Evaluation of Two Suture Patterns for Jejunum Anastomosis in Donkeys (Equus asinus), in Tamboul Area, Sudan

Abstract

This study was carried out to compare two different suture patterns of jejunal anastomosis, two rows sero-submucosal continuous Lembert suture (SSCLS) patterns (group one) and one layer sero-submucosal interrupted suture (SSIS) patterns (group two). The study conducted in veterinary hospital in Faculty of Veterinary Medicine AlButana University in tamboul area in the east of Gezira State on May to July 2017. A total number of twelve donkeys both sexes, different breeds, 7 ±4.1 years of age, and weighing 93 ±7.8 kg were used in this study; they were divided into two groups. All animals were under general anaesthesia. A fifteen-cm length of jejunum was resected from the first part of the jejunum and end to end anastomosis using 2–0 Polyglycolic acid with two rows serosubmucosal continuous Lembert sutures (SSCLS) group and one row serosubmucosal interrupted suture (SSIS) group. Three animals from each group were euthanized on the 15th and 30st postoperative days. A 7-cm segment of jejunum including the anastomosed area was resected from each animal, in the two groups the investigations include physiological, haematological and biochemical parameters as well as post mortem, histopathological findings and real-time jejunum imaging. Clinically both suture patterns were found to be successful and reliable in jejunal anastomosis in donkey, all animals were returned to their normal appetite, urination and defecation after twenty four hours post jejunual anastomosis. No significant deferent (P value ≤ 0.05) in respiratory rate, heart rate and rectal temperature. The hematological indices showed slight increase in red blood cells count in SSIS compared with SSCLS group, and significant increase (P value ≤ 0.05) white blood cells count in (SSIS) group compared with serosubmucosal continuous lembert suture pattern (SSCLS) group. The blood biochemical parameters showed that significant elevation (P value ≤ 0.05) in blood glucose in both groups at 24, 48 and 72 hours respectively post surgery, Significant decrease (P value ≤ 0.05) was detected in blood urea nitrogen in (SSCLS) on day 3 post surgery, while non-significant different in total protein and albumin in both groups, Blood total lipid was significant increase (P value ≤ 0.05) in both groups at 72 hours post surgery. The time required to achieve jejunal anastomosis suture patterns were found significantly shorter (P value ≤ 0.05) in (SSIS) group compared with (SSCLS) group, the mortality rate was 33.3% and 16.7% in SSIS and SSCLS group respectively. Wound infection was recognize more in animals underwent SSIS suture pattern compared with that anastomized using SSCLS suture pattern. On the other hand, the anastomatic leakage was seen in (SSIS) group while was not found in the other (SSCLS) group. The adhesive degrees showed 40% severe adhesion, 40% mild adhesion and 20% slight adhesion at anastomatic site in SSIS group, while in the animals underwent surgery using SSCLS suture patterns resulted 40% mild adhesion and 60% slight adhesion. The degree of the wound healing in SSCLS group were 16.67% by grade 5, 50% by grade 4 and 33.33 % by grade 3, while in SSIS group showed 20% , 60%,20% for grade 5, grade 4, and grade 1 respectively. There was no significant statistical difference between the two types of suture patterns in lumen diameter. Slight stenosis were observed at 30th day post surgery in two rows sero-submucosal continuous lembert suture (SSCLS) patterns and significant increase in jejuna wall thickness was observed in (SSCLS) group on day 30 following surgery. On conclusion, the results of the present study indicated that the SSCLS suture patterns showed better physiological, haematological, biochemical, histological and histopathological findings compared to the SSIS technique, while SSIS group consumed shorter time and lower jejunal luminal stenosis compare to SSCLS group.