[Suture technics for the abdominal wall after midline laparotomy]

During the last 10 years 268 laparotomies by a midline incision were performed. A high incidence of seromas, fistulas caused by suturing material and wound ruptures were observed. After finding only a small number of publications in the veterinary medicine about wound healing disturbances an analysis of the human medical literature was done. This induced the change of our surgical procedure and suturing technique: The midline incision and surgical management during the laparotomies in 14 horses suffering from colic were performed by a minimized trauma. The abdominal wall was closed layer by layer in the following manner: peritoneum by a running suture of catgut metric 5, linea alba by Sultan single sutures of polyglycolic acid material metric 5 (12 cases) or of polydioxanone metric 4 (2 cases), subcutaneous layer by a running suture of polyglycolic acid material metric 4, skin by single sutures of monofilamentous synthetic material metric 2. Thus, no complications in wound healing were observed in these 14 horses. Therefore, we recommend to prove the described surgical and suturing procedure by a larger number of horses undergoing a laparotomy by a midline incision.