In cases with possible abdominal sepsis, delayed healing or the presence of significant amounts of abdominal transudate or
exudate, we use a non-absorbable suture. Using a simple continuous suture pattern for abdominal wall closure has been shown
to be as safe and efficient as using simple interrupted sutures. In either case appropriate suture size, proper knot technique
and security is important. In most routine cases using an absorbable monofilament for abdominal closure is satisfactory. In
general, this type of suture material maintains +75 percent of its strength during the critical time for abdominal wound healing.
There are several different methods of skin closure, including the use of surgical adhesives, use of absorbable monofilament
or simply bandaging the site. In general, we recommend using an appropriate size absorbable monofilament suture. In mature
animals, it is important to ligate the digital blood supply and accurately appose the skin edges. In neonates, one may use
either a small hemostat or scissors to clamp and remove the dewclaw and then appose the skin edges with suture.
The options for skin closure include skin staples, intradermal sutures and skin sutures. Skin staplers have enjoyed more widespread
use in veterinary surgery over the last decade (Photo 1). Staplers have become more affordable, and their ease and speed of
application are primarily responsible for their popularity (Table 1, p. 11).
Photo 1: During the last decade, skin staples have offered veterinarians an easier and more pratical procedure for closing
wounds and surgical sites.
There are several important points to remember for skin closure.
- Skin sutures or staples are placed 3-5 mm apart and at least 5 mm from the skin edge.
- It is important to place sutures or staples to accurately approximate the skin edges. Sutures tied too tightly may cause tissue
strangulation and cause tissue necrosis. Sutures tied too loosely fail to accurately appose the skin edges.
- In general using a series of simple square knots is recommended.
- Use a reverse cutting needle so that the flat edge of the needle hole faces the incision.
- Remember the role of skin suture is to appose skin edges, not "hold everything in."
There are several acceptable methods for tissue apposition, closure and ligation. Automated stapling or ligation devices offer
the advantage of speed, simplicity and versatility. Regardless of the method chosen for wound closure and ligation, basic
principles of knot security, tissue apposition and proper technique are important factors to remember.
Dr. Taylor is the owner of Alameda East Veterinary Hospital in Denver. He received his veterinary degree from Texas A & M
College of Veterinary Medicine. Dr. Taylor has a master's degree in veterinary surgery from the University of Colorado College
of Veterinary Medicine (CSU). He is a diplomate of the American College of Veterinary Surgeons. Dr. Taylor serves as a clinical
affiliate to CSU's veterinary teaching hospital.