Complications of Soft Tissue Surgery Flashcards
How long does the stomach and intestines take to heal?
10-14 days
How long does the bladder take to heal?
21-28 days
What is dehiscence?
Wound breakdown
What are causes of dehiscence?
○ Comorbidities
○ Not sutured well
○ Infection present
When is dehiscence going to occur if it does?
72-96 hours post surgery
Lag phase
Fibrin seal begins to break down due to macrophages
Too early for collagen to bind to wound
Only suture material supporting wound
What checks should you carry out during an operation?
Integrity of repair
○ No defects
○ Good blood supply
○ No contamination
Check for bleeding
Lavage and suction if contamination present
Count swabs before and after
Change gloves and instruments if contamination present
Clinical signs of dehiscence
Dull
Lethargic
Depression
Anorexic (off food)
Vomiting
Diarrhoea
Swollen painful abdomen
Guards abdomen
Resists palpation
Pyrexia
What diagnostics can you carry out to confirm dehiscence?
Radiography - retrograde +ve contrast urethrogram
Abdominal ultrasound
Radiography
Abdominal tap - Placing cannula in and trying to sample fluid present
What can be triggered by dehiscence?
Peritonitis
Uroabdomen
What should you do if dehiscence has occured?
Re open animal
Debride dehiscence
Remove previous site if intestinal - end to end anastomoses
Flush abdomen with large volumes of sterile isotonic solution until clear fluid back
What is the suture holding layer of the linea alba?
External rectus sheath
What suture pattern should you use to close the linea alba?
First bite in uncut tissue
Not through rectus muscle uncomfortable
Simple continuous
Why do you use this suture pattern for closing the linea alba?
Simple continuous
* Even distribution of tension along length of closure
* Don’t over tighten
* More rapid closure
* Less suture material (= less foreign material)
More efficient
What suture material do you use to close the linea alba?
robust long lasting absorbable monofilament
2/0 or 0 in dogs
3/0 or 2/0 in cats
