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

Abstract

Objective To determine the prevalence of surgical site infection (SSI) after internal fixation and to identify risk factors for SSI and nonsurvival. Study design Retrospective study. Animals One hundred fifty‐five horses with long bone fractures or arthrodesis treated by internal fixation at 1 hospital between 2008–2016. Methods Signalment, diagnosis, surgical repair, surgeon, surgical time, antimicrobial use, SSI onset, bacterial identification, and adjunct treatments were recorded. Perioperative variables were analyzed to identify risk factors associated with outcomes. Results Surgical‐site infection was reported in 22 of 155 (14.2%) horses, which is lower than what has been previously reported (P = .003). Horses with fetlock arthrodesis or ulnar fracture were more likely to develop SSI. Local prophylactic antimicrobial therapy was associated with an increased risk of SSI. Horses with SSI were 12 times (P < .0001) less likely to survive to discharge than horses without SSI. Horses with a fetlock or carpal arthrodesis or those with radial/humeral/femoral fractures were less likely to survive. No association was identified between open fractures, open reduction and internal fixation, or surgical times and SSI. Conclusion The prevalence of SSI in this population was lower than what has been previously reported. Horses with fetlock or carpal arthrodesis or radial/humeral/femoral fractures were at increased risk for SSI and/or nonsurvival to discharge. A protective role of local antimicrobial therapy for SSI could not be established. Clinical relevance The impact of SSI on outcomes of cases of equine internal fixation remains substantial. Identification of cases at higher risk of SSI should influence surgical technique, postoperative management, and early intervention when SSI is suspected. Additional investigation is warranted regarding local antimicrobial therapy.

Nomogram prediction of surgical site infection of HIV-infected patients following orthopedic surgery: a retrospective study

“…HIV patients have low or even reduced immunity and a higher risk of opportunistic infections [24]. More and more complex internal fixations were likely to cause infection of the incision, and the disturbance to the physiological function of the body is also large, which could active the inflammatory system [25]. When the acute inflammation occurred, blood acutephase reactant increased rapidly, including α-antirypsin, α2-mactoglobulin, C reactive protein, haptoglobin, transferrin, fibrinogen, etc.…”

Antimicrobial regional limb perfusion: Does it really fight infection?

“…However, the details and protocol for A-RLP were not reported and the selection of cases for A-RLP was based on the individual case and attending surgeon's preference. The same clinician group from the same equine hospital have subsequently produced another similar retrospective study, recently (Curtiss et al 2019), where they retrospectively reviewed the records of 155 cases undergoing internal fixation. They found a postoperative orthopaedic infection rate of 14.2%, which was much lower than in the previous study.…”

In vitro efficacy of a 0.2% polyhexamethylene biguanide‐impregnated gauze dressing against pathogenic bacterial isolates found in horses

“…[2][3][4] Similarly, surgical site infections (SSIs) associated with fracture repair, exploratory laparotomies, and arthroscopy can result in substantial complications with significant implications for both the patient and owner, including delayed healing and increased hospitalization, and may become a limiting factor in successfully treating these cases. [2][3][4][5] Pathogenic bacteria in equine wounds and infected surgical sites have been categorized in multiple studies spanning the last 30 years. A study by Schneider et al 2 looked at 192 horses with septic arthritis/tenosynovitis, and as part of that study they reported the culture results of 156 horses and found that Staphylococcus spp.…”

“…1 Involvement of underlying synovial structures or bones is not uncommon and complicated infections can lead to increased morbidity and mortality in such cases. [2][3][4] Similarly, surgical site infections (SSIs) associated with fracture repair, exploratory laparotomies, and arthroscopy can result in substantial complications with significant implications for both the patient and owner, including delayed healing and increased hospitalization, and may become a limiting factor in successfully treating these cases. [2][3][4][5] Pathogenic bacteria in equine wounds and infected surgical sites have been categorized in multiple studies spanning the last 30 years.…”