Suture choice for flank cat spay - what do you use? Anything you would not use?

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

Carl Gorman — Fri, 02 May 2025 17:56:31 GMT

i agree re catgut ligatures. Reliable and I have never had one of the horror reactions the young vets get taught to fear - been using over 40 years and ligated many a naughty vessel or pedicle

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

John Thompson — Sun, 27 Apr 2025 14:25:00 GMT

Cat gut for everything.

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

Malcolm Ness — Sun, 27 Apr 2025 12:17:17 GMT

Catgut is inexpensive, easy to handle, holds knots well and remains adequately strong for an appropriate time. It has also stood the test of time - most of catgut's (many and often noisy) detractors have little if any first hand experience of its use. It remains a valid choice for ligating and suturing in flank cat speys and for ligating in bitch speys.

Vicryl 'reactions' are much talked about, but most are actually good old-fashioned infections as can be readily confirmed by anyone that takes the time to perform microscopy of the accumulated/discharged fluid. To quote my former teacher and long-time mentor, Gary Clayton-Jones: 'Germs don't like good surgeons'.

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

Noweia — Sun, 27 Apr 2025 11:13:52 GMT

Catgut!

I like vicryl for skin because it's not as sharp and pokey as the monofilament ones, but I do see a lot of skin reactions with vicryl at about 10 days. Does Monocryl get softer once it's been used?

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

Ian Paterson — Sat, 26 Apr 2025 10:56:56 GMT

3/0 Monocryl for everything. Would not use catgut or anything braided. Other monofilament absorbable sutures of 3/0 or 4/0 I’d also be happy with.

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

David Mills — Sun, 20 Apr 2025 21:50:11 GMT

[quote userid="6386" url="~/f/clinical-questions/31167/suture-choice-for-flank-cat-spay---what-do-you-use-anything-you-would-not-use/247040#247040"]Just as quick[/quote]

Have to disagree.

A flank, done with experience, takes about 5-7 minutes.

There have been various studies done showing non inferiority of either technique. For me flank is a smaller incision, and whilst cutting through muscle it isn't that which causes an issue but excessive handling of tissue. The muscles when cut should never need to be manipulated apart from suturing.

Also 1 X cruciate through both muscles, 1 X cruciate in fat before continuing to ID suture. 2M vicryl throughout (wonderful handling) though in the past used catgut without issues including 1 x cruciate in skin which falls out after a week.

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

Dinu Catilina — Sat, 19 Apr 2025 12:23:07 GMT

[quote userid="6386" url="~/f/clinical-questions/31167/suture-choice-for-flank-cat-spay---what-do-you-use-anything-you-would-not-use/247040#247040"] I converted to midline about 15 years ago and haven't looked back[/quote]

I converted to flank 15 years ago and never looked back! Vicryl 2M, for everything including skin.

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

janine redman — Thu, 17 Apr 2025 19:53:34 GMT

In my hands it’s quicker with tiny incision and no disruption to midline so just tuck the muscles back together with flank . Midline if any possible pregnancy only

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

Kate Richardson — Thu, 17 Apr 2025 19:51:41 GMT

Why do flank spays these days? UK only country that does them routinely. I converted to midline about 15 years ago and haven't looked back. If something goes wrong (rarely) much easier to extend incision and sort. Just as quick,

Anyways, PDS for ligs, muscle closure and subcut fat. Vicryl intradermal for skin

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

Sarah Keir — Wed, 16 Apr 2025 19:42:35 GMT

[quote userid="3169" url="~/f/clinical-questions/31167/suture-choice-for-flank-cat-spay---what-do-you-use-anything-you-would-not-use/246994#246994"] tie a standard square not with Vicryl and the same with catgut and see which is more secure.[/quote]

Even better, do it when wet and see which is more secure.

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

William Easson — Wed, 16 Apr 2025 13:01:41 GMT

So my response is typical of, perhaps, observation bias.

I use either 2Metric Monocryl (Ethicon) throughout, or 2M Vicryl (Ethicon). I do inverted/subcuticular sutures to close the skin.

I wouldn't use PDS for the skin - it's present for 8months or more, and I've seen a fair few surgeries done by others where they have a visible skin reaction weeks or months after the surgery, presumably a foreign body effect. I say observation bias because plenty of people use PDS in/under the skin without seeing issues.

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

Anthony Dennison — Mon, 14 Apr 2025 13:23:22 GMT

3/0 PDS for all. I hate the way vicryl feels when you're suturing, can feel it dragging through tissues.

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

Clive Ansell — Thu, 10 Apr 2025 15:09:09 GMT

[quote userid="3169" url="~/f/clinical-questions/31167/suture-choice-for-flank-cat-spay---what-do-you-use-anything-you-would-not-use/246994#246994"]

Clive Ansell said:
I've used Vicryl or PDS for 29 years and thousands of spay ligatures. Not a single problem as far as I am aware

Knot security, mainly. Grab a rubber ET tube, tie a standard square not with Vicryl and the same with catgut and see which is more secure.

The only reason they stopped using it in people is because of BSE. Older human surgeons miss it.

[/quote]

I know what you mean, I just can't get on with catgut at all, don't like how it handles or ties.

I use Vicryl for almost all surgeries, and not aware of a single knot failure in 29 years and n=1000's of cases

I think it is just personal preference and what one gets used too, and not case of one being better or worse.

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

Michael Woodhouse — Wed, 09 Apr 2025 22:34:13 GMT

[quote userid="5012" url="~/f/clinical-questions/31167/suture-choice-for-flank-cat-spay---what-do-you-use-anything-you-would-not-use/246988#246988"]I've used Vicryl or PDS for 29 years and thousands of spay ligatures. Not a single problem as far as I am aware[/quote]

Knot security, mainly. Grab a rubber ET tube, tie a standard square not with Vicryl and the same with catgut and see which is more secure.

The only reason they stopped using it in people is because of BSE. Older human surgeons miss it.

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

janine redman — Wed, 09 Apr 2025 21:30:32 GMT

Monocryl 3-0 for everything. Vicryl caused too many skin reactions when I used it though we do have it on a roll and sometimes use in cats that are friable or in season on cervix

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

Clive Ansell — Wed, 09 Apr 2025 09:14:59 GMT

[quote userid="3169" url="~/f/clinical-questions/31167/suture-choice-for-flank-cat-spay---what-do-you-use-anything-you-would-not-use/246985#246985"]Wouldn't want do ligate a bitche's pedicle with anything other than catgut.[/quote]

Why?

I've used Vicryl or PDS for 29 years and thousands of spay ligatures. Not a single problem as far as I am aware

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

Rob Loxley — Wed, 09 Apr 2025 07:37:31 GMT

vicryl - for ligatures, muscle, fat and intradermal skin closure

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

Michael Woodhouse — Tue, 08 Apr 2025 22:42:15 GMT

We price in 1 pack of 4/0 monocryl (generic) and I use it for ligatures, muscle, fat and intra dermals. Went through a period maybe 8-10 years ago with a number of suture reactions to Vicryl/generics so moved away. This is for flank. If heavily pregnant and midline then I'd just swap for a PDS generic of similar gauge.

Wouldn't want do ligate a bitche's pedicle with anything other than catgut. Nothing as good for a cow caeser (I believe I have tried everything). Bloody love catgut. Sometimes even use the 6M on in season cat spay uterus. If very friable.

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

Clive Ansell — Tue, 08 Apr 2025 19:36:43 GMT

3/0 vicryl by choice for ligatures, muscle/linea alba closure and intradermal with glue. Same for flank or midline approach.

I don't like catgut and wouldn't use it, but others I know use it without any issues, so just personal choice.

RE: Suture choice for flank cat spay - what do you use? Anything you would not use?

Evelyn Barbour-Hill — Tue, 08 Apr 2025 19:00:30 GMT

3/0 catgut. 4/0 or 5/0 Vicryl.

What would I not use? Anything of a heavier gauge.