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Comparative Study Of Different Suturing Techniques For Cystotomy Closure In Canines

By: Imdadullah Khan | Prof. Dr. Muhammad Arif Khan.
Contributor(s): Dr. Ayesha Hassan | Pror. Dr.
Material type: materialTypeLabelBookPublisher: 2012Subject(s): Department of Clinical Medicine & SurgeryDDC classification: 1445,T Dissertation note: The cystotomy is an incision in to the wall of urinary bladder which is commonly indicated for the removal of urinary stones and for the excision of invading tumors. Cystotomy wound is closed by varieties of suturing patterns which commonly include simple appositional and inversion types of suturing patterns. Appositional patterns are used in single-layer while double-layer appositional pattern is also used. Inversion types of suturing patterns are commonly used in double layers. Single-layer appositional patterns are commonly used in small and young animals while double-layer inverting pattern is preferred to apply in large animals. Double-layer inversion pattern has been found to decrease the size of bladder lumen when the bladder wall is thick. Bladder mucosa in all cases is not penetrated because of the danger of the formation of bladder stones. In three-layer closure mucosa is sutured as a separate layer and is indicated commonly when there is bleeding. The present project is aimed to conduct a comparative study of appositional versus inversion type of suturing patterns and two-layer versus three-layer of bladder wall repair. The study was conducted on 24 dogs divided into four groups comprising 6 dogs each. In 18 dogs experimental cystotomies were performed which were closed in following manners. Group-A: the cystotomy wound was closed in two-layer simple interrupted suturing pattern, group-B: cystotomy wound was closed in two layers by simple continuous and continuous lembert suturing pattern, group-C: the cystotomy wound was closed in three layers and group-D was the control group. These suturing techniques were evaluated for leakage with the help of contrast radiography, ultrasonography, renal function tests and physical signs. These techniques were also evaluated for their effect on residual urine volume with the help of ultrasound machine. All the suturing techniques provided water tight closure when evaluated through radiography, ultrasonography, kidney function tests and physical examination. The two-layer inversion patterns and three-layer closure techniques were found to effect residual bladder volume but the effect of three-layer closure technique was more pronounced. No crystals/stones were observed on postmortem examination of the urinary bladder in each operated dog. A well demarcated stricture was noted in dogs whose bladders were sutured in three layers. It was thus concluded form the research that appositional patterns do not affect the residual bladder volume, the catgut can be penetrated through the mucosa without endangering for cystolithiasis and the two-layer appositional suturing pattern is as effective as three-layer closure of cystotomy wound for the control of hemorrhage from the bladder mucosa.
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Veterinary Science 1445,T (Browse shelf) Available 1445,T
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The cystotomy is an incision in to the wall of urinary bladder which is commonly indicated for the removal of urinary stones and for the excision of invading tumors. Cystotomy wound is closed by varieties of suturing patterns which commonly include simple appositional and inversion types of suturing patterns. Appositional patterns are used in single-layer while double-layer appositional pattern is also used. Inversion types of suturing patterns are commonly used in double layers. Single-layer appositional patterns are commonly used in small and young animals while double-layer inverting pattern is preferred to apply in large animals. Double-layer inversion pattern has been found to decrease the size of bladder lumen when the bladder wall is thick. Bladder mucosa in all cases is not penetrated because of the danger of the formation of bladder stones. In three-layer closure mucosa is sutured as a separate layer and is indicated commonly when there is bleeding. The present project is aimed to conduct a comparative study of appositional versus inversion type of suturing patterns and two-layer versus three-layer of bladder wall repair.
The study was conducted on 24 dogs divided into four groups comprising 6 dogs each. In 18 dogs experimental cystotomies were performed which were closed in following manners. Group-A: the cystotomy wound was closed in two-layer simple interrupted suturing pattern, group-B: cystotomy wound was closed in two layers by simple continuous and continuous lembert suturing pattern, group-C: the cystotomy wound was closed in three layers and group-D was the control group. These suturing techniques were evaluated for leakage with the help of contrast radiography, ultrasonography, renal function tests and physical signs. These techniques were also evaluated for their effect on residual urine volume with the help of ultrasound machine.
All the suturing techniques provided water tight closure when evaluated through radiography, ultrasonography, kidney function tests and physical examination. The two-layer inversion patterns and three-layer closure techniques were found to effect residual bladder volume but the effect of three-layer closure technique was more pronounced. No crystals/stones were observed on postmortem examination of the urinary bladder in each operated dog. A well demarcated stricture was noted in dogs whose bladders were sutured in three layers. It was thus concluded form the research that appositional patterns do not affect the residual bladder volume, the catgut can be penetrated through the mucosa without endangering for cystolithiasis and the two-layer appositional suturing pattern is as effective as three-layer closure of cystotomy wound for the control of hemorrhage from the bladder mucosa.

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