Intern Equine Veterinary Medical Center Kanegem, Belgium
Bilateral Castration with Electrosurgical Scrotectomy, Primary Closure and Dead Space Reduction. Ysebaert MP, Pompermayer E, Johnson JP, Ryan J, David F. Equine Veterinary Medical Center, Qatar Foundation, Doha, Qatar.
Despite being routinely performed, equine castrations are associated with significant complication rates. The purpose of this study was to describe an elective castration technique involving electrosurgical scrotectomy, with primary closure, and to report outcomes. Cases presenting for elective castration (bilaterally-descended testes and unilateral-inguinal cryptorchids), performed under general anesthesia, were included. Electro-scrotectomy, semi-closed or closed castration using transfixing ligatures, and 2-layer primary closure with dead space reduction, were performed. Surgery time was recorded. Horses received 24 hours of procaine penicillin and seven days of NSAIDs. Postoperative care consisted of one week of rest and one week of hand-walking. Retrospectively analyzed cases were evaluated for complications and client satisfaction by telephone/email survey. Prospectively analyzed cases were monitored q48h for 14 days and thereafter, at one and six months post-surgery. Sixty-nine horses (eight Thoroughbreds, 61 Arabians; 37 prospective, 32 retrospective) were included, ranging from six months to seven years. Average surgery time was 47.36 min. Overall surgical-related complication rate was 4.35%: subcutaneous scrotal hematoma (1.45%) and deep surgical site infection with secondary wound dehiscence (2.90%). A high incidence of self-limiting wound crusting/moistening (43.24%) was detected in prospective cases associated with fecal contamination. Low complication rate is likely associated with three main surgical details: 1) electro-scrotectomy, 2) transfixation ligatures, and 3) primary closure with dead-space reduction. Postoperative loose feces responsible for scrotal wound crusting/moistening did not impact overall outcome. Lack of controls with limited case numbers are study limitations. This castration technique with short convalescence and low complication rate, to be performed in equine hospitals, is an appealing alternative for bilateral castration and unilateral-inguinal cryptorchids.