The 1–1–1 technique: A modified novel approach to feline ovariohysterectomy with minimal incision, rapid recovery and antibiotic free outcomes

This study describes the development and clinical outcomes of the ''1-1-1 Technique'', a modified novel surgical approach for feline ovariohysterectomy. The technique is characterized by a single 0.5-0.7 cm incision, one suture each layer in the uterus, muscle, and skin with strict aseptic handling without the use of <i>peri</i> or postoperative antibiotics. A routine clinical case series involving client owned cats (<i>n</i> = 40) was performed using only intramuscularly (IM) ketamine and xylazine without any additional medications. A single left lateral flank incision of 0.5-0.7 cm was made in 2 inches below to the midline between the 4th and 5th lumbar vertebra, extending through the abdominal muscles and peritoneum. The ovarian and uterine pedicles were ligated, then the muscle layers and skin layers were sutured like a water drop using only one absorbable suture and ensuring effective hemostasis. Povidone-iodine was applied to each tissue layer during closure to maintain aseptic conditions. No intraoperative complications were observed, and mean surgical time was 14.6 ± 2.4 min. Postoperatively, cats resumed feeding and ambulation within hours, with complete wound healing by day 7. Importantly, zero infections or dehiscence occurred despite the elimination of antibiotics. Compared to conventional spay protocols requiring larger incisions (2-4 cm), longer recovery periods (10-14 days), this technique demonstrates substantial improvements in efficiency, safety, and patient comfort. These findings support the feasibility of antibiotic free elective feline surgeries and align with global antimicrobial stewardship efforts. Further multicenter studies with larger cohorts are recommended to validate these promising results.