Small Animal Referral Hospital Langford Vets, University of Bristol, Bristol, UK.
The Royal Veterinary College, Queen Mother Hospital for Animals, Hatfield, UK.
Vet Surg. 2022 Aug;51(6):990-1001. doi: 10.1111/vsu.13846. Epub 2022 Jun 28.
To determine and compare median sternotomy (MS) closure-related complication rates using orthopedic wire or suture in dogs.
Multi-institutional, retrospective observational study with treatment effect analysis.
331 client-owned dogs, of which 68 were excluded.
Medical records of dogs with MS were examined across nine referral centers (2004-2020). Signalment, weight, clinical presentation, surgical details, complications, and outcomes were recorded. Follow-up was performed using patient records and email/telephone contact. Descriptive statistics, treatment effect analysis and logistic regression were performed.
Median sternotomy closure was performed with wire in 115 dogs and suture in 148. Thirty-seven dogs experienced closure-related complications (14.1%), 20 in the wire group and 17 in the suture group. Twenty-three were listed as mild, four as moderate and 10 as severe. Treatment effect analysis showed a mean of 2.3% reduction in closure-related complications associated with using suture versus wire (95% CI: -9.1% to +4.5%). In multivariable logistic regression, the only factor associated with increased risk of closure-related complications was dog size (p = .01). This effect was not modified by the type of closure used (interaction term: OR = 0.99 [95% CI: 0.96/1.01]).
The incidence of closure-related complication after MS was low compared to previous reports. The likelihood of developing a closure-related complication was equivalent between sutures and wires, independent of dog size, despite a higher proportion of complications seen in larger dogs (≥20 kg).
Use of either orthopedic wire or suture appear to be an appropriate closure method for sternotomy in dogs of any size.
比较骨科钢丝或缝线用于犬正中胸骨切开术（MS）闭合相关并发症的发生率。
多机构、回顾性观察性研究，采用治疗效果分析。
331 只患犬，其中 68 只被排除在外。
检查了 9 个转诊中心（2004-2020 年）患有 MS 的犬的病历。记录了一般情况、体重、临床表现、手术细节、并发症和结果。通过患者病历和电子邮件/电话联系进行随访。采用描述性统计、治疗效果分析和逻辑回归进行分析。
115 只犬采用钢丝闭合，148 只采用缝线闭合。37 只犬发生闭合相关并发症（14.1%），钢丝组 20 只，缝线组 17 只。23 例为轻度，4 例为中度，10 例为重度。治疗效果分析显示，与使用钢丝相比，使用缝线可使闭合相关并发症的发生率平均降低 2.3%（95%CI：-9.1%至+4.5%）。多变量逻辑回归显示，与闭合相关并发症风险增加相关的唯一因素是犬体型（p=0.01）。该效应不受闭合方式的影响（交互项：OR=0.99 [95%CI：0.96/1.01]）。
与以往报道相比，MS 后闭合相关并发症的发生率较低。尽管较大（≥20kg）犬只的并发症比例较高，但缝线和钢丝的使用与犬体型无关，发生闭合相关并发症的可能性相当。
对于任何体型的犬，使用骨科钢丝或缝线似乎都是一种合适的胸骨切开术闭合方法。
