Page 220 - Manual of Equine Field Surgery
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CHAPTER                                                                  39                                                                                                         I









                                                                                Caslick's Procedure (Vulvoplasty)




                                                                                                                                                                                                                                                                                      \


                                                                                                                     John  C.  Janicek































                                                                                                                                                   mare's conformation.3  To reduce the likelihood  of
                        INDICATION
                                                                                                                                                   removing  an  excessive  width  of  mucosa,  thumb


                                                                                                                                                   forceps  may be  used  to  apply  downward  tension

                        Pneumovagina  resulting  from  abnormal  perineal                                                                           on the band of excised mucosa. Excessive mucosal


                        conformation.
                                                                                                                                                    removal  results  in  excessive  scar  tissue  forma-


                                                                                                                                                    tion,  making  future  Caslick's  procedures  more


                                                                                                                                                    difficult.        3'4

                        EQUIPMENT                                                                                                                         Once the mucosa  has been  excised, the exposed




                                                                                                                                                    surfaces are apposed beginning  at the dorsal  com-
                        No special equipment  is required.











                         POSITIONING AND PREPARATION







                         The  mare  is  restrained  standing  in  a  stock  or


                         backed  into a stall doorway. The tail is held  out of


                         the  way  by  an  assistant  or  wrapped  and  tied


                         forward.  Following  aseptic preparation  of the per-



                         ineal region,  local anesthetic  (15 to 20 mL using a


                         22-gauge  needle)  is  infiltrated  along  the  vulvar                                                                                                           ~\


                         labial  mucocutaneous                                   margin  (Figure  39-1).                                                                                   \1  '
                                                                                                                                                                                           \I  I
                         Excessive  local  anesthetic  infiltration  should  be


                         avoided  to  prevent  distortion  of  the  mucocuta-                                                                                                               ~



                         neous  margins.                    1                                                                                                                              i










                         PROCEDURE







                         Beginning  at  the  level of the  ischiatic  tuber  and


                         extending to  the  dorsal  commissure,  a thin band



                         of  mucosa  approximately  3  to  5  mm  wide  is


                         excised  from  each  side  of  the  vulva  along  the                                                                                                                                       'o/.t.12-t:.~t --


                         mucocutaneous  margin'  (Figure  39-2).  The                                                                                Figure 39-1                    Infiltration  of local anesthetic  along the


                          exact  length  of  tissue  removed  depends  on  the                                                                      vulvar mucocutaneous  margin,






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