A single-layer, full-thickness, simple continuous suture pattern is safe for hysterotomy closure in dogs undergoing cesarean section.

Single-layer full-thickness appositional hysterotomy closure is safe and supports future successful pregnancies in dogs.

This retrospective cohort study evaluated short-term complications associated with single-layer, full-thickness, simple continuous appositional closure (AC) versus inverting closure (IC) for hysterotomy in dogs undergoing cesarean section (CS) at Colorado State University between May 2014 and February 2025. The study population comprised 77 dogs undergoing 89 CS procedures (70 AC, 19 IC). Overall postoperative complication rate was low at 6.7% (6/89 cases), and closure pattern was not identified as a significant risk factor for postoperative complications. No dogs required reoperation or intervention specifically related to hysterotomy closure failure, and all animals survived the 14-day follow-up period. One notable adverse event included post-epidural paralysis, unrelated to closure technique. Twenty-four dogs had subsequent pregnancies, with 19 following AC and 5 following IC, demonstrating that both techniques are compatible with future successful whelping and repeat CS. The study provides clinically relevant evidence supporting the safety of single-layer, full-thickness, simple continuous appositional hysterotomy closure as an alternative to the traditionally preferred inverting (double-layer) technique. This is significant as the AC pattern is technically simpler, potentially faster, and may reduce surgery time. Limitations include the retrospective design, relatively small sample size particularly in the IC group, and limited long-term follow-up. Nevertheless, findings support surgeon flexibility in choosing hysterotomy closure technique without compromising short-term patient safety or future reproductive outcomes.

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