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occurs here increasing the threat/risk of SSIs. These powerful mat- tress sutures are pre- placed 3 and 4 cm beyond the hernial ring (Fig- ure 3 ), the staggered spacing reducing stress risers which may occur along single longitudinal rows of standard suture placement. They provide strong secure closure. Sutures are counted, should infection occur, and ultrasound could be used to identify which sutures are in- volved for individual removal. Each pre- placed tape suture is lavaged with 1:50 dilution of 10% povidone– iodine solution, borrowed from its use in corneal surgery (Pierce & Townsend, 2019 ) before closure of the remaining layers. Simple interrupted tape sutures are also placed in the now apposed hernial ring edges. The Maxon loop pro- vides a firm suture for closure and elimination of surgical dead space in the layers superficial to the closed hernial ring, protecting the tape sutures from external contamination. Laparoscopic repairs of
incisional hernia have also been de-
scribed by Caron and Mehler ( 2009 ) and Gandini et al. ( 2017 ). Caron placed a composite polypropylene- expanded polytetrafluoroethy- ene mesh (Bard Composix E/X Mesh) in four of five horses on the abdominal side of the peritoneal lining laparoscopically. Some degree of post- op pain is a feature of many incisional her-
niorrhaphy procedures (Freeman, 2005 ). Ramos et al. ( 2024 ) also notes the evolution of neonatal pe-
nile anatomy between 0 and 30 days with regard to resorption of the annular attachment between the glans and the preputial ring
WOODFORD
(Schumacher, 2019 ). Occasionally this attachment can persist tem- porarily Figure 4 , as in this 2.5- month- old foal with spontaneous resolution occurring at 14 weeks of age Figure 5 .
ORCID Nigel Woodford
https://orcid.org/0000-0003-0680-8900
REFERENCES
Caron , J.P. & Mehler , S.J. ( 2009 ) Laparoscopic mesh incisional hernio- plasty in five horses . Veterinary Surgery , 38 , 318 – 325 .
Davis , B.E. & Rakestraw , P.C. ( 2002 ) Outcome of horses following surgi- cal repair of incisional hernias of the ventral midline abdominal wall: 60 cases (1987- 2001) . Veterinary Surgery , 31 ( 5 ), 480 .
Duhamel , G.E. & Wheeldon , E.B. ( 1982 ) Intestinal adenomatosis in a foal . Veterinary Pathology , 19 , 447 – 450 .
Edwards , G.B. ( 2002 ) Repair of large incisional hernias in 36 horses using polypropylene mesh . In: Proceedings of the 7th international equine colic research symposium . Newmarket : Equine Veterinary Journal Ltd , p. P37 .
Elce , Y.A. , Kraus , B.M. & Orsini , J.A. ( 2005 ) Mesh hernioplasty for repair of incisional hernias of the ventral body wall in large horses . Equine Veterinary Education , 17 , 252 – 256 .
Frank , N. , Fishman , C.E. , Gebhart , C.J. & Levy , M. ( 1998 ) Lawsonia in- tracellularis in a weanling foal . Equine Veterinary Journal , 30 ( 6 ), 549 – 552 .
Freeman , D.E. ( 2005 ) Management of ventral incisional hernias in large horses: a surgical challenge . Equine Veterinary Education , 17 ( 5 ), 247 – 251 .
Gandini , M. , Giusto , G. , Caramello , V. , Comino , V. & Rosso , A. ( 2017 ) Single- port laparoscopic incisional hernia repair in a horse . Equine Veterinary Education , 29 ( 7 ), 362 – 366 .
Haupt , J. , Garcia- Lopez , J.M. & Chope , K. ( 2015 ) Use of a novel silk mesh for ventral midline hernioplasty in a mare . BMC Veterinary Research , 11 , 58 .
Holihan , J.L. , Nguyen , D.H. , Nguyen , M.T. , Mo , J. , Kao , L.S. & Liang , M.K. ( 2016 ) Mesh location in open ventral hernia repair: a systematic review and network meta- analysis . World Journal of Surgery , 40 , 89 – 99 .
Kelmer , G. & Schumacher , J. ( 2008 ) Repair of abdominal wall hernias in horses using primary closure and subcutaneous implantation of mesh . Veterinary Record , 163 , 677 – 679 .
Neal , H. ( 1997 ) BEVA meeting details unavailable . (Personal communication).
Pierce , K.E. & Townsend , W.M. ( 2019 ) Surgery of the globe and orbit . In: Auer , J. , Stick , J. , Kummerle , J. & Prange , T. (Eds.) Equine Surgery , 5th edition . St Louis : Elsevier , p. 917 .
Ramos , S. , Storms , N. , Vandersmissen , M. , Dupont , J. & de la Rebiere , G. ( 2024 ) Caudal ventral midline herniation in a foal . Equine Veterinary Education , 36 , 20 , e25–e31.
https://doi.org/10.1111/eve.13850 .
Schumacher , J. ( 2019 ) Penis and prepuce . In: Auer , J. , Stick , J. , Kummerle , J. & Prange , T. (Eds.) Equine Surgery , 5th edition . St Louis : Elsevier , pp. 1051 – 1080 .
Stonex , T.M. , Zibura , A.E. , Andes , M. & Oh , A. ( 2021 ) Sclerotherapy for treatment of a superficial orbital venous malformation in a horse . Veterinary Ophthalmology , 24 ( 6 ), P45 .
Toth , F. & Schumacher , J. ( 2018 ) Prosthetic mesh repair of abdominal wall hernias in horses . Veterinary Surgery , 47 , 536 – 542 .
FIGURE 5 Same foal as in Figure 4, annular attachment between glans and preputial ring now fully resorbed with conservative management (Photo courtesy of James Bosley MRCVS).
Toth , F. & Schumacher , J. ( 2019 ) Abdominal hernias . In: Auer , J. , Stick , J. , Kummerle , J. & Prange , T. (Eds.) Equine Surgery , 5th edition . St Louis : Elsevier , pp. 645 – 659 .
Van der Velden , M.A. & Klein , W.R. ( 1994 ) A modified technique for implantation of polypropylene mesh for the repair of external Continued on page 41
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