Incisional complications after skin closure with stainless-steel skin staples compared to nylon sutures in horses undergoing colic surgery

Background: Incisional complications following ventral midline celiotomy represent a challenge for equine surgeons. Preventative measures to minimise risks of incisional complications are continuously being investigated. This includes the search for an ideal surgical closure method.Objective: To compare the incidence of incisional complications after skin closure with nylon sutures versus stainless-steel skin staples (SSS) following ventral midline celiotomy for colic surgery in horses and to assess additional risk factors for incisional complications.Study design: Prospective blinded randomised study (2012-2014).Methods: One hundred and twenty-three horses that underwent colic surgery between May 2012 and May 2014 and survived for >2 weeks were included in the study. Horses were allocated randomly to two groups-65 horses were closed with skin staples, and 58 horses were closed with skin sutures (nylon-0). Patient records and a follow-up questionnaire were used to record incisional complications that occurred during hospitalisation and after discharge.Results: Follow-up information was available in 119 of 123 horses. Four horses without follow-up were excluded. With strict inclusion criteria, incisional drainage was recorded in 43% (49/115) of the horses, including 40% (25/63) of the surgical staples skin closure group and 46% (24/52) of the nylon suture skin closure group. Pregnancy and large colon intestinal lesions were risk factors for incisional complications. Surgeon 3 was found to decrease the incidence of incisional infection. No association was detected between incisional complications and hernia development.Main limitations: The non-uniformity of the follow-up examination; reliance on owners or caregiver of the horse for follow-up information, horses lost to follow-up, incomplete data. Another limitation was the single-centre design of the study.Conclusions: Although not significantly superior, the use of staples may serve as a valid alternative for ventral midline abdominal incision skin closure.