Primary closure of equine laryngotomy incisions: Healing characteristics and complications of 180 cases

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The objective was to report healing characteristics and complications after primary closure of equine laryngotomies and analyse factors potentially associated with complications. This retrospective case series of the medical records of horses (n = 180) undergoing laryngoplasty and laryngotomy incision between January 1995 and June 2012 were reviewed. Horses with a laryngotomy incision closed in three layers for primary healing were included. Descriptive data on healing characteristics and complications of laryngotomy wounds were collected from the medical records and via follow-up questionnaires sent to the owners. During hospitalisation 6.1% of the laryngotomy wounds became infected. In addition, 3.3% had oedema around the wound and 3.3% had subcutaneous emphysema after surgery. Neither oedema nor emphysema required additional treatment. No signs of respiratory distress, need of a tracheotomy or need for a reopening of the laryngotomy was observed in any horse. Infection of the laryngoplasty wound occurred in one horse. A total of 96 questionnaires were answered. Prolonged healing of the incision after discharge from the hospital was reported in four horses (4.2%). Laryngotomy infections were confined to the subcutaneous tissues; none led to complete dehiscence and all healed within 4 weeks. Regression analysis showed that closure of the skin with suture carried significantly higher odds of infection than skin staples (OR = 7.93 [95% CI: 2.55–24.67]; P = 0.032). Complications after primary closure of equine laryngotomy incisions are infrequent and considered of minimal severity and can be performed safely when paying careful attention to the closure of the cricothyroid membrane.

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