Spay/Neuter Suture Size/Type

[jtom]

Hey guys I just graduated and will be starting my new job next week. I was told by my boss that I will be starting out primarily in surgery doing spays/neuters. I have done spay/neuter externships in the past but the last time I have performed one was back in December.

At my previous shelter externship, they used Monocryl almost exclusively. For canine neuters they would use 0 or 1 monocryl for the spermatic cord and 2/0 or 3/0 for closure(linea/subq/intradermal). For canine spays they would use 0 or 1 for the pedicles/cervix and 2/0 or 3/0 for closure. At that place they would always ligate the broad ligaments but in school that was not performed from what I remember, what are your guys thoughts on that?For cats they would use 3/0 for everything.

I realize size/type depends a lot of things but was wondering what you guys use for suture type/size since I will be the one who decides this from now on. Also, I was wondering if you guys knew of any great videos etc of spay/neuters to refresh my memory. I feel confident but its been a while.

Thank you so much!

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[katryn]

I use 2/0 for medium-large dogs (spays and neuters, all parts), and 3/0 for cats and cat sized dogs. If I have a very large or a larger-medium but very active dog I'll use 0 on the linea, but that's about the only place I use it. The only time I ligate the broad ligament is in pregnant animals and a few of the in heat ones that have more prominent vasculature.


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[cowgirla]

I still sometimes watch the humane alliance videos before a large dog spay.

I tend to use PDS in dogs Will usually use the generic monocryl in cats. Mostly personal preference with a dash of paranoia during dog spays.


I also rarely need more than one pack of suture so tend to close with what I've been using. Especially for dog neuters. Whether I ligate the broad ligament or just clamp/tear depends on the individual.

 

[chickenlittle]

Anything under about 10 lbs, I use 3-0 suture. We use generic Monocryl at my current practice, though I'd slightly prefer PDS. (Not enough to make a stink, but theoretically the Monocryl may not retain holding strength long enough for all animals... though I have yet to see an issue with it.)

Dogs & cats 10-55ish lbs, 2-0 suture. (Again, I prefer PDS but have been using Monocryl for some time with no issues).

Dogs >55ish lbs, or smaller but crazy, get 0 for their pedicles and linea with 3-0 for the SQ & skin. (That's the only time that I use more than one pack of suture.)

I rarely ligate the broad ligament - typically only for big in-heat dogs or in pregnancy.

 

[CalliopeDVM]

Hey guys I just graduated and will be starting my new job next week. I was told by my boss that I will be starting out primarily in surgery doing spays/neuters. I have done spay/neuter externships in the past but the last time I have performed one was back in December.

At my previous shelter externship, they used Monocryl almost exclusively. For canine neuters they would use 0 or 1 monocryl for the spermatic cord and 2/0 or 3/0 for closure(linea/subq/intradermal). For canine spays they would use 0 or 1 for the pedicles/cervix and 2/0 or 3/0 for closure. At that place they would always ligate the broad ligaments but in school that was not performed from what I remember, what are your guys thoughts on that?For cats they would use 3/0 for everything.

I realize size/type depends a lot of things but was wondering what you guys use for suture type/size since I will be the one who decides this from now on. Also, I was wondering if you guys knew of any great videos etc of spay/neuters to refresh my memory. I feel confident but its been a while.

Thank you so much!

Yes, the Humane Alliance video on dog spays () is great -- it taught me to do a Miller's Knot (which is amazing). I find it interesting that a shelter used Monocryl, because I think it's more expensive; they must have gotten a good deal. It is my favourite suture material, though.

Will you really be the one who decides on this, or will you only be able to choose from what your boss chooses to stock? There's a big difference.

In general, remember that larger suture is not always better -- in dehiscenses, it's usually the tissue that fails, not the suture (sutures pull through the tissue, not suture material breaking) -- unless it's your knots that fail. Your suturing and knotting techniques are as important as suture size and type.

If I had my druthers, I'd use Monocryl for just about everything - dog spays and neuters usually 2-0 or 3-0; cat spays usually 3-0. I usually use the same size (and pack) for both ligatures and closure, though if it's a really big dog and I do need a second pack, I will often choose a smaller size (since I have to open a new pack anyway). That's the kind of economy your boss will like, but suture management is probably something that will take you a while to get better at.

As for ligating the broad ligament -- like ligating the tunic bundle in a dog neuter, it depends on the size and vascularity.

Learn the Miller's knot -- I wish I'd learned it a decade earlier than I did.

 

[katryn]

Oh yes, Miller's knot is my best friend!


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[cowgirla]

Oh yes, Miller's knot is my best friend!


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Thirded.
The combo of millers plus transfixing at every possible spot makes me sleep better at night