The Most Common Procedure: Castration. Primary Closure or Second Intention Healing? – Debate

The surgical technique used for equine castration is largely influenced by the surgeon's experience and training, available equipment and facilities, the horse owners or horse trainers' requests, expectations and financial constraints. Further regional differences in traditions and horse breeds, season, type of use of the horse, and its training schedule as well as a horse's economic value also impact the choice of the surgical approach. More recently, the horse owners perceived benefits in reduction of aftercare, earlier return to full training and possible impact on the animal’s welfare may also influence the used technique.

Despite being a common surgical procedure in equine practice, the potential of complications is omnipresent, considering the conditions under which the surgery is performed and the anatomical components of the male anatomy. In the literature complication rates as high as 20-38% are reported. The incidence of some complications is, at least in part, linked with the performed technique. In general, castration associated complications can be grouped as minor or major as well as peri- or post-operative. Post-operative complications may occur within minutes to hours or days following surgery but may also be encountered after several months or years. For procedures performed under general anesthesia, anesthesia-related morbidity and mortality risks exist. Reported studies and reviews in the English speaking literature on castration related complications mainly focus on open, closed or half-closed (semi-closed, modified-open) castration, in general with a scrotal approach left to heal by second intention. Definition of complications, differences in duration of follow up, modifications of the applied technique such as the additional use of ligatures or instead of an emasculator as well as the different ages and breeds of a study population complicate the comparison of the different study results. Most postoperative complications are mild and not considered life-threatening. However, evisceration, hemorrhage, infection or peritonitis may be fatal.  [...]