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在接受腹部手术的马中,使用氰基丙烯酸正丁酯或不锈钢皮肤钉进行皮肤闭合后的切口并发症。

Incisional complications after skin closure with n-butyl cyanoacrylate or stainless-steel skin staples in horses undergoing colic surgery.

机构信息

Department of Large Animal Clinical Sciences, Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, Virginia.

Population Health Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Population Health Sciences, Blacksburg, Virginia.

出版信息

Vet Surg. 2021 Jan;50(1):186-195. doi: 10.1111/vsu.13534. Epub 2020 Oct 27.

Abstract

OBJECTIVE

To compare the prevalence of incisional complications after skin closure with n-butyl cyanoacrylate (NBC) or stainless-steel skin staples (SS) after ventral midline celiotomy for colic surgery in the horse.

STUDY DESIGN

Retrospective study (2014-2018).

ANIMALS

Two hundred eighteen horses.

METHODS

Medical records of horses that underwent exploratory celiotomy for colic were included when the skin was closed with NBC or SS and the horse survived ≥15 days after surgery. Records and a follow-up questionnaire were used to determine in-hospital and posthospital discharge incisional complications. Associations between variables were assessed by using bivariable and multivariable analysis.

RESULTS

The cutaneous incision was closed with SS in 113 of 218 (51.8%) horses and with NBC in 105 of 218 (48.2%) horses. Follow-up information was available in 166 of 218 horses. Five horses with incisional complications prior to discharge but without follow-up were included in the overall analysis. Incisional complications were recorded in 17.5% (30/171) of horses, including 19.1% (17/89) of closures with SS and 15.9% (12/82) of closures with NBC (P = .54). Complications occurred before discharge in 14 of 218 (6.4%) horses and after discharge in 16 of 166 (9.6%) horses. Four horses with in-hospital incisional complications (surgical site infection) developed a second complication after discharge (hernia). Packed cell volume was a risk factor for in-hospital incisional complications (P = .04), and in-hospital incisional complications were associated with posthospital discharge incisional complications (P = .01).

CONCLUSION

Occurrence of incisional complications did not differ between NBC and SS.

CLINICAL SIGNIFICANCE

N-butyl cyanoacrylate is a suitable alternative to SS to close the cutaneous incision for ventral midline celiotomy for colic surgery in the horse.

摘要

目的

比较氰基丙烯酸正丁酯(NBC)与不锈钢皮肤钉(SS)缝合腹壁正中切口在马腹部外科手术后切口并发症的发生率。

研究设计

回顾性研究(2014-2018 年)。

动物

218 匹马。

方法

纳入接受剖腹探查术治疗腹痛且术后存活时间≥15 天的马的病历资料。记录和随访问卷用于确定院内和出院后切口并发症。采用双变量和多变量分析评估变量之间的相关性。

结果

218 匹马中 113 匹(51.8%)采用 SS 缝合皮肤切口,105 匹(48.2%)采用 NBC 缝合皮肤切口。218 匹马中有 166 匹获得随访信息。5 匹出院前发生切口并发症但无随访的马纳入总体分析。30 匹(171 匹中的 17.5%)发生切口并发症,其中 SS 组发生率为 19.1%(89 匹中的 17 匹),NBC 组为 15.9%(82 匹中的 12 匹)(P =.54)。218 匹马中有 14 匹(6.4%)在院内发生切口并发症,166 匹中有 16 匹(9.6%)在出院后发生切口并发症。4 匹院内发生切口并发症(切口感染)的马在出院后又发生了第 2 次并发症(疝)。住院期间切口并发症是发生切口并发症的危险因素(P =.04),且住院期间切口并发症与出院后切口并发症相关(P =.01)。

结论

NBC 和 SS 缝合切口的并发症发生率无差异。

临床意义

氰基丙烯酸正丁酯是替代 SS 缝合马腹部正中切口的合适选择。

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