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EQUINE VETERINARY EDUCATION / AE / FEBRUARY 2022


a)


b)


Fig 6: Stent sutured using horizontal mattress, to a modified Forssell’s incision (a) and a flank laparotomy (b) to decrease tension on the suture line, apply pressure and protect the incision.


a) b)


Fig 7: A mass (exuberant granulation tissue) near the tarsus (a) Using Top Closure system to enable closure of the wound resulted from removal of the mass (b).


another horse, the surgery went well but the horse succumbed to unrelated complications and in the fourth, the gap was so wide and the forces applied by movement so extensive that the wound opened shortly after closure. The human surgeon, who developed the device and helped to apply it to the wounds of two horses, opined that the device must be modified to be more resilient and increase its efficacy, if it is to be used in horses. An improvised method for closing gaping wounds under


tension is by incorporating buttons into the repair in both sides of the wound. The technique relies on repeated loops of


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suture across the wound, similar to the mattress sutures and NFFN. However, the buttons allow for distributing the pressure on the skin to a larger surface area and thus enable the skin to withstand further tension across the wound (Fig 8). Another method of relieving tension on a sutured incision


that does not involve stretching skin adjacent to cutaneous defect is to create one or more relaxing incisions adjacent and parallel to the defect. The width of the skin between the incision and the wound should be equal to the width of the wound when a single incision is used to relieve tension. Creating a relaxing incision on each side of the wound


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