Risk factors for incisional complications after exploratory celiotomy in horses: do skin staples increase the risk?
Authors: Torfs Sara, Levet Tamara, Delesalle Catherine, Dewulf Jeroen, Vlaminck Lieven, Pille Frederik, Lefere Laurence, Martens Ann
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Incisional Complications After Exploratory Celiotomy in Horses Surgical site infection (SSI) following exploratory celiotomy remains a significant concern in equine colic surgery, yet evidence regarding best practice for skin closure has been limited. This retrospective case series of 356 horses surviving more than two weeks post-celiotomy identified risk factors for incisional complications, with particular focus on closure method, surgeon experience, and surgical technique. Among the cohort, 15% developed SSI (predominantly purulent drainage in 14% of cases), and multivariate analysis revealed that skin staple closure carried substantially higher infection risk (odds ratio 3.85) compared to monofilament sutures, whilst closure by less experienced surgeons (1st or 2nd year residents) approximately doubled infection likelihood. Notably, intraoperative lavage of the linea alba with sterile saline proved protective, reducing SSI risk by 62%. For practitioners managing post-operative celiotomy patients, these findings suggest reconsidering staple closure in favour of suture techniques, ensuring adequate surgeon experience handles critical fascial layers, and implementing routine linea alba lavage—practical measures that may substantially improve healing outcomes and reduce complications in a procedure already fraught with post-operative challenges.
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Practical Takeaways
- •Avoid skin staples for celiotomy closure in horses—use monofilament sutures instead to significantly reduce infection risk
- •Ensure experienced surgeons close the abdominal incision, as junior surgeons have substantially higher complication rates
- •Routinely lavage the linea alba with sterile saline before closing—this simple step provides strong protection against SSI
Key Findings
- •15% of horses (53/356) developed surgical site infections after exploratory celiotomy for colic
- •Skin staples for closure increased SSI risk 3.85-fold compared to sutures (P<0.001)
- •Closure by 1st or 2nd year residents increased SSI risk 2.20-fold (P=0.016)
- •Lavage of linea alba with sterile saline after closure reduced SSI risk to 0.38× (P=0.004)