Longitudinal or transverse enterotomy incisions can be made to collect samples. Enterotomy allows collection of full-thickness biopsies from all areas of the intestine and other abdominal structures. Performed if endoscopy or ultrasound biopsy if not possible or is nondiagnostic. Indications: foreign body removal, full thickness intestinal biopsy, linear foreign body removal Antibiotics should be continued in the postoperative period only if the animal is septic from peritonitis.ĭefinition: an incision into the lumen of a segment of small intestine. Antiobiotics should be redosed 2 hours after the initial dose and discontinued after surgery. First generation cephalosporins (cefazolin) should be administered 20 minutes before surgery involving the upper and middle small intestine, while second generation cephalosporins (cefmetazole or cefoxitin) should be administered for procedures involving the distal small intestine and large intestine. Prophylactic antibiotics are indicated in animals undergoing intestinal surgery. Holding animals off food decreases bacterial numbers in the stomach and small intestine. Coli, Enterococcus spp., and coagulase-positive Staphylococcus aureus.īacterial numbers are less in the duodenum and jejunum (upper and middle intestine) than in the ileum, colon, and rectum. Common pathogens responsible for peritonitis following intestinal surgery are E. Post operative infections following contaminated surgery increases with patient stress, organism pathogenicity, tissue susceptibility, and duration of surgery. The maturation phase occurs between 10 to 180 days and this is when collagen is reorganized and remodeled during the healing phase.Īll surgeries that involve entering the intestinal lumen are classified as clean-contaminated or contaminated procedures depending on the amount of spillage that occurs during surgery. The strength of the repair site approximates that of normal intestine 10 to 17 days following repair. Fibrous repair occurs, which is followed by a rapid gain in wound strength. The proliferative phase of healing occurs between days 3 and 14. Healing is biomechanically weakest at the end of the lag phase because fibrinolysis and collagen deposition and therefore dehiscence commonly occurs between day 3 and 5. A fibrin seal forms during the first few hours, although this contributes to early wound strength, most of the wound strength is attributed to sutures. The three phases of wound healing overlap with the lag phase occurring during days 0 to 4 and is associated with inflammation and edema of the intestinal wound. Tension on the anastomosis caused by ingesta, fluid, gas, or ileus increases the potential for intestinal dehiscence. Healing of the intestine is influenced by systemic factors such as hypovolemia, hypoproteinemia, debilitation and concurrent infection. Healing is also enhanced by the omentum, which helps seal the wound and contributes to the blood supply of intestinal. Approximating suture patterns facilitate rapid healing of the intestine, while everting and inverting suture patterns slow intestinal healing and may result in lumen stenosis. Intestinal healing dependent on good blood supply, accurate mucosal apposition and good tissue handling. Serosa is important in forming a quick seal at a site of injury or at an incision. The muscularis is needed for normal motitliy. The submucosal layer provides blood vessels, lymphatics, and nerves. Submucosa is the intestinal layer that provides mechanical strength and must be engaged when suturing intestine. Mucosa and intestinal blood supply are important for normal intestinal secretion and absorption. ![]() Mucosa is important because it provides a barrier that separates the luminal environment from the abdominal cavity. ![]() Layers of the intestinal wall include mucosa, submucosa, muscularis, and serosa.
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