The overall rate of dehiscence of full-thickness intestinal incisions in dogs is reported to be between 12% and 16%.1-4 This risk is substantially higher in patients that have a pre-existing septic abdomen (eg, from a perforating foreign body, an earlier intestinal surgery failure).1-4 More than one-third of patients experience dehiscence after repairs of an intestinal incision breakdown.1-4 Other pre- or intraoperative factors that should alert a practitioner to an increased dehiscence risk include intraoperative hypotension, hypoalbuminemia, intestinal foreign body, and a trauma patient. 1-2,4 Surprisingly, GI neoplasia has not yet been shown to increase the risk of GI incision dehiscence in veterinary studies.1,5
The healing process of any incision involves a period when tissues break down and lose strength before they become stronger. Briefly stated, this happens because the inflammatory processes of healing characterized by edema, neutrophil recruitment, and increased local collagenase activity begin before the repair processes of healing characterized by fibroblast recruitment and new collagen production. In the first few days of healing when the inflammatory phase predominates, the up-regulation of collagenase activity causes a tremendous loss of structural integrity as collagen is broken down at the incisional edges.