Thursday, January 14, 2016

2916. Farm Visit with intern - Caesarean section of 3-day-old Maltese pups healthy

Jan 14, 2016

I find time to visit the breeder after Caesarean section to do a follow up. For home breeders, I phone them to enquire about the dam and puppies. Much can be learned by going to the grass root level instead of being in the ivory tower all the time.

In this visit, Breeder William Goh wanted subcutaneous sutures as the ends of the sutures will not prick the suckling puppies. I did use subcuticular sutures and two horizontal mattress sutures on the Dachshund and he had no complaint. He was not happy with the simple interrupted sutures done by Dr Daniel and said it was old school and outdated as the ends pricked the puppies trying to suckle.

He has a point. I use only horizontal mattress sutures in over 100 caesarean sections in dogs and had no complaint. He did not complain about my sutures being stiff and high risk to his puppies because I use Polysorb which is a braided absorbable while Dr Daniel used Monosyn which is monofilament absorbable closer to the "nylon" in composition. What he wanted was subcuticular sutures for all his Caesarean sections. This is not necessary and I seldom use this subcuticular sutures as they may break down. I used horizontal mattress sutures with the ends on one side of the incision, unlike monofilament simple interrupted sutures with ends on both sides..    

Horizontal mattress sutures may not look good but they are not crossing the incision line and may be stronger in holding the ends of the skin together. This is my experience in over 100 C-sections.

I hope the intern Su-en going to 3rd year of Melbourne University Vet School in 2016 learnt more on this farm visit than from textbooks and lectures.

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