Faculty of Animal Science and Food Engineering, Department of Veterinary Medicine, University of São Paulo, Pirassununga, São Paulo, Brazil.
Faculty of Animal Science and Food Engineering, Department of Veterinary Medicine, University of São Paulo, Pirassununga, São Paulo, Brazil.
J Equine Vet Sci. 2020 Apr;87:102903. doi: 10.1016/j.jevs.2019.102903. Epub 2020 Jan 9.
Surgical site infection of abdominal incisions is an important complication after laparotomy with increased risk of incisional hernia formation in horses. This study aims to evaluate the healing process of abdominal incisions and correlate peritonitis with the occurrence of surgical site infection and incisional hernias. Nine horses underwent standardized laparotomy, intestinal exploration, and induced septic peritonitis. Standardized relaparotomy was performed two (n = 3), four (n = 3), and six (n = 3) months later to evaluate the abdominal cavity for adhesions and to collect the sutured ventral abdominal wall to evaluate and prepare it for histopathological and tensile strength study. All horses presented with endotoxemia, controllable peritonitis, heat and touch-sensitive ventral abdominal edema and surgical wound infection with presence of purulent discharge. Adhesion of the cecum or colon to the internal portion of the surgical wound was observed. Healing of the infected surgical wounds occurred by second intention and a space between the rectus abdominis muscles developed because of the presence of a scar, which was related to incisional hernia. In the histopathological evaluation, the collagen content increased, and the inflammation decreased over time. The tensile strength increased over time and was highest after 6 months. After the second surgical intervention, there was no infection of the surgical wound in any of the animals and healing by first intention occurred. Surgical site infection may be a symptom of peritonitis in horses recovering from abdominal surgery. Infected surgical wounds heal by second intention, which favors the spacing of rectus abdominis muscle and the formation of incisional hernia.
腹部切口的手术部位感染是剖腹术后的一种重要并发症，会增加马疝形成的风险。本研究旨在评估腹部切口的愈合过程，并将腹膜炎与手术部位感染和切口疝的发生相关联。9 匹马接受了标准的剖腹术、肠道探查和诱导性脓毒性腹膜炎。在两个月（n=3）、四个月（n=3）和六个月（n=3）后进行标准的再次剖腹术，以评估腹腔是否有粘连，并收集缝合的腹侧腹壁以进行评估并准备进行组织病理学和拉伸强度研究。所有马都出现了内毒素血症、可控制的腹膜炎、发热和触痛性腹侧水肿以及手术伤口感染，伴有脓性分泌物。观察到盲肠或结肠与手术伤口内部粘连。感染的手术伤口通过二期愈合愈合，由于存在疤痕，腹直肌之间形成了一个空间，这与切口疝有关。在组织病理学评估中，胶原含量随时间增加，炎症随时间减少。拉伸强度随时间增加，在 6 个月后最高。在第二次手术干预后，没有动物的手术伤口感染，通过一期愈合。手术部位感染可能是腹部手术后恢复的马腹膜炎的症状。感染的手术伤口通过二期愈合愈合，这有利于腹直肌的间隔和切口疝的形成。
