33rd Annual Scientific Meeting proceedings

Wound dehiscence following enterotomy can be fatal, with mortality rates of up to 50%. Various risk factors impacting the development of dehiscence are reported, however, early leakage is commonly attributed to technical error or sealing device failure. Surgical sealants are commonplace in veterinary practice and provide valuable alternatives or adjuncts to sutures for incision closure, although intracorporeal use is not widely researched. This study aims to investigate the use of surgical sealants in enterotomy closure and the impact on intestinal leakage pressures in-vitro.

Forty-five chilled jejunal segments (n=15/group) were assigned to a hand-sewn group (HSE), a surgical sealant group (SSE) and a hand-sewn and surgical sealant group (HS+SSE).  A 2cm antimesenteric enterotomy was performed and closure with one of above techniques. Initial leakage pressures (ILP), maximal intraluminal pressures (MIP) and initial leakage location (ILL) were recorded.  

The mean ± SD ILP for the HSE, SSE and the HS+SSE group was 43.8 ± 5.3 mm Hg, 18.6 ± 3.5 mm Hg and 83.3 ± 4.6 mm Hg, respectively. The HS+SSE group leaked at significantly higher ILP compared to the HSE group (p <0.001). The SSE group leaked at a lower MIP compared with the other groups (p <0.001) and there was no significant difference in the MIP between the HSE and the HS+SSE groups (p = .19).

Using surgical sealant atop a handsewn enterotomy significantly increased the initial leak pressures in cadaveric canine jejunum. An increase in leakage pressures could consequently reduce the incidence of intestinal leakage following an enterotomy.