Simini Boards Cast

Chapter 84 - Part C: Mesh or Muscle: When Primary Closure Is a Lie

Simini Podcasts Season 1 Episode 60

In this BoardsCast episode, we dive into Chapter 84 of Tobias & Johnston’s Veterinary Surgery (2nd ed) to tackle one of the most deceptively simple decisions in abdominal wall reconstruction:
Can you actually close this primarily… or are you lying to yourself?

When tension is high, tissue is weak, infection is present, or the defect is biomechanically doomed, primary closure becomes the wrong choice — and mesh or muscle flaps become the only path to success.

You’ll learn:

  • How to determine when primary closure is contraindicated
  • Why tension kills tissue — and why surgeons underestimate it
  • When to choose mesh vs muscle vs combined reconstruction
  • Biological vs synthetic mesh: what boards expect you to know
  • How to manage contaminated or infected fields
  • How to evaluate defect geometry, load, and blood supply
  • Case-driven decision frameworks for hernias, trauma, and oncologic defects

If you’ve ever thought, “I can probably close this,” this episode helps you know when you absolutely should not.

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