Colic diseases in horses and the use of abdominal bandages during recovery
Gastrointestinal diseases in horses are one of the most common reasons for hospitalization in specialist emergency clinics (Southwood et al. 2009, Viljoen et al. 2009). Colics were also the most frequently solved acute problem among practicing veterinarians (Traub-Dargatz et al. 1991). It is very difficult to obtain a long-term, objective and error-free study that would conclusively determine the incidence of colics in the horse population. The percentage value of the occurrence of the risk of colic disease in all equines is reported from 2.8 to 2.9% (NAHMS 2015; Slater 2016).
The incidence, together with the high economic burden on the owner or breeder when losing a valuable individual and financially demanding treatment, have made colics a routine health problem for clinics and a space for reducing possible risks associated with the procedure or complications in the post-surgery period.
The necessity of surgical therapy in the case of colic disease in horses is reported in up to 17% (Proudman 1992, Kaneene et al. 1997, Tinker et al. 1997, Curtis et al. 2015). For economic reasons, the fact of future horse sport or breeding use and the quality of life of horses after colic surgery also plays a big role. The development of equine surgery, and especially the advent of routine laparotomy procedures, makes it possible to extend the lives of many horses that would not have survived without the procedure. Early recognition of the onset of complications and immediate appropriate treatment of common non-surgical complications can improve post-operative horse survival (Hackett and Hassel 2008). Abdominal surgery in horses has many challenges, and the closure of the laparotomy wound after gastrointestinal surgery is a very important component of successful therapy.
This topic contains a number of variable factors that entail various complications. The most common incisional complications are: wound edema, local infection, sinus formation, hematoma formation, wound secretion, wound dehiscence and incisional hernia formation (Klohnen 2009). The incidence of incisional complications can be as high as 40% (Wilson et al. 1995, Mair and Smith 2005b). Secretions of laparotomy wounds are recorded in 32-36% of cases, dehiscence in 3-5% of cases and hernia formation in 6-17%. (Kobluk et al. 1989, Gibson et al. 1989, Wilson et al. 1995). Over time, several factors have been identified as risky. These include: patient age, patient weight, type of incision, type of suture material, method of wound closure, degree of surgical trauma, length of surgery, and possible complications during recovery from anesthesia (Honnas and Cohen 1997, Galuppo el al. 1999, Stone et al. 1990, French et al. 2002). Complications of wound healing after laparotomy increase depending on the rising level of plasma proteins on patient admission. Horses undergoing a relaparotomy are at higher risk of complications than horses undergoing a first laparotomy (Mair and Smith 2005b). Opinions on the use of abdominal bandages vary. There are studies that support their use, on the other hand, there are studies that do not confirm their benefit (Mair and Smith 2005b, Klohnen et al. 2008b). As another possibility to prevent the occurrence of wound infection, the relationship of different types of suture materials used for suturing the laparotomy wound was observed. Bacterial contamination of the material and the wick effect can increase the virulence of the infection at the operated area (Edmiston et al. 2006).
Preventive measures at the place of the surgery are an important point in the fight against the formation and spread of wound infection. Patients who develop wound secretion are more likely to develop an incisional hernia. Wound infection can be considered a predisposing factor to the development of a hernia. This finding is supported by studies reporting a 17.8- to 62.5-times increase in the risk of hernia formation in infected wounds (Gibson et al. 1989, Ingle-Fehr et al. 1997). Hernia formation can be reduced through the use of specially designed bandages that allow daily care of the infected wound (Kohlen and Lores 2008). Abdominal wall distension is the most serious complication of laparotomy wounds and carries with it the risk of prolapse of the organs of the abdominal cavity.
At the Clinic of Horse Diseases of the Veterinary University in Brno, incisional complications were evaluated as the most frequent complications after laparotomy procedures.
A group of incisional complications was recorded in up to 81 cases, which meant 47.1% of the cases in the monitored group. Individual complications in this group were represented as follows:
- laparotomy wound edema in 77 cases (95.1%)
- wound infection in 23 cases (28.4%)
- wound dehiscence or incisional hernia in 6 cases (7.4%)
For these reasons, it was a priority for us to create an abdominal bandage that would have several preventive and therapeutic functions. The established cooperation with the company VETOFLEX exceeded our expectations and the result was the creation of 2 types of abdominal bandages. We use the first type at the Horse Disease Clinic during recovery from general anesthesia, when the bandage mainly has a barrier function and prevents contamination of the sterile covering of the laparotomy wound. The second type of bandage is designed to be more favorable and comfortable for horses and nursing staff due to long-term use during recovery. This bandage has several functions: barrier (protects the wound from dusty environment, bedding and insects), compressive (strengthens the abdominal wall and prevents the formation of soft tissue edema around the laparotomy wound). Due to the sophisticated shape, the abdominal bandage is comfortable for horses, soft and reinforced materials do not traumatize the skin. The modern materials ensure breathability. The bandage is easy to maintain, disinfect and clean. High temperatures and disinfectants do not have a negative effect on materials even with frequent treatment. Commercially available post-surgery bandages had unsuitable material for our clinic, on which the dust, bedding and fur were caught. They were difficult to disinfect and washing at high temperatures was not possible. VETOFLEX met our needs and supplied us with bandages that are resistant to the demanding conditions created by the needs of post-laparotomy horses and the equine clinic environment.
MVDr. Zuzana Kecerová Ph. D.
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