Comparison of Two Intradermal Suture Patterns to Optimize Blood Flow in Feline Skin: A Within Animal Randomized Controlled Trial

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Given the propensity for wound dehiscence and decreased perfusion in the feline skin compared to other species, optimizing perfusion to the skin through surgical technique is critical. The standard continuous horizontal mattress intradermal pattern (SP) takes dermal bites close to and paralleling the wound edge, possibly limiting further perfusion, whilst the modified continuous Allgower-Donati pattern (mAD) takes dermal bites at 90 degrees to the wound edge, which may spare more capillary feeders. The study objective was to compare the effect of SP with mAD on acute changes in cutaneous perfusion in feline patients undergoing ovariohysterectomy. Feline patients were recruited from three animal shelters. Within each feline patient, the cranial half of the incision was randomized to SP or mAD, while the caudal half received the alternate pattern. Changes from baseline in cutaneous perfusion were measured for each pattern using Laser Doppler Perfusion Imaging. Analysis from thirty-two feline patients revealed significant differences. With mAD, cutaneous perfusion increased a mean of 59.7 ± 124.1 BPU from baseline, while SP showed a mean decrease of 20.2 ± 119.9 BPU (p<0.01). No feline patients re- presented for incisional complications. The findings show that a simple modification of the commonly performed intradermal pattern notably enhances cutaneous perfusion along the incision margin. Study limitations included the absence of active long-term follow-up due to the shelter setting and of perfusion measurement over a single period of time. Incorporating the modified continuous Allgower-Donati pattern into wound management protocols could be beneficial in feline patients at a high risk for wound dehiscence.

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Hayes, Galina

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