Antimicrobial prophylaxis is considered sufficient to preserve an acceptable surgical site infection rate in clean orthopaedic and neurosurgeries in dogs

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http://hdl.handle.net/10138/320338

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Välkki , K J , Thomson , K H , Grönthal , T S C , Junnila , J J T , Rantala , M H J , Laitinen-Vapaavuori , O M & Mölsä , S H 2020 , ' Antimicrobial prophylaxis is considered sufficient to preserve an acceptable surgical site infection rate in clean orthopaedic and neurosurgeries in dogs ' , Acta Veterinaria Scandinavica , vol. 62 , no. 1 , 53 . https://doi.org/10.1186/s13028-020-00545-z

Title: Antimicrobial prophylaxis is considered sufficient to preserve an acceptable surgical site infection rate in clean orthopaedic and neurosurgeries in dogs
Author: Välkki, Kirsi Johanna; Thomson, Katariina Hanne; Grönthal, Thomas Sven Christer; Junnila, Jouni Juho Tapio; Rantala, Merja Hilma Johanna; Laitinen-Vapaavuori, Outi Maria; Mölsä, Sari Helena
Contributor: University of Helsinki, Small Animal Hospital
University of Helsinki, Faculty of Veterinary Medicine
University of Helsinki, Equine and Small Animal Medicine
University of Helsinki, Equine and Small Animal Medicine
University of Helsinki, Equine and Small Animal Medicine
University of Helsinki, Equine and Small Animal Medicine
Date: 2020-09-17
Language: eng
Number of pages: 10
Belongs to series: Acta Veterinaria Scandinavica
ISSN: 0044-605X
URI: http://hdl.handle.net/10138/320338
Abstract: Background Surgical site infections (SSI) are associated with increased morbidity and mortality. To lower the incidence of SSI, antimicrobial prophylaxis is given 30-60 min before certain types of surgeries in both human and veterinary patients. However, due to the increasing concern of antimicrobial resistance, the benefit of antimicrobial prophylaxis in clean orthopaedic and neurosurgeries warrants investigation. The aims of this retrospective cross-sectional study were to review the rate of SSI and evaluate the compliance with antimicrobial guidelines in dogs at a veterinary teaching hospital in 2012-2016. In addition, possible risk factors for SSI were assessed. Results Nearly all dogs (377/406; 92.9%) received antimicrobial prophylaxis. Twenty-nine dogs (7.1%) did not receive any antimicrobials and only four (1.1%) received postoperative antimicrobials. The compliance with in-house and national protocols was excellent regarding the choice of prophylactic antimicrobial (cefazolin), but there was room for improvement in the timing of prophylaxis administration. Follow-up data was available for 89.4% (363/406) of the dogs. Mean follow-up time was 464 days (range: 3-2600 days). The overall SSI rate was 6.3%: in orthopaedic surgeries it was 6.7%, and in neurosurgeries it was 4.2%. The lowest SSI rates (0%) were seen in extracapsular repair of cranial cruciate ligament rupture, ulnar ostectomy, femoral head and neck excision, arthrotomy and coxofemoral luxation repair. The highest SSI rate (25.0%) was seen in arthrodesis. Omission of antimicrobials did not increase the risk for SSI (P = 0.56; OR 1.7; CI(95%)0.4-5.0). Several risk factors for SSI were identified, including methicillin-resistantStaphylococcus pseudintermediuscarriage (P = 0.02; OR 9.0; CI(95%)1.4-57.9) and higher body temperature (P = 0.03; OR 1.69; CI(95%)1.0-2.7; mean difference + 0.4 degrees C compared to dogs without SSI). Conclusions Antimicrobial prophylaxis without postoperative antimicrobials is sufficient to maintain the overall rate of SSI at a level similar to published data in canine clean orthopedic and neurosurgeries.
Subject: Antibiotic
Canine
Prophylaxis
Surgery
PLATEAU LEVELING OSTEOTOMY
CARPAL ARTHRODESIS
RISK-FACTORS
COMPLICATIONS
SURGERY
PREVENTION
REDUCTION
GUIDELINE
RESISTANT
RUPTURE
413 Veterinary science
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