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

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; CI95% 0.4-5.0). Several risk factors for SSI were identified, including methicillin-resistant Staphylococcus pseudintermedius carriage (P?=?0.02; OR 9.0; CI95% 1.4-57.9) and higher body temperature (P?=?0.03; OR 1.69; CI95% 1.0-2.7; mean difference +?0.4 °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.

SUBMITTER: Valkki KJ

PROVIDER: S-EPMC7495856 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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

Välkki Kirsi Johanna KJ Thomson Katariina Hanne KH Grönthal Thomas Sven Christer TSC Junnila Jouni Juho Tapio JJT Rantala Merja Hilma Johanna MHJ Laitinen-Vapaavuori Outi Maria OM Mölsä Sari Helena SH

Acta veterinaria Scandinavica 20200917 1

<h4>Background</h4>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 r ...[more]

PMID: 32943076

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Project description:IntroductionThe purpose of this study was to determine which components of sports medicine fellowships are most important to applicants when reviewing fellowship websites during the application process.MethodsAn anonymous survey was distributed to 492 fellowship applicants from the 2017-2018 and 2018-2019 cycles. The survey included questions about the importance of including components of fellow education, recruitment, and experience on program websites. The weighted average of responses determined each component's rank, with 5 being "very important" and 1 being "not at all important." Responses were analyzed by application cycle, current position, and sex using the Wilcoxon rank-sum test.ResultsSixty-five applicants participated in the survey and completed the demographics section, resulting in a 13.2% response rate. According to participants, the most important components to include on fellowship websites were exposure to advanced operative sports medicine techniques (weighted average, 4.62), complexity of cases performed (4.52), and number of cases performed (4.50). Analysis demonstrated statistically significant differences in opinion between application cycles for flexibility for conducting a remote interview (P = .0074), jobs obtained by previous fellows (P = .019), national rank of department (P = .021), program's geographic location (P = .026), protected academic time (P = .038), current positions for criteria for fellows' performance evaluations (P = .028), program's geographic location (P = .0097), and protected academic time (P = .0079). There were statistically significant differences in opinion between current positions regarding flexibility for conducting a remote interview (P = .0026), jobs obtained by previous fellows (P = .012), and national rank of department (P = .0013).ConclusionsOrthopaedic sports medicine fellowship applicants believe that it is most important to include information about the volume and complexity of fellows' cases and their day-to-day commitments on program websites.Clinical relevanceThis information would enable applicants to identify programs that will support professional development and allow program directors to communicate expectations.

Dataset Information

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

Publications

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

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