Abdominal incision and closure

Closure of the rectus sheath with a continuous looped suture and the skin with staples in dogs: Speed, safety, and costs compared to closure of the rectus sheath with interrupted sutures and the skin with a continuous subdermal suture

“…Continuous closure is at least as safe as interrupted closure if correctly performed (1, 5,17,18,20,22,25,27,30,33). This implies that an adequate portion of rectus sheath is included in each suture bite, that the sutures are not tied too tightly, and that the suture material is not grasped by instruments that may damage it (6,22,32).…”

“…Overall, infection rates vary between 0 and 5% (5,8,17,18,20,25,27,28,33,34,39). The infection rate in our study is in accordance with the findings of Cruse et al who reported that infection rates in clean procedures are higher when the operation is done between midnight and 8 AM than when they are performed at other times (7).…”

“…However, the shorter operative procedure when a continuous suture pattern is used can also have cost-saving advantages (17,20,34), and stapling may be economically feasible if the reduced costs of surgical time and anaesthesia are considered (38). Ranaboldo (24) found no significant advantage in the use of staples over subcuticular suturing because of small time savings (only 77 seconds per wound) in relation to the additional costs.…”

“…The costs per dog in group 1 were nearly two times as high as in group 2 ( (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) were used. The unused staples were discarded.…”

“…A series of interrupted sutures has been the standard procedure for ventral midline closure in this clinic, but more recently many veterinary surgeons have used a continuous suture of polydioxanone for closure of the linea alba (2). The advantages of a continuous suture are speed, an equal distribution of tension, less foreign material in the wound, and less wound trauma (5,17,25,27,33). The safety of continuous sutures has been shown to be equal to that of interrupted closure (5,18,20,27,30).…”