Today's Veterinary Practice

JUL-AUG 2014

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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July/August 2014 Today's Veterinary Practice 47 PRACTICAL TECHNIQUES | FELINE PERINEAL URETHRoSToMy: VENTRAL APPRoACH tvpjournal.com 8 A mattress suture can be placed in the 6 o'clock position (see Surgical Insights: Sutures and Tissue Handling ). This tissue bite sequence has 4 steps. The needle: 1. Engages split thickness skin (A) 2. Penetrates the urethral mucosa (into urethral lumen) (B) 3. Passes back through the urethral mucosa (from lumen out) (C) 4. Passes split thickness skin. SURGICAL INSIGHT: SUTURES » It is critical to identify the cut edge of the urethral mu- cosa (glistening pale tissue plane medial to the adjacent red cavernous tissue) and achieve perfect apposition of mucosa to skin. » A 5-0 synthetic absorbable monofilament suture on a ta- per-cut needle is ideal. » Encompass 2 to 3 individual tissue bites during each su- ture pass: 1. Urethral mucosa 2. Fibrous tunica albuginea (this bite may be included with the first) 3. Split thickness skin. » Absorbable suture materi- al does not require removal, which makes its use advan- tageous. 9 The remaining interrupted sutures of the PU site are placed in a dorsal to ventral sequence (A through C). 8B 8A 8C 9B 9A 9C Cranial Dorsal/Caudal SURGICAL INSIGHT: TISSUE HANDLING » Do not grasp the fragile ure- thral mucosa or skin with for- ceps. » Instead, grasp only the adja- cent fibrous tunica albugin- ea and hypodermal layer of the skin. » Dissipating mild hemorrhage with saline lavage and suc- tion will facilitate visualization of tissue planes.

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