Troy Jarrod R, Holcombe Susan J, Fogle Callie A, Epstein Kira L, Woodie J Brett
Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan.
Department of Large Animal Medicine, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina.
Vet Surg. 2018 Apr;47(3):385-391. doi: 10.1111/vsu.12777. Epub 2018 Feb 20.
To determine the influence of hyaluronate-carboxymethylcellulose (HA-CMC) membranes applied to intestinal anastomoses or enterotomies on postoperative complications after emergency exploratory celiotomy.
Multicenter retrospective case-controlled series.
Adult horses (59 in the HA-CMC group and 91 controls).
Medical records from 4 referral hospitals were searched for horses ≥1 year of age, treated between 2008 and 2014 with emergency exploratory celiotomy, and surviving at least 24 hours postoperatively. Horses receiving repeat celiotomy during the same hospitalization were excluded. Horses who received HA-CMC were matched with controls who did not receive HA-CMC but had similar intestinal lesions and procedures at the same referral hospital. Postoperative complications (colic, nasogastric reflux, fever, incisional infection, and septic peritonitis), duration of hospitalization, and survival were compared between groups. Data were compared between horses by t test, Wilcoxon signed rank test, and χ test.
The volume of nasogastric reflux at admission (P = .02) and the duration of administration of lidocaine after surgery (P = .02) were greater in horses with HA-CMC membranes than in controls. No difference in postoperative complications or survival was detected between groups: 48 of 59 (81%) horses treated with HA-CMC survived until discharge from the hospital compared with 80 of 91 (88%) horses in the control group (P = .27). Fifteen of 21 horses treated with HA-CMC and 30 of 43 horses in the control group survived >12 months after hospital discharge.
Application of HA-CMC membranes to anastomoses or intestinal incisions did not influence postoperative complications or survival after emergency celiotomy compared with controls.
The safety and efficacy of HA-CMC membrane application to intestinal sites during colic surgery in horses is equivocal.
确定在急诊剖腹探查术中，应用透明质酸盐 - 羧甲基纤维素（HA - CMC）膜于肠吻合口或肠切开处对术后并发症的影响。
多中心回顾性病例对照系列研究。
成年马（HA - CMC组59匹，对照组91匹）。
检索4家转诊医院2008年至2014年期间治疗的年龄≥1岁、接受急诊剖腹探查术且术后存活至少24小时的马的病历。排除在同一住院期间接受再次剖腹探查术的马。接受HA - CMC治疗的马与未接受HA - CMC但在同一转诊医院有相似肠道病变和手术操作的对照组马进行匹配。比较两组之间的术后并发症（腹痛、鼻胃反流、发热、切口感染和化脓性腹膜炎）、住院时间和存活率。通过t检验、Wilcoxon符号秩检验和χ检验对马的数据进行比较。
应用HA - CMC膜的马入院时鼻胃反流量（P = 0.02）和术后利多卡因给药时间（P = 0.02）均高于对照组。两组之间术后并发症或存活率未检测到差异：HA - CMC治疗的59匹马中有48匹（81%）存活至出院，而对照组91匹马中有80匹（88%）存活至出院（P = 0.27）。HA - CMC治疗的21匹马中有15匹和对照组43匹马中有30匹在出院后存活超过12个月。
与对照组相比，在急诊剖腹探查术中将HA - CMC膜应用于吻合口或肠切口对术后并发症或存活率没有影响。
在马的腹痛手术中，将HA - CMC膜应用于肠道部位的安全性和有效性尚不明确。
