Female urogenital surgery
Teat wounds are managed similarly to other wounds. Preoperative milk cultures are recommended to determine the best perioperative antibiotics. If not available, samples should be taken at the start of surgery.
Surgery should be performed in lateral recumbency with the cow sedated and limbs restrained. Local anesthesia can be performed by a ring block around the teat, supplemented with infusion of lidocaine into the teat. Suction is nice if available.
The wound should be gently cleaned and debrided if needed. Sharp debridement is preferred but minimize the amount of tissue removed to avoid constricting milk flow.
Full thickness teat wounds should be closed in 3 layers to minimize fistula formation. The smallest diameter suture material reasonable should be used; 3-0 is typical. Monocryl should not be used as it dissolves rapidly in normal milk. Dexon dissolves rapidly in mastitic milk. Teat tissue heals rapidly; a short duration suture material could be used. However, monofilaments are less traumatic in the delicate mucosa. The final layer can be closed in a subcuticular (intradermal) pattern, standard skin or with wound glue.
Note: it is not possible to recreate a functional teat sphincter at time time.
Typical teat laceration repair
Mucosa closure – 3-0 absorbable suture in a simple continuous pattern
options include polydioxanone, polyglactin 910
Submucosa closure – 3-0 absorbable suture in a simple continuous pattern
options include polydioxanone, polyglactin 910 and poliglecaprone 25
Skin closure – 3-0 absorbable or nonabsorbable suture in a subcuticular or appositional pattern
Teats should not be milked until a fibrin seal forms, typically in 6 hours. After that, frequent milking is useful to minimize swelling. Avoid hand stripping and hand milking for at least 24 hours.
Local blocks of the teat, slide #47
Repair of teat laceration in a cow, case report
Traumatic teat laceration in a Jersey cow, case report
Teat fistula in a Jamunapari goat, case report
tissue layers are lined up in apposition; direct approximation of layers