Does intraoperative low arterial partial pressure of oxygen increase the risk of surgical site infection following emergency exploratory laparotomy in horses?
Abstract: Decreased tissue oxygenation is a critical factor in the development of wound infection as neutrophil mediated oxidative killing is an essential mechanism against surgical pathogens. The objective of this prospective case series was to assess the impact of intraoperative arterial partial pressure of oxygen (PaO2) on surgical site infection (SSI) in horses undergoing emergency exploratory laparotomy for acute gastrointestinal disease. The anaesthetic and antibiotic protocol was standardised. Demographic data, surgical potential risk factors and PaO2, obtained 1h after induction of anaesthesia were recorded. Surgical wounds were assessed daily for infection during hospitalisation and follow up information was obtained after discharge. A total of 84 adult horses were included. SSI developed in 34 (40.4%) horses. Multivariate logistic regression showed that PaO2, anaesthetic time and subcutaneous suture material were predictors of SSI (AUC=0.76, sensitivity=71%, specificity=65%). The use of polyglycolic acid sutures increased the risk and horses with a PaO2 value < 80 mm Hg [10.6 kPa] and anaesthetic time >2h had the highest risk of developing SSI (OR=9.01; 95% CI 2.28-35.64). The results of this study confirm the hypothesis that low intraoperative PaO2 contributes to the development of SSI following colic surgery.
Copyright © 2014 Elsevier Ltd. All rights reserved.
Publication Date: 2014-02-08 PubMed ID: 24582131DOI: 10.1016/j.tvjl.2014.01.029Google Scholar: Lookup
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- Journal Article
Summary
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This study investigates the impact of oxygen pressure in the arteries during surgery (PaO2) on the risk of infection at the surgical site (SSI) in horses undergoing emergency abdominal surgery. The research found that low PaO2 during the operation, longer anesthesia time, and specific suture material could contribute to a higher risk of post-operative infections.
Research Methodology
- This inquiry was a prospective case series aiming to evaluate the effects of intraoperative arterial partial pressure of oxygen (PaO2) on the surgical site infection (SSI) rate in horses that underwent emergency exploratory laparotomy due to acute gastrointestinal diseases.
- The protocols for anesthesia and antibiotics were consistent across all examined cases.
- The researchers collected various data, including demographic information, potential surgical risk factors, and PaO2 values obtained one hour after the induction of anesthesia.
- Post-surgery, the researchers monitored all surgical wounds daily during the hospital stay to detect any signs of infection and collected follow-up information after the horses were discharged.
Research Findings
- The research included a total of 84 adult horses and found that 34 of those (or 40.4%) developed SSIs.
- A multivariate logistic regression pointed to three main predictors of SSIs: PaO2 levels, the duration of anesthesia, and the type of subcutaneous suture material used.
- Horses that were anesthetized for more than 2 hours, and those that had a PaO2 level of fewer than 80 mm Hg, were identified as having the greatest risk of developing an SSI.
- The life of polyglycolic acid sutures was also found to contribute to a higher risk of infection.
Conclusion
- This study confirms the initial hypothesis that a low level of oxygen in the arteries during surgery can increase the likelihood of a horse developing an infection in the surgical site following an abdominal surgery.
- The study also identified two other significant factors that contribute to the increased risk of SSIs: anesthesia time and the type of suture material used.
Cite This Article
APA
Costa-Farré C, Prades M, Ribera T, Valero O, Taurà P.
(2014).
Does intraoperative low arterial partial pressure of oxygen increase the risk of surgical site infection following emergency exploratory laparotomy in horses?
Vet J, 200(1), 175-180.
https://doi.org/10.1016/j.tvjl.2014.01.029 Publication
Researcher Affiliations
- Departament de Medicina i Cirurgia Animal, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain. Electronic address: cristina.costa@uab.cat.
- Departament de Medicina i Cirurgia Animal, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain.
- Departament de Medicina i Cirurgia Animal, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain.
- Servei d'estadística aplicada, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain.
- Departament d'Anestesiologia, Hospital Clínic de Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain.
MeSH Terms
- Animals
- Colic / microbiology
- Colic / surgery
- Colic / veterinary
- Emergency Treatment / veterinary
- Female
- Horse Diseases / microbiology
- Horse Diseases / surgery
- Horses
- Laparotomy / veterinary
- Male
- Oxygen
- Partial Pressure
- Prospective Studies
- Risk Factors
- Surgical Wound Infection / microbiology
- Surgical Wound Infection / veterinary
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