Clinical and ultrasonographic evaluation of three suture techniques for closure of the equine linea alba

Surgical technique plays an important role in preventing ventral midline incisional complications. The aim of this study was to compare the clinical and ultrasonographic outcome of three suture techniques for closure of the linea alba. In this prospective case series (n = 43), horses operated for acute abdominal intestinal disease through a midline incision were randomised in three groups: closure with a conventional continuous technique (Group 1), a small stitches continuous technique (Group 2) and the UX-technique (shoe-lace configuration, Group 3). Age, sex, body weight, type and duration of surgery were recorded and the suture to wound length ratio was calculated. Clinical evaluation of the wound (wound discharge) was performed daily during hospitalisation. At 7 weeks post-operatively the linea alba was evaluated clinically and ultrasonographically. The linea alba width was measured halfway along the length of the incision. One horse in Group 1 had acute incisional dehiscence, but there were no further significant differences between the groups in the short term. Seven weeks post-operatively two horses had complete herniation in Group 1 and one horse had partial herniation in Group 2. In the UX group no herniation occurred. The incidence of herniation was not significantly different between the groups. On ultrasound at 7 weeks the linea alba width was significantly smaller in Group 2 (P = 0.00029) and Group 3 (P = 0.0018) compared with Group 1, even with exclusion of the acute incisional dehiscence and two herniated horses. Limitations were the small group size and relatively low incidence of incisional complications for statistical analysis. It was concluded that the use of small stitches and the UX-technique resulted in a smaller linea alba width compared with the conventional continuous suture technique and might therefore be preferred for closure of the linea alba in equine colic surgery.