticulous drain management protocols to minimise fluid leakage and obstruction during the treatment period.
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Practical Takeaways
- •Closed-suction abdominal drains are a practical and effective tool for managing peritonitis and preventing adhesions post-colic surgery, but expect minor complications in roughly half your cases.
- •Plan for frequent lavage protocols (every 4-12 hours) and monitor closely for drain obstruction, fluid leakage, and subcutaneous fluid pockets—these are common and manageable issues.
- •Be aware that incisional infection occurs in about 1 in 3 horses and hernia in 1 in 10, so proper post-operative care and client communication about these risks are essential.
Key Findings
- •Closed-suction abdominal drains were successfully placed in 67 horses with 68 drains total, with 83% peritoneal lavage solution retrieval rate.
- •Minor complications occurred in 49% of horses including drain obstruction (26%), fluid leakage around drain (16%), and subcutaneous fluid accumulation (12%).
- •Incisional suppuration developed in 32% of horses and incisional herniation in 11% of horses following drain removal.
- •Drains were successfully placed under general anesthesia (93%) and standing sedation (7%) with the technique described as easily performed.