A Comparative Study between Inverting and Appositional Suture Patterns for Cystotomy Closure in Dog


The present study is designed to evaluate two sutures pattern techniques (inverting andappositional) for urinary bladder closure following experimental cystotomy in dogs. Thirty two adultlocal breed males’ dogs were enrolled for this study, aged 1-3 years and weighing 18-23 kg. Dogswere randomly allocated into two equal groups. In the first group, cystotomies were closed viadouble-layers of continuous inverting suture pattern (Lambert and Cushing); while, in the secondgroup, bladders incisions were closed by single-layer appositional suture pattern (simple interrupted)which did not involve the mucosa (extra-mucosal). Synthetic absorbable suture material polydiaxnonePDS 3/0 was used to close the bladder in all experimental animal groups. Surgery was doneunder the effect of general anesthesia using a combination of ketamine at a dose rate of 15mg/kg andxylazine at a dose 5mg/kg B.W. Dogs were premedicated by atropine sluphate at a dose 0.03mg/kg.All drugs administered intramuscularly. There were highly significant (P <0.05) differences inoperative times between the two groups. In inverting group, the time was 40 ± 4.50 minutes whichwas higher than that recorded for appositional group 25±2.50 minutes. The animals were followedupclinically during the studied period to record the secondary complications. Results reflectedhematuria n=4, swelling of the operative site n=3 and urinary incontinence n=2. These complicationswere transient and disappeared in a short time. Also macroscopical and microscopical examinationswere performed at 3,7,14 and 21 days post-surgery. Four dogs were used for each period. The mainmacroscopical finding was slight to moderate adhesions n = 3 between omentum and the wall ofurinary bladder in both group. Microscopical examination of urinary bladder reflected earlierurolithium formation in appositional pattern (14 days) while inverted group (21 days). In conclusion,appositional pattern is technically easier and economic. Bladder regeneration was accomplishedwithin 14 days in comparison with inverting pattern which reflected bladder regeneration at 21 dayspost-surgery.