Influence of administration of antimicrobial medications after tibial plateau leveling osteotomy on surgical site infections: A retrospective study of 308 dogs

Clark, Andrea C.; Greco, Justin J.; Bergman, Philip J.

doi:10.1111/vsu.13337

Cited by 15 publications

(32 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…9,[22][23][24] Among the studies included for evaluation, 31% (4/13) provided evaluation of the research question as a principal focus. 7,[25][26][27] Two studies were prospective with modified Oxford Level of Evidence (mOLE) classifications of 1b, 25,27 and two studies were retrospective with mOLE classifications of 4b 23 and 4c 7 (Table 1A). Combined, these four studies provided evaluation of 908 TPLO procedures in publications from 2014 to 2020.…”

Section: Resultsmentioning

confidence: 99%

“…In 77% (10/13) of the studies evaluated, 7,[9][10][11][22][23][24]26,28,29 the use and administration of postoperative antibiotics were left up to the surgeon, or the rationale for use was unclear or not part of the study design. In seven studies, 9,11,23,24,26,28,29 a statement that antibiotics were administered at the surgeon's discretion was present in the article text. This pattern of use has the potential to interject potential bias because introducing the possibility for conscious or unconscious selection of antibiotics in noncontrolled retrospective studies limits any ability to detect a difference between treatment groups.…”

Section: Discussionmentioning

confidence: 99%

“…The remaining two studies were retrospective and were assigned a low LoE. 7,26 Only one study supported the use of postoperative antibiotics. 7 The remaining 69% (9/13) of studies provided data on postoperative antibiotic use as a secondary outcome measurement (Table 1B).…”

Section: Manuscript Reviewmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of postoperative antibiotic use after tibial plateau leveling osteotomy in dogs: A systematic review

2021

View full text Add to dashboard Cite

Objective: A systematic review of published data to determine whether postoperative antibiotic use after tibial plateau leveling osteotomy (TPLO) decreases infection rates. Study design: Systematic review.Methods: A broad bibliographic search was performed in three online databases through March 2020 for publications on postoperative antibiotic use after TPLO in dogs. Search terms included dog, canine, TPLO, tibial plateau leveling osteotomy, infection, antibiotic, and antimicrobial. Articles that met inclusion criteria were evaluated for level of evidence (LoE) by a modified Oxford Level of Evidence (mOLE) and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) classification and evaluation.Results: Thirteen studies met the inclusion criteria. Effect of antibiotic use was the primary question in four studies. Among those, 50% (2/4) were assigned a mOLE of 1b and a GRADE of moderate, while the other 50% (2/4) were assigned a mOLE of 4b or 4c with a GRADE of low. The two studies with the highest LoE did not provide evidence of the benefit of antibiotic usage.Results of only one study provided evidence to support the use of postoperative antibiotics. The remaining nine studies provided evaluation of antibiotic use secondarily and were all assigned a low LoE. Among these, 78% (7/9) provided evidence to support the use of postoperative antibiotics. Conclusion:We found little evidence to support the use of postoperative antibiotics to reduce the risk of surgical site infections in dogs after TPLO. The answer to this clinical question is complicated by the lack of prospective studies and inconsistent treatment protocols in the evaluated studies.Clinical significance: The clinical impact of postoperative antibiotic administration on infection rates after TPLO is uncertain.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of postoperative antibiotic use after tibial plateau leveling osteotomy in dogs: A systematic review

2021

View full text Add to dashboard Cite

show abstract

“…In that study, 6.0% of 150 cases that received cefpodoxime developed surgical site infections and 23.1% of 13 cases that received amoxicillin/clavulanate developed surgical site infections [15]. A study published in 2019 found that administration of antimicrobial medications after TPLO surgery did not protect against surgical site infections or predispose to antibiotic resistance [21]. The findings of our study indicate that even use of stronger antibiotics may not have any effect on outcomes.…”

Section: Plos Onementioning

confidence: 54%

Risk factors for short-term postoperative complications in the 8 weeks after tibial plateau leveling osteotomy in dogs weighing less than 15 kilograms: A retrospective study

Marín¹,

Unis²,

Horgan³

et al. 2021

PLoS ONE

View full text Add to dashboard Cite

The purpose of this retrospective study was to evaluate the risk factors for short-term postoperative complications in the 8 weeks after unilateral tibial plateau leveling osteotomy (TPLO) for cranial cruciate ligament rupture in small dogs weighing less than 15 kg. Medical records were retrospectively reviewed for 90 dogs weighing <15 kg that underwent medial parapatellar arthrotomy with inspection of the meniscus and TPLO performed by the same surgeon between January 2012 and December 2017. The overall complication rate was 4.44% (4/90 dogs). There were four cases of partial incisional dehiscence, none of which required surgical revision. Complications were significantly more likely in dogs that had undergone placement of a 2.4-mm TPLO plate. Overall, the complication rate was less than that in previous studies of dogs weighing > 15kg. In this study, patients in which 2.4-mm TPLO plates were used were more likely to develop postoperative complications. Dogs weighing <15 kg that underwent TPLO had good short-term outcomes with minimal complications. In our study, the overall complication rate after TPLO in dogs weighing <15 kg is less than that historically reported in heavier dogs. Our data suggests that TPLO is a safe treatment option in small dogs with cranial cruciate ligament rupture.

show abstract

“…A longer anaesthetic episode increases the risk for surgical site infections. 20,33 To the best of our knowledge, whether two separate anaesthesia episodes that have a combined increase in anaesthetic time would have an increased, similar, or decreased rate of surgical site infections compared with the anaesthesia time of a simultaneous procedure is unknown. Our study found an surgical site infection rate of 10.1 and 10.4% for the SIM and ST groups respectively.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Intra- and Postoperative Complications between Bilateral Simultaneous and Staged Tibial Plateau Levelling Osteotomy with Arthroscopy in 176 Cases

Peress

Mejía

Unis

et al. 2020

Vet Comp Orthop Traumatol

View full text Add to dashboard Cite

Objective The aim of this study was to compare the resulting short-term complications after simultaneous (SIM) or staged (ST) tibial plateau levelling osteotomy (TPLO) in patients that presented with bilaterally torn cranial cruciate ligaments. Study Design This was a retrospective study. Materials and Methods Medical records of dogs diagnosed with bilateral cranial cruciate ligament disease that underwent bilateral SIM or ST TPLO surgery with arthroscopy (2005–2015) were reviewed to evaluate the intra- and postoperative complications. Data were analysed and major and minor complications were compared between the two groups. Results A total of 176 client-owned dogs (352 stifles) that had TPLO performed bilaterally with SIM or ST procedures were included for analysis. The overall complication rate was 47.5% for the SIM group and 19.5% for the ST group. The incidence of major complications was 10.1 and 3.8% in the SIM and ST groups respectively. Minor complications were 38.4 and 15.6% in the SIM and ST groups respectively. Tibial tuberosity fractures requiring revision were noted in 2% of the SIM group and none of the ST group. Clinical Significance Although no significant difference was noted in major complication rate or tibial tuberosity fractures in our cohort of patients, a Type II statistical error was found. The complication rate in the SIM group is numerically greater by a factor of 2–3× or more for nearly all categories. Surgeons should consider the risks and benefits of SIM versus ST procedures as well as relevant individual patient and client factors before electing either alternative.

show abstract

Influence of administration of antimicrobial medications after tibial plateau leveling osteotomy on surgical site infections: A retrospective study of 308 dogs

Cited by 15 publications

References 34 publications

Efficacy of postoperative antibiotic use after tibial plateau leveling osteotomy in dogs: A systematic review

Efficacy of postoperative antibiotic use after tibial plateau leveling osteotomy in dogs: A systematic review

Risk factors for short-term postoperative complications in the 8 weeks after tibial plateau leveling osteotomy in dogs weighing less than 15 kilograms: A retrospective study

Comparison of Intra- and Postoperative Complications between Bilateral Simultaneous and Staged Tibial Plateau Levelling Osteotomy with Arthroscopy in 176 Cases

Contact Info

Product

Resources

About