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Published on: June 11, 2009
Comparison of blind end closure techniques in equine ileum
Rachel L Hilliard1, Amanda Prisk2, Sichao Wang3
1Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA.
Objective:
To determine the difference in bursting pressure (BP), bursting wall tension (BWT), and closure speed between commonly utilized methods of ileal stump closure.
Study Design:
Randomized experimental study.
Sample Population:
A total of 71 ileal segments from 18 healthy horses.
Methods:
Ileum was collected postmortem from 18 horses and divided into four segments. One end of each segment was closed using one of three techniques: Parker-Kerr (PK), gastrointestinal staples (ST), or gastrointestinal staples with a Lembert staple oversew (SO). Closure time was recorded. Control (C) segments were not altered. Segments were distended until failure. BP and infusion volume were documented, and BWT was calculated.
Results:
BP and BWT were higher for controls compared to all closure methods (p < .001). No differences in BP (p > .999) or BWT (p > .77) were found between closure methods. ST technique was 27.1 times faster than PK (p < .001) and 23.4 times faster than SO (p < .001). SO was 1.2 times faster than PK (p < .001). Mechanisms of failure were predictable within each technique.
Conclusion:
No difference in BP or BWT was observed between closure techniques in healthy ileum. ST and SO were significantly faster than PK.
Clinical Significance:
The similarity in bursting strength across techniques suggests that closure method should be chosen based on other factors. The ST closure was faster compared to other techniques, and the addition of an oversewing pattern did not improve security of closure.
