Use of an Active Intra-abdominal Drain in 67 Horses

Objective - To describe the insertion technique, efficacy, and complications associated with the use of an active (closed-suction) abdominal drain in horses. Study Design - Retrospective study. Animals - Sixty-seven horses with abdominal contamination treated by abdominal lavage and use of a closed-suction abdominal drain. Methods - Medical records of horses (1989-1996) that had a closed-suction abdominal drain were reviewed. Follow-up information was obtained by telephone interviews with owners. Results - Sixty-eight closed-suction abdominal drains were used in 67 horses that had abdominal contamination, peritonitis, or to prevent adhesion formation. The drain was placed under general anesthesia (62 horses) or in a standing position (6 horses). Abdominal lavage was performed every 4 to 12 hours and about 83% of the peritoneal lavage solution was retrieved. Minor complications associated with drain use occurred in 49% of the horses and included obstruction or slow passage of fluid through the drain in 18 horses (26%), leakage of fluid around the drain in 11 horses (16%), and subcutaneous fluid accumulation around the drain in 8 horses (12%). Incisional suppuration developed in 20 of 62 (32%) and incisional herniation in 5 of 46 (11%) horses. Conclusions - A closed-suction drain system was easily placed and was associated with only minor complications in most horses. Clinical Relevance - Active abdominal drainage and lavage is a useful adjunct in the treatment of peritonitis or as a prophylactic procedure in horses at risk of developing septic peritonitis and abdominal adhesions. Clinicians should be aware of the high incidence of minor complications.