Plus-Hex CLINICAL
Figure 2 . A horse draped for colic surgery with a heavy-duty sterile , impervious laparotomy drape with separate leg covers , a bag to retain the intestines , and a centre fenestration . Note the colon tray in place between the hind limbs .
laparotomy drape itself must be heavy duty and fully impervious [ 7 ] . Equine laparotomy drapes ideally have plastic side pockets to safely contain the intestines and suction equipment within the drape [ 7 ] . A sterile adhesive drape with impregnated iodophor should be initially applied to the abdomen [ 7 ] . Leg drapes can be used to cover the hind limbs first as they are high-risk areas for contamination [ 7 ] . The horse will then be completely covered in a single drape with a centre fenestration and adhesive inner edges that adhere to the underlying drape [ 7 ] ( Figure 2 ). The drape should be held in place by towel clamps , which , once secured to the skin over a non-prepared surface ( such as the limbs or sternum ), should be considered contaminated [ 7 ] .
Surgery equipment
Non-woven surgical swabs have significant advantages over woven swabs for use in this type of surgery , as they hold more fluid and are less abrasive [ 10 ] . These 10 cm × 10 cm gauze swabs should be counted before and at the end of surgery , although this is not always practical in equine surgery [ 1 , 11 ] . The basic surgical instrument kit for the procedure [ 11 ] is listed in Table 1 ( overleaf ). A suction unit delivering 100 mmHg and sterile suction tubing with a needle connection are required for decompression of gas in the colon to facilitate abdominal exploration [ 11 ] . This may be carried out several times during the laparotomy [ 12 ] . Decompression of the gas is carried out using 21 – 14 G needles , depending on the size of the patient and the section of intestine to be decompressed [ 11 ] . The needle is inserted into the lumen of the intestine for decompression , where it then becomes contaminated by intestinal contents ( Figure 3 ). The contaminated needle should be discarded by the VS away from the sterile field and table [ 7 ] . To evacuate fluid from the abdomen , a Poole Suction Tip is connected to the suction tubing and the suction unit [ 13 ] .
The adult equine linea alba will be closed using a slowly absorbable braided synthetic suture material , such as polyglactin 910 , ranging from USP 2 to USP 7 ( 5 to 9 metric ), which has a good size-to-strength ratio and nice handling properties [ 14 ] . The subcutaneous layer of tissue should be closed using an absorbable monofilament suture material , such as polydioxanone or polyglycolide , USP 2-0 to USP 0 ( 3 to 3.5 metric ) [ 14 ] . The skin can be closed with skin staples or either absorbable or nonabsorbable monofilament suture material [ 14 ] .
Figure 3 . Needle decompression of the caecum using an 18 G needle connected to suction tubing .
Volume 38 ( 3 ) • June 2023
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