An examination of the occurrence of surgical wound infection following equine orthopaedic surgery (1981–1990)

Abstract

Summary Post operative surgical wound infection rates were determined for 452 cases of equine orthopaedic surgery performed at the Western College of Veterinary Medicine, Saskatoon, Saskatchewan, between January 1, 1981 and December 31, 1990. Only surgical procedures classified as clean or clean‐contaminated by the National Research Council were included in this study. The overall post operative infection rate was 10.0% (45 of 452). Clean surgeries (n=433) had an 8.1% infection rate while clean‐contaminated surgeries (n=19) had a 52.6% infection rate. Information collected from the medical records was used in univariate and multivariate logistic regression models to evaluate significant determinates of post operative infection. Significant determinates of post operative infection were: surgical classification, orthopaedic involvement, duration of surgery, administration of preoperative antibiotics and gender. Clean‐contaminated surgeries had an increased risk of infection compared to clean surgeries (odds ratio (OR)=24.3), procedures involving long bones had an increased risk of infection compared to procedures involving articular surfaces (OR =5.1), surgeries lasting 90 minutes or longer had an increased risk of infection compared to those less than 90 minutes (OR =3.6), administration of preoperative antibiotics was associated with an increased risk of infection (OR =4.6) and female patients were 2.6 times more likely to develop post operative infection than male patients.

Surgical site infection associated with equine orthopedic internal fixation: 155 cases (2008–2016)

“…Routine equine arthroscopy and other clean orthopedic surgeries are associated with a very low prevalence of SSI at 1%–8% of cases; however, the use of metal implants in a procedure substantially increases these values. Previous reports have described SSI in 10%–80% of cases in which implants were used, depending on inclusion criteria . In our previous study in which we used identical inclusion criteria from the same hospital between 1990 and 2006, we identified SSI in 28% of cases, which is significantly higher than the prevalence of 14% in the current study.…”

“…The morbidity associated with SSI highlights the importance of decreasing its occurrence. It is our clinical impression that improved technique and increased local prophylactic antimicrobial use at our institution has decreased SSI since previous reports . Therefore, the objective of this study was to determine the prevalence of SSI in cases of equine long bone fracture and joint arthrodeses repaired with internal fixation during an 8‐year period.…”

“…Closed fractures and closed reduction with internal fixation were identified as having reduced odds of infection, whereas increased surgical duration was identified as a risk factor for developing SSI . In an earlier review of infection after all types of equine orthopedic surgery, authors identified SSI in 10% of all cases but identified a much higher prevalence in cases that required implants . In several studies specifically examining the clinical use of orthopedic plates for equine lower limb fracture repair or arthrodesis, SSI was identified in 32%–80% of cases …”

Clinical use of antimicrobial regional limb perfusion in horses: 174 cases (1999–2009)

“…57 This practice provides high tissue concentrations of antimicrobials when surgically approached and might be beneficial when horses undergo long surgical procedures, such as repair of complex fractures or difficult arthrodesis, which are associated with a higher risk of infection. 58 The inclusion criteria and the retrospective nature of this study preclude conclusions regarding effectiveness of the technique. Regional limb perfusion with antimicrobials is usually used as an adjunct to conventional treatment (systemic administration of antimicrobials, lavage, debridement, administration of anti-inflammatory drugs, and rest), which also limits the evaluation of the effectiveness of RLP as a sole treatment.…”

In vitro bactericidal activity of equine platelet concentrates, platelet poor plasma, and plasma against methicillin-resistant Staphylococcus aureus

“…Staphylococcus aureus is one of the most common bacteria isolated from normal skin (Alvarez et al 2010), and in surgical infections is related to colic (Ingle-Fehr et al 1997), orthopaedic surgery (Macdonald et al 1994), metritis, pneumonia, catheter site infections (Weese 2004) and septic arthritis or synovitis in horses (Pille et al 2009). Recently, a study conducted in 206 horses with septic synovitis reveled that 23 horses (34.3%) were positive for Staphylococcus aureus of which 7 (30.3%) were subjected to euthanasia by the non-resolution of the infection (Taylor et al 2010).…”