Page 235 - Manual of Equine Field Surgery

Third-Degree Perinea! Laceration Repair 231

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A B

Figure 42-5 A, Suture pattern placement in the Figure 42-5 B, To prevent this complication, the

cranial area of a third-degree perineal laceration repair purse-string suture is tied before the ridge starts to

when excessive loss of tissue or thick, inelastic connec- form.

tive tissue is present. When the purse-string suture is

tightened, tension on the connective tissue produces a

transverse ridge in the rectal submucosa that reduces

the diameter and elasticity of the rectum.

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Figure 42-5 C, Sagittally oriented simple inter- Figure 42-5 D, Tissues are approximated without

rupted sutures are then placed from rectal submucosa excessive tension. Several of these purse-string sutures

to vaginal submucosa to obliterate dead space. with their associated simple interrupted sutures may be

necessary in mares that have suffered excessive tissue

loss or that have developed excessive fibrosis.