Comparative efficacy of gambee and single interrupted suture patterns in reducing complications after canine enterotomy.

PICO question: In dogs undergoing enterotomy does using a Gambee suture pattern instead of a single interrupted suture pattern to close the intestinal incision reduce the risk of postoperative complications? Clinical bottom line: Category of research: Treatment. Number and type of study designs reviewed: Three papers addressed the PICO question and matched the search terms. All were experimental clinical trials. One study was a controlled but non-randomised trial, another was a non-controlled, non-randomised clinical trial, and the third was a randomised but non-controlled clinical trial. Strength of evidence: Weak. Outcomes reported: The first study suggested that the simple interrupted technique was easier, faster, and safer, with a significantly lower stenotic index at the anastomotic site and with relatively lower adhesion formation and rapid gain in tensile strength than the Gambee method. The second study found the risk of postoperative complications after enterotomy in dogs was no different whether Gambee or simple-interrupted sutures were used. The third study showed that the time for closure was significantly less for the simple interrupted suture group compared to the Gambee suture group. Despite this, the mean initial and maximum leak pressure values in the Gambee group were higher. Conclusion: The study design of those papers is considered poor and the strength of evidence weak in support of the PICO question. For now, the decision between Gambee and single interrupted suture for intestinal closure depends on the vet surgeon's choice. Future studies should be designed more efficiently before recommending a specific technique in clinical practice.