Boone Lindsey Helms, Epstein Kira, Cremer Jeanette, Rogers Andrew, Foutz Tim, Quandt Jane, Howerth Elizabeth, Mueller P O Eric
Department of Large Animal Medicine, University of Georgia, Athens, Georgia; Department of Physiology and Pharmacology, University of Georgia, Athens, Georgia.
Vet Surg. 2014 Aug;43(6):741-9. doi: 10.1111/j.1532-950X.2014.12139.x. Epub 2014 Jan 27.
To compare tensile strength, failure location, and histologic features after acute repeat celiotomy through a ventral median (RVM) or a right ventral paramedian (RVP) celiotomy in horses.
Ex vivo experimental study.
Adult horses (N = 18).
Twelve adult horses had original ventral median (OVM) celiotomy. Repeat celiotomy was performed 72 hours postoperatively through the original ventral median (RVM, N = 6) or a RVP (N = 6) celiotomy. Celiotomies were scored daily for edema, drainage, and dehiscence. Fourteen days after repeat celiotomy, horses were euthanatized and abdominal wall containing celiotomy(ies) were collected for biomechanical and histological evaluation. The abdominal wall of control horses (N = 6; no celiotomy) was collected for biomechanical testing. Vital sign variables, incisional edema, and histologic scores were compared using a Wilcoxon signed-rank test. Incisional fibrotic depth and tensile strength per unit length (N/cm) was compared using repeated measures ANOVA.
RVM and RVP horses had significantly less tensile strength compared to control horses, but no differences were observed between RVM and RVP horses. No differences in healing, inflammation, infection, or necrosis of repeat celiotomies was observed, but RVP horses accumulated more fibrin and hemorrhage within the incision. RVP horses had significantly greater incisional edema scores, but incisional drainage was more frequent in RVM horses.
Acute repeat celiotomy through a RVM incision results in similar incisional healing and tensile strength compared with repeat celiotomy through a RVP incision.
比较马通过腹正中（RVM）或右腹旁正中（RVP）切口进行急性重复剖腹术后的拉伸强度、破裂位置和组织学特征。
离体实验研究。
成年马（N = 18）。
12匹成年马进行了原腹正中切口（OVM）剖腹术。术后72小时通过原腹正中切口（RVM，N = 6）或RVP切口（N = 6）进行重复剖腹术。每天对剖腹切口的水肿、引流和裂开情况进行评分。重复剖腹术后14天，对马实施安乐死，并收集包含剖腹切口的腹壁进行生物力学和组织学评估。收集对照马（N = 6；未进行剖腹术）的腹壁进行生物力学测试。使用Wilcoxon符号秩检验比较生命体征变量、切口水肿和组织学评分。使用重复测量方差分析比较切口纤维化深度和单位长度的拉伸强度（N/cm）。
与对照马相比，RVM组和RVP组马的拉伸强度显著较低，但RVM组和RVP组马之间未观察到差异。重复剖腹术的愈合、炎症、感染或坏死方面未观察到差异，但RVP组马的切口内积聚了更多纤维蛋白和出血。RVP组马的切口水肿评分显著更高，但RVM组马的切口引流更频繁。
与通过RVP切口进行重复剖腹术相比，通过RVM切口进行急性重复剖腹术导致相似的切口愈合和拉伸强度。
