Incisional complications following relaparotomy in horses

Incisional complications occur frequently following laparotomy in horses. To the authors' knowledge, there is no data regarding frequency of suture dehiscence, incisional infection and incisional hernia subsequent to relaparotomy. The aim of this retrospective study was to determine incisional complications after repeated laparotomy in our clinic. Furthermore, the influence of time elapsed after initial laparotomy on the occurrence of incisional complications of relaparotomy was investigated. For this purpose, patient records from January 2010 to October 2016 of the Large Animal Clinic for Surgery at the University of Leipzig have been analysed. Horses were included, when subjected to relaparotomy due to colic. The following parameters were analysed: breed, sex and age of the horses, localisation of colic disease and invasiveness of the surgical intervention as well as placement of an abdominal bandage. Incisional complications were differentiated into suture dehiscence, incisional secretion/infection and incisional hernia. Wound oedemas were considered separately. Within the evaluation period 22 relaparotomies due to colic have been performed. The interval between initial laparotomy and relaparotomy ranged from one day to 5 years. 11 relaparotomies took place in the first 8 weeks following initial surgery. The other 11 relaparotomies were performed at a later date. Suture dehiscence occurred in none of the investigated horses. Wound secretion was observed in 9.1% (2/22) of the relaparotomies. Wound oedemas occurred in 90.9% (20/22) of the cases. Postoperative hernias developed in 4.8% (1/21). In relaparotomies performed up to 8 weeks following initial surgery, wound secretion as the incisional complication was observed in 18.2% (2/11). Relaparotomies performed later than 8 weeks after the initial laparotomy did not show any incisional complications. Based on the results of this case series it can be assumed that relaparotomy performed within 8 weks after the initial laparotomy carries an increased risk for the development of incisional complications as compared with relaparotomies performed at a later date.