Surgical wound reactions after ovariohysterectomy in dogs: comparing a knotless subcuticular suture technique to cruciate skin sutures for skin closure.

Abstract

Aims: To describe a novel knotless subcuticular suture technique using traditional smooth suture material, and to demonstrate its safety by comparing the post-operative complications with traditional interrupted cruciate skin sutures.

Methods: Forty-four dogs undergoing ovariohysterectomy were randomised into two groups, whereby the skin was closed using either a knotless subcuticular suture (NKSS; n = 22) pattern or traditional cruciate skin sutures (CSS; n = 22). The surgical wounds were assessed using a semiquantitative scoring system 10-14 days post-operatively. Data was analysed for variables associated with any wound reaction first using univariable comparisons. Then, to address small event counts and complete separation, multivariable analysis was conducted using Firth's penalised logistic regression.

Results: Wound reactions occurred in 0/22 dogs with NKSS vs. 5/22 (22.7%) with CSS (p = 0.048). The univariable odds of reaction calculated using Haldane's correction were lower with NKSS (OR = 0.071 (95% CI = 0.0037-1.37); Fisher's exact p = 0.0796). Only suture type was retained in the logistic regression, with findings for the protective effect of NKSS consistent in direction but with greater precision (OR  = 0.071 (95% CI = 0.000-0.693); p = 0.0190).

Conclusions: In this prospective cohort, the absolute risk of any wound reaction was 0% with NKSS and 22.7% with CSS. Findings are compatible with reduced odds of wound reactions for NKSS, but precision is limited by the small sample size and few events. Larger, blinded studies are required before firm conclusions about comparative safety can be drawn.

Clinical relevance: The novel knotless subcuticular suture technique was safe and effective for the skin closure of ovariohysterectomy incisions in dogs, and it may result in lower superficial wound reactions.