Occurrence of incisional complications and associated risk factors using a right ventral paramedian celiotomy incision in 159 horses.
Authors: Anderson Stacy L, Vacek John R, Macharg Margaret A, Holtkamp Derald J
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Incisional Complications Following Right Ventral Paramedian Celiotomy Anderson and colleagues evaluated outcomes in 159 horses undergoing right ventral paramedian celiotomy at a private equine hospital between 2003 and 2007, with particular focus on identifying risk factors for incisional complications within and beyond the hospitalisation period. Using univariate and multivariate logistic regression analysis on 161 surgical procedures (121 with follow-up data ≥90 days post-operatively), the researchers documented incisional complications in 16.8% of cases, predominantly presenting as drainage (15.5%), with lower rates of skin dehiscence (3.7%), noticeable scarring (1.9%), and herniation (0.6%). Three variables emerged as statistically significant predictors of complications: Quarter horse-type breeds showed 3.9-fold increased odds, use of abdominal bandaging increased odds 9.5-fold, and more than four days of post-operative fever (>38.3°C) elevated odds 12.9-fold. The favourable complication profile of this approach compared to ventral median celiotomy supports continued use of right paramedian incisions, though the unexpected association with abdominal bandaging warrants further investigation—this may reflect confounding rather than true causation, given that bandages are typically applied to higher-risk cases. Practitioners should remain alert to prolonged post-operative febrile responses and breed-specific predispositions, whilst reconsidering routine bandaging protocols pending additional evidence.
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Practical Takeaways
- •Incisional drainage is common (15.5% of cases) but serious complications like herniation are rare (0.6%); monitor for infection signs particularly in Quarter horses and horses with prolonged fever
- •Use abdominal bandages selectively—they were strongly associated with complications, so reserve them for specific indications rather than routine post-op care
- •Manage postoperative fever aggressively, as more than 4 febrile days dramatically increased complication risk; this may be your most controllable risk factor
Key Findings
- •Incisional complications occurred in 16.8% of celiotomies, with drainage being the most common complication at 15.5%
- •Quarter horse-type breeds had 3.9× higher odds of incisional complications compared to other breeds
- •Use of abdominal bandaging was associated with 9.5× higher odds of complications
- •More than 4 postoperative febrile days (>38.3°C) was associated with 12.9× higher odds of incisional complications