A retrospective analysis of the risk factors for surgical site infections and long-term follow-up after transpalpebral enucleation in horses.
Abstract: Implants are often used to improve the cosmetic appearance of horses after enucleation of the eye. When surgical site infection (SSI) occurs, the implant will almost always be lost. The aim of this study is to collect data on the risk factors for SSIs and report long-term follow-up (cosmetic results and return to work) after transpalpebral enucleations. In this retrospective study, records of horses undergoing transpalpebral enucleation were reviewed (2007-2014) and telephone interviews were used to obtain long term follow-up. The potential risk factors for SSIs (indication for enucleation, use of an implant, standing procedures, duration of surgery, opening of the conjunctival sac and prolonged use of antimicrobials) were analysed for their association with the outcome measure 'SSI' vs 'no SSI' by multivariable binary logistic regression testing. Indications for enucleation were grouped as follows: Group 1 (clean) included equine recurrent uveitis, too small or too large globes, and intraocular tumours, Group 2 (non-clean) included corneal perforation/rupture and infected ulcers and Group 3 (tumour) included extraocular tumours. Results: One hundred and seven cases of enucleation were evaluated. An implant was used in 49 horses. The overall number of SSIs was 8 (7.5%). Multivariable logistic regression testing showed implants (OR 7.5, P = 0.04) and standing procedures (OR 12.1; P = 0.03) were significantly associated with the percentage of SSIs and increased the risk of SSI. The eyes of horses in Groups 2 and 3 trended towards a larger risk for developing SSIs (OR 4.9; P = 0.09 and OR 5.9; P = 0.1, respectively). Prolonged use of antimicrobials, long surgery times and the opening of the conjunctival sac during dissection did not show significant associations with SSI risk. Conclusions: The risk of SSI after enucleation is low in clean eyes and when no implant is used. Placing an implant or performing a standing enucleation significantly increases the risk of SSIs. Although implants can be used for eyes that fall into Groups 2 and 3, 17% of the horses in these two groups developed an SSI leading to loss of the implant.
Publication Date: 2017-06-02 PubMed ID: 28578668PubMed Central: PMC5457630DOI: 10.1186/s12917-017-1069-5Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
The research article retrospectively analyzes the risk factors associated with surgical site infections (SSIs) in horses, following eye removal procedures known as enucleation. It sheds light on how cosmetic implants used after these procedures can potentially increase SSI risk, and presents a long-term follow-up to gauge cosmetic and practical success.
About the Study
- This is a retrospective study, which implies the researchers examined existing data rather than conducting a fresh experiment or trial.
- They examined records of horses undergoing enucleation, a surgery performed to remove the eye completely, between 2007 and 2014.
- Additional data was gathered through follow-up telephone interviews.
Risk Factors for Surgical Site Infections
- Surgical Site Infections (SSIs) are a common risk associated with any surgical procedure. In this study, the researchers focus specifically on SSIs following horse enucleation surgeries.
- Various potential risk factors for SSIs were examined. These include: the reason for enucleation, the use of an implant, the horse standing during procedures, the duration of the surgery, opening of the conjunctival sac, and prolonged use of antimicrobials.
- To determine the risk factors, the researchers used a statistical method known as multivariable binary logistic regression testing. This method helped draw conclusions about how these factors might influence ‘SSI’ versus ‘no SSI’ outcomes.
Enucleation Groupings
- The horses’ enucleation surgeries were categorized into three groups based on their medical situation: Group 1 was ‘clean’ (equine recurrent uveitis, size issues, or intraocular tumors), Group 2 was ‘non-clean’ (corneal perforation/rupture, infected ulcers), and Group 3 ‘tumour’ (extraocular tumors).
Study Results
- A total of 107 enucleation cases were evaluated, with implants used in 49 horses.
- The overall number of SSIs was 8 (7.5% of cases), indicating that SSIs are relatively uncommon after this type of surgery.
- The usage of implants and standing procedures were significantly associated with the occurrence of SSIs, implying they increase the risk.
- Horses in groups 2 and 3 were more likely to develop SSIs, although not in a statistically significant way.
- Factors such as antimicrobial usage, surgery duration, or opening the conjunctival sac were not significantly linked to SSI risk.
Conclusions
- The study concluded that in clean surgeries without implants, the risk of SSI is low.
- However, when implants are used or the procedure is performed while the horse is standing, this significantly increases the risk of developing an SSI.
- For horses falling into the group 2 and 3 categories, despite an implant potentially being usable, there was a noted 17% SSI development leading to implant loss.
Cite This Article
APA
Huppes T, Hermans H, Ensink JM.
(2017).
A retrospective analysis of the risk factors for surgical site infections and long-term follow-up after transpalpebral enucleation in horses.
BMC Vet Res, 13(1), 155.
https://doi.org/10.1186/s12917-017-1069-5 Publication
Researcher Affiliations
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, 3584 CM, Utrecht, Netherlands. t.huppes@uu.nl.
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, 3584 CM, Utrecht, Netherlands.
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, 3584 CM, Utrecht, Netherlands.
MeSH Terms
- Eye Enucleation / adverse effects
- Eye Enucleation / methods
- Eye Enucleation / veterinary
- Follow-Up Studies
- Orbital Implants / veterinary
- Retrospective Studies
- Risk Factors
- Surgical Wound Infection / epidemiology
- Surgical Wound Infection / veterinary
References
This article includes 17 references
- Pierce KE, Townsend WM. Surgery of the globe and orbit.. In: Auer JA, Stick JA, editors. Equine surgery. 4th ed. St. Louis: Saunders; 2012. p. 737–8.
- Apt L, Isenberg S, Yoshimori R, Paez JH. Chemical preparation of the eye in ophthalmic surgery: III. Effect of povidone-iodine on the conjunctiva.. Arch Ophthalmol 1984;102(5):728–729.
- Binder CA, Miño de Kaspar H, Klauss V, Kampik a. Preoperative infection prophylaxis with 1% polyvidon-iodine solution based on the example of conjunctival staphylococci.. Ophthalmologe 1999;96(10):663–667.
- Herring IP. Enucleation and Orbital Exenteration.. In: Bojrab MJ, Waldron DR, Tooms JP, editors. Current Techniques in Small Animal Surgery. 5th ed. Jackson: Teton NewMedia; 2014. p. 165.
- Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Center for Disease Control and Prevention (CDC) hospital infection Control practices advisory committee.. Infect Control Hosp Epidemiol 1999;20(4):250–278.
- Pollock PJ, Russell T, Hughes TK, Archer MR, Perkins JD. Transpalpebral eye Enucleation in 40 standing horses.. Vet Surg 2008;37(3):306–309.
- Hewes C, Keoughan GC, Gutierrez NS. Standing enucleation in the horse: a report of 5 cases.. Can Vet J 2007;48(5):512–514.
- Hamor RE. Use of orbital implants after enucleation in dogs, horses, and cats: 161 cases (1980-1990). J Am Vet Med Assoc 1993;203(5):701–706.
- Freeman K, Woods E, Welsby S, Percival SL, Cochrane CA. Biofilm evidence and the microbial diversity of horse wounds.. Can J Microbiol 2009;55(2):197–202.
- Costerton JW, Montanaro L, Arciola CR. Biofilm in implant infections: its production and regulation.. The International journal of Artificial Organs 2005;28(11):1062–1068.
- Santschi EM. Prevention of Postoperative Infections in Horses.. Vet Clin North Am Equine Pract 2006;22(2):323–334.
- Michau TM, Gilger BC. Cosmetic globe surgery in the horse.. Vet Clin N Am Equine Pract 2004;20(2):467–484.
- Raahave D, Friis-Moller A, Bjerre-Jepsen K, Thiis-Knudsen J, Rasmussen LB. The infective dose of aerobic and anaerobic bacteria in postoperative wound sepsis.. Arch Surg 1986;121(8):924–929.
- Merritt K, Hitchins VM, Neale AR. Tissue colonization from implantable biomaterials with low numbers of bacteria.. J Biomed Mater Res 1999;44(3):261–265.
- Parviainen AKJ, Trim CM. Complications associated with anaesthesia for ocular surgery: a retrospective study 1989?1996.. Equine Vet J 2000;32(6):555–559.
- Maninchedda U, Nottrott K, Gangl M. Enucleation in equids with and without the use of an orbital suture meshwork implant: a retrospective study of 37 cases.. Vet Rec 2015;177(14):367.
- Utter ME, Wotman KL, Covert KR. Return to work following unilateral enucleation in 34 horses (2000-2008). Equine Vet J 2010;42(2):156–160.
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
