Page 246 - Manual of Equine Field Surgery

242 FEMALE UROGENITAL SURGERIES

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Figure 43-14 A, Vest-over-pants (dotted line) is used
Figure 43-13 A, Following creation of a second-

degree perinea! laceration, the dorsal vaginal mucosa to close the fistula. The first two sutures are placed

caudal to the fistula is dissected 2 cm and ventrally through the cranial aspect of the vaginal shelf and the

reflected. B, Sagittal cross section of the ventrally caudal edge of the rectal shelf. B, Sagittal cross section

reflected vaginal mucosa. The dotted line depicts hori- indicating caudal traction of the vaginal shelf so that at

zontal dissection through the cranial and lateral aspects least 2 cm of tissue overlap is obtained.

of the fistula, allowing separation of the fistula into

rectal and vaginal shelves.

POSTOPERATIVE CARE

EXPECTED OUTCOME

Postoperative Care

Primary healing is reported to occur in approxi-

Exercise Restridions: Small-pen turnout should mately 65°/o to 1000/o of repaired rectovaginal

be maintained for 30 days. fistulas.l" Short-term complications such as de-

Medications: Broad-spectrum antibiotics are

administered for 7 to 1 O days. A nonsteroidal anti- hiscence or fistula formation are reported to occur

inflammatory agent is administered for 3 to 5 days. in 6o/o to 35o/o of all surgical repairs.l"" Subsequent

Suture Removal: Perinea] and Caslick's sutures surgeries are essential when complications arise to

should be removed l O to 14 days after surgery. improve the chances for complete healing. Post-

Dietary Modifications: Free-choice access to operative conception rates are reported to be 330/0

grass, a gruel diet, or both should be provided for to 92°/o within 1-year postoperatively.v'" Recur-

30 days, with gradual return to normal diet. Occa- rence of rectovaginal fistulas and third-degree

sionally, mineral oil may be added to the diet to perineal lacerations during subsequent foalings

maintain a soft manure consistency. are reported in 8°/o to 10% of mares as a result of

Other: Sexual rest is recommended until the fol- stress on inelastic tissues secondary to excessive

lowing breeding season.
scar tissue deposition.