Chapter 7: Table of Contents
Close the Uterus in 2 Layers
The uterus and the edges of the incision should be wiped with clean, moist towels or gauzes and the uterine wall closed in two layers using absorbable, monofilament suture (typically 3-0 or 2-0 Monocryl or PDS®). I perform a simple continuous pattern, sometimes followed by an inverting pattern such as Cushing or Lembert. Remove the ‘dirty’ towels and wipe any surfaces that were in contact with fetal fluids. Abdominal lavage can be performed if abdominal contamination occurred. Routine abdominal closure is performed. Skin staples or an intradermal closure are preferred due to the puppies nursing.
Ovariohysterectomy (OVH) can be performed before or after removing the puppies/kittens. En-bloc, removal of the uterus with the puppies/kitttens in-situ must be performed quickly to prevent fetal anoxia. In general, I personally prefer to deliver the puppies/kittens by cesarian section and then proceed with ovariohysterectomy if the owners request it or if there is excessive uterine hemorrhage. The uterus is generally closed with a single simple continuous suture pattern following cesarian section and prior to OVH in order to prevent contamination of the abdomen.