Seventeen Month Suture Retention with Severe Tissue Response in a Sea Raven (Hemitripterus americanus)
IAAAM 2011
Julie M. Cavin
New England Aquarium, Boston, MA, USA

Abstract

A 2.0 kg mature female sea raven (Hemitripterus americanus) was diagnosed with retention of mixed healthy and necrotic eggs. Manual expression was unsuccessful due to the adherent nature of sea raven eggs, so an ovariosalpingectomy was performed in August 2009. Surgery was overall unremarkable; broad ligament vessels were ligated with small hemoclips (Pilling Surgical Inc., Research Triangle Park, NC 27709) and ovarian pedicles with 3-0 polyglactin 910 (Coated Vicryl, Ethicon Inc., Somerville, NJ 08876). The same suture was used to close both the coelomic wall and musculature in a simple continuous pattern and the skin with a simple interrupted pattern. The animal recovered well and skin sutures were removed seven weeks post surgery. No significant swelling or inflammation was noted at that time. A persistently distended abdomen was noted in January 2011, seventeen months post surgery. Physical exam revealed a raised, firm cylindrical mass along the ventral midline with visible suture material near the cranial aspect. Malodorous, yellow, caseous material and thick, white exudate were surgically debrided from the subcutaneous space. The coelomic wall was approximately 90–95% healed except for two 2–3 mm diameter openings into the coelom. Due to the risk of recurrent inflammation or infection, the coelomic wall and musculature were reopened, freshened and reclosed as a single layer with freshened skin tissue using 2-0 polyglactin 910 suture (Coated Vicryl, Ethicon).

While the use of monofilament sutures are recommended for fish, braided, multifilaments have been used successfully with no significant tissue reactions noted.1,2 Multiple comparisons of suture material in fish agree that polyglactin 910 causes moderate to severe tissue reaction, but has an increased retention time, which is necessary in the current species due to the extended time of wound healing.3-5 Based on the decreased tissue reactivity and increased stability of the material, polydioxanone monofilament (PDS, Ethicon) is recommended for future surgeries in cold marine teleosts.

Acknowledgements

The author would like to thank the staff and volunteers of the Animal Health and Husbandry departments at the New England Aquarium for assistance with this case.

References

1.  Lewbart GA, Stone EA, Love NE. Surgical management of a swim bladder disorder in a red devil cichlid (Cichlasoma citrinellum). IAAAM 25th Annual Conference Proceedings, Vallego, CA; 1994; pp. 141–143.

2.  Stamper MA, Norton, T. Ovariectomy of a brook trout (Salvelinus fontinalis). AAZV 29th Annual Conference Proceedings, Houston, TX; 1997; pp. 4.

3.  Gilliland ER. Comparison of absorbable sutures used in largemouth bass liver biopsy surgery. Prog Fish Cult 1994; 56: 60–61.

4.  Harms CA, Lewbart GA. Surgery in fish. Vet Clin North Am Exot Anim Pract 2000; 3: 759–774.

5.  Hurty CA, Brazik DC, Law JM, Sakamoto K, Lewbart GA. Evaluation of the tissue reactions in the skin and body wall of koi (Cyprinus carpio) to five suture materials. Vet Rec 2002; 151: 324–328.

Speaker Information
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Julie M. Cavin
New England Aquarium
Boston, MA, USA


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