Haupt Jennifer, García-López José M, Chope Kate
Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, MA, 01536, USA.
BMC Vet Res. 2015 Mar 13;11:58. doi: 10.1186/s12917-015-0379-8.
Ventral midline hernia formation following abdominal surgery in horses is an uncommon complication; however, it can have serious consequences leading to increased morbidity and mortality. Currently, mesh hernioplasty is the treatment of choice for large ventral midline hernias in horses to allow potential return to normal function. Complications following mesh hernioplasty using polypropylene or polyester mesh in horses can be serious and similar to complications seen in human patients, including persistent incisional drainage, mesh infection, hernia recurrence, intra-abdominal adhesions, mesh or body wall failure, recurrent abdominal pain (colic), and peritonitis. This report describes the use of a novel bioresorbable silk mesh for repair of a large ventral midline incisional hernia in a mature, 600-kg horse. To our knowledge, this is the first report of its kind in the literature.
A 9-year-old, 600-kg Warmblood mare presented with a ventral midline hernia following emergency exploratory celiotomy 20 months prior. The mare was anesthetized and a hernioplasty was performed using a novel bioresorbable silk mesh (SERI(®) Surgical Scaffold; Allergan Medical, Boston, MA). No complications were encountered either intra- or postoperatively. The mare was discharged from the hospital at 3 days postoperatively in an abdominal support bandage. At 8 and 20 weeks postoperatively, ultrasonographic assessment showed evidence of tissue ingrowth within and around the mesh. The mare was able to be bred 2 years in a row, carrying both foals to full gestation with no complications. Following both foalings, the abdomen has maintained a normal contour with no evidence of hernia recurrence.
Ventral abdominal hernias can be repaired in horses using a bioresorbable silk mesh, which provides adequate biomechanical strength while allowing for fibrous tissue ingrowth. The use of a bioresorbable silk mesh for the repair of ventral hernias can be considered as a realistic option as it potentially provides significant benefits over traditional non-resorbable mesh.
马匹腹部手术后腹中线疝形成是一种罕见的并发症；然而，它可能会导致严重后果，增加发病率和死亡率。目前，网片疝修补术是治疗马匹大型腹中线疝的首选方法，以使其有可能恢复正常功能。在马匹中使用聚丙烯或聚酯网片进行网片疝修补术后的并发症可能很严重，与人类患者中所见的并发症相似，包括持续的切口引流、网片感染、疝复发、腹腔内粘连、网片或体壁失效、复发性腹痛（绞痛）和腹膜炎。本报告描述了使用一种新型生物可吸收丝质网片修复一匹600千克成年马的大型腹中线切口疝。据我们所知，这是文献中此类报告的首例。
一匹9岁、600千克的温血母马在20个月前接受急诊剖腹探查术后出现腹中线疝。对该母马进行麻醉，并使用一种新型生物可吸收丝质网片（SERI®手术支架；艾尔建医疗公司，马萨诸塞州波士顿）进行疝修补术。术中及术后均未出现并发症。术后3天，该母马带着腹部支撑绷带出院。术后8周和20周，超声评估显示网片内部及周围有组织长入的迹象。这匹母马连续两年能够受孕，两次妊娠均足月产驹，无并发症。两次产驹后，腹部保持正常轮廓，无疝复发迹象。
使用生物可吸收丝质网片可修复马匹的腹侧疝，该网片在允许纤维组织长入的同时提供足够的生物力学强度。使用生物可吸收丝质网片修复腹侧疝可被视为一种切实可行的选择，因为与传统的不可吸收网片相比，它可能具有显著优势。
