ObjectivesTo determine (1) the incidence of surgical site infection (SSI) in patients undergoing soft tissue surgery at a veterinary teaching hospital and to study (2) and describe the main risk factors associated with SSI and (3) assess the economic impact of SSI.DesignProspective cohort study.SettingVeterinary teaching hospital.Participants184 dogs undergoing soft tissue surgery during a 12-month period (October 2013 to September 2014).Primary outcome measureSurgical site infection.ResultsOut of the 184 patients analysed, SSI was diagnosed in 16 (8.7 per cent) patients, 13 (81.3 per cent) were classified as superficial incisional infection, 2 (12.5 per cent) as deep incisional infection and 1 (6.3 per cent) as organ/space infection. The administration of steroidal anti-inflammatory drugs (P=0.028), preoperative hyperglycaemia (P=0.015), surgical times longer than 60 minutes (P=0.013), urinary catheterisation (P=0.037) and wrong use of the Elizabethan collar (P=0.025) were identified as risk factors. Total costs increased 74.4 per cent, with an increase in postsurgical costs of 142.2 per cent.ConclusionsThe incidence of SSI was higher than the incidence reported in other published studies, although they were within expected ranges when a surveillance system was implemented. This incidence correlated with an increase in costs. Additionally new important risk factors for its development were detected.
BackgroundInfection rate associated with intravenous (IV) catheter placement is emerging as an important issue in small animal veterinary medicine, mostly because of the economic costs associated with these infections. Identification of possible associated factors may provide useful information for the surveillance and prevention of such infections.ObjectivesTo determine the incidence of positive bacterial cultures obtained from IV catheters used in dogs hospitalized for at least 48 hours and removed because of clinical complication. To identify the bacteria involved and factors associated with bacterial colonization.AnimalsOne‐hundred eighty‐two dogs that underwent IV catheterization from January 2015 to July 2015 at the Veterinary Teaching Hospital of Alfonso X el Sabio University of Madrid were enrolled in the study.ResultsThe bacterial colonization rate of all IV catheters removed in response to clinical complications was 39.6%, the cumulative proportion of catheters that remained in place at 24, 48, and 72 hours after placement was 89.5, 78, and 59.4%, respectively. Multivariable Cox proportional hazards regression indicated significant associations for staff who performed catheterization (junior, P = .002; student, P = .034) and use of steroidal anti‐inflammatory drugs (P = .036). The most frequently isolated bacterium was Acinetobacter spp. (21.7%).Conclusions and Clinical ImportanceThe bacterial colonization incidence related to IV catheter placement was slightly higher than the incidence described in other veterinary studies. Associated factors not previously described in veterinary medicine were found. The most frequently isolated organism was Acinetobacter spp., indicating its importance as an emerging pathogen in catheter colonization.
Background The goals of this randomized double-blind trial were to assess the antimicrobial activity in vivo of Sodium hypochlorite (NaOCl) vs. chlorhexidine gluconate (CHX) used in combination either with EndoActivator® or IRRI S® files in patients with apical periodontitis. Material and MethodsA total of 120 patients with apical periodontitis (in single or multiple root canals) were randomly assigned to the four irrigation protocols outlined below: Group A: 5.25% sodium hypochlorite (NaOCl) + EndoActivator®; Group B: 5.25% NaOCl + IRRI S® files; Group C: 2% chlorhexidine gluconate (CHX) + EndoActivator®; Group D: 2% CHX + IRRI S® files. Paper points were used to collect microbiological samples before (1A samples) and after (1B samples) irrigation. Viable colony-forming units (CFU) were quantified twice: (1) without speciation, and (2) only for Enterococcus Faecalis(EF). Statistical analysis was performed using SPSS 22.0 for Windows.ResultsNo significant differences were observed between NaOCl and CHX in the reduction of CFU; in fact, reduction was < 93% for the two irrigants. Conversely, statistically significant differences were found between the two activation techniques (sonic and ultrasonic) in the reduction of Enterococcus Faecalis(EF). Thus, the effectiveness of ultrasonic activation was significantly higher (< 93%; p=0.012) as compared to sonic activation. Following the combination of the two irrigants with the two activation techniques (groups A, B, C and D), significant differences were observed between group A and B (p=0.025) in the reduction of EF populations, reaching up to 94%.Conclusions NaClO and CHX are effective in reducing intracanal bacterial load. Ultrasonic activation is the most effective activation technique in reducing EF populations. Key words:Chlorhexidine gluconate, sodium hypochlorite, ultrasonic irrigation, sonic irrigation, apical periodontitis, Enterococcus faecalis.
Introduction: The clinical effect of low-level laser therapy (LLLT) on canine wounds is still under debate. The aim of this pilot study was to evaluate the potential influence of LLLT on the bacterial loads of wounds, using two different energy densities or doses of laser light as an adjuvant therapy for traumatic contaminated wound management. Methods: A prospective, randomized, blinded, placebo-controlled pilot clinical trial was used to evaluate the effect of two different doses of LLLT as an adjuvant treatment of contaminated traumatic wounds on the bacterial load and wound scoring in dogs. Fourteen dogs with traumatic bites or laceration wounds were randomly assigned to one of the three groups. Animals in groups A and B received a dose of LLLT of 6 and 2 J/cm2 respectively. Four wavelengths were used simultaneously: 660 nm, 800 nm, 905 nm, and 970 nm. Animals in group C received placebo LLLT. Bacterial burden and clinical wound scores were evaluated. Results: A statistically significant reduction in the average count of colony forming units was observed in group B (2 J/cm2 ) when compared to placebo group C. Group B also showed improved wound scores. No clinically adverse effects were observed in the patients treated with LLLT. Conclusion: LLLT, with the parameters used in this pilot trial, decreased bacterial loads of contaminated wounds in dogs and improved wound scores, especially when using a dose of 2 J/ cm2 . This is the first time the effect of LLLT on bacterial load has been investigated in a clinical setting using traumatic wounds in canine patients.
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