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Home / Equine Research Bank / Vet Med Sci / Evaluation of factors associated with surgical site infectio...
Veterinary medicine and science2022; 8(4); 1478-1488; doi: 10.1002/vms3.839

Evaluation of factors associated with surgical site infection in equine proximal interphalangeal joint arthrodesis: 54 cases (2010-2019).

Abstract: The frequency of surgical site infection (SSI) following orthopaedic implant placement in horses has been reported but not compared with respect to specific antibiotic protocols administered. To determine factors associated with SSI in horses undergoing proximal interphalangeal joint (PIPJ) arthrodesis including perioperative antibiotic protocols. Records were evaluated (2010-2019), and horses undergoing PIPJ arthrodesis were identified. Patient signalment, supervising surgeon, reason for surgery, limb, implants placed, anaesthetic time, duration casting/coaptation postoperatively, antibiotic regimen and incidence/onset SSI were recorded. Bayesian and frequentist logistic regressions were used to estimate the contribution of covariates to infection occurrence. Fifty-four PIPJ arthrodeses were performed. SSI occurred in 2/54 (3.7%) on day 15,30. Arthrodesis was performed most commonly for osteoarthritis (33/54, 61.1%), fracture (11/54, 20.4%), and subluxation (5/54, 9.3%). Perioperative systemic antibiotics were administered 1-3 days (15/54, 27.8%) or > 3 days (39/54, 72.2%). Antibiotic protocols included cefazolin/gentamicin (20/54, 37%), cefazolin/gentamicin/doxycycline (14/54, 25.9%) and potassium penicillin/gentamicin (10/54, 18.5%). Regional limb perfusion was performed preoperatively 31/54 (57.4%) and postoperatively 7/54 (13%). Survival to dismissal was 98.1% (53/54 horses) with one horse euthanized due to support limb laminitis. No association was identified between antibiotic selection or duration (1-3 vs. > 3 days), pre-operative regional antibiotic perfusion, intraoperative antibiotic lavage or anaesthetic time ( 3 h) and SSI; however, modelling was complicated by quasi-complete or complete separation of the data. Bayesian analysis (but not frequentist analysis) indicated an association between post-operative regional antibiotic perfusion and SSI. Limitations include the retrospective nature of data collection and the low rate of infection overall. The prevalence of SSI in this population was lower than that in previous reports of equine orthopaedic internal fixation. There was no difference in SSI rate in cases administered systemic antibiotics for 1-3 days or >3 days, or for those horses that did or did not receive preoperative regional antibiotic perfusion.
© 2022 The Authors. Veterinary Medicine and Science published by John Wiley & Sons Ltd.
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Publication Date: 2022-05-20 PubMed ID: 35594487PubMed Central: PMC9297777DOI: 10.1002/vms3.839Google Scholar: Lookup
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  • N.I.H.
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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.

This study looked at surgical site infection (SSI) in horses after undergoing proximal interphalangeal joint (PIPJ) arthrodesis. It sought to identify factors influencing the likelihood of SSI, with a particular focus on the role of different antibiotic protocols. The findings suggest that antibiotic duration and pre-operative regional antibiotic perfusion don’t significantly affect infection rates, but Bayesian analysis indicates a possible link between post-operative regional antibiotic perfusion and SSI.

Research Methodology

  • The researchers analyzed medical records of horses undergoing PIPJ arthrodesis from 2010 to 2019.
  • Various factors were recorded including: patient’s details, supervising surgeon, reason for surgery, limb treated, implants placed, anaesthetic time, postoperative casting/coaptation duration, antibiotic regimen, and incidence/onset of SSI.
  • For the analysis, both Bayesian and frequentist logistic regressions were used to calculate the contribution of each factor to the occurrence of infection.

Findings

  • In total, 54 PIPJ arthrodeses were performed, with SSI occurring in only 2 cases (3.7%).
  • Most common reasons for arthrodesis were osteoarthritis (61.1%), fracture (20.4%), and subluxation (9.3%).
  • Antibiotics were administered systematically, either for 1-3 days (27.8% of cases) or for more than 3 days (72.2% of cases). The antibiotic protocols included cefazolin/gentamicin, cefazolin/gentamicin/doxycycline, and potassium penicillin/gentamicin.
  • Regional limb perfusion was performed preoperatively in 57.4% of horses and postoperatively in only 13%.
  • Almost all horses (98.1%) survived until they were discharged, except for one that was euthanized due to support limb laminitis.

Analysis and Conclusions

  • There was no seen association between SSI and factors like antibiotic selection, duration of antibiotic administration (1-3 vs. more than 3 days), pre-operative regional antibiotic perfusion, intraoperative antibiotic lavage, and anaesthetic time.
  • However, data analysis was complicated by quasi-complete or complete separation of data.
  • Interestingly, Bayesian (but not frequentist) analysis pointed towards a potential link between post-operative regional antibiotic perfusion and SSI.
  • It’s important to consider the study’s limitations, particularly the retrospective nature of data collection and the overall low rate of infection, which could affect the analysis.
  • The prevalence of SSI in this study was lower compared to previous reports of equine orthopaedic surgeries involving internal fixation.
  • The study concluded that there was no difference in SSI rate in cases administered systemic antibiotics for 1-3 days or more than 3 days, or for those horses that did or did not receive preoperative regional antibiotic perfusion.

Cite This Article

APA
Daniels A, Pezzanite LM, Griffenhagen GM, Hendrickson DA. (2022). Evaluation of factors associated with surgical site infection in equine proximal interphalangeal joint arthrodesis: 54 cases (2010-2019). Vet Med Sci, 8(4), 1478-1488. https://doi.org/10.1002/vms3.839

Publication

Veterinary medicine and science
ISSN: 2053-1095
NlmUniqueID: 101678837
Country: England
Language: English
Volume: 8
Issue: 4
Pages: 1478-1488

Researcher Affiliations

Daniels, Alyssa
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Pezzanite, Lynn M
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Griffenhagen, Gregg M
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Hendrickson, Dean A
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.

MeSH Terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Arthrodesis / methods
  • Arthrodesis / veterinary
  • Bayes Theorem
  • Cefazolin
  • Forelimb
  • Gentamicins
  • Horse Diseases / epidemiology
  • Horse Diseases / surgery
  • Horses
  • Retrospective Studies
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / veterinary

Grant Funding

  • TL1 TR002533 / NCATS NIH HHS
  • 5T32OD010437-19 / NIH HHS
  • 5TL1TR002533-02 / NCATS NIH HHS
  • T32 OD010437 / NIH HHS

Conflict of Interest Statement

The authors have no conflicts of interest to declare.

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Citations

This article has been cited 2 times.
  1. Guo Y, Feng H, Du L, Yu Z. Patterns of antibiotic resistance genes and virulence factor genes in the gut microbiome of patients with osteoarthritis and rheumatoid arthritis. Front Microbiol 2024;15:1427313.
    doi: 10.3389/fmicb.2024.1427313pubmed: 39633808google scholar: lookup
  2. Mita H, Kuroda T, Niwa H, Tamura N, Fukuda K, Ohta M. Incidence of surgical site infection after internal fixation of the first phalangeal bone and the third metacarpal/metatarsal bone fractures in Thoroughbred racehorses. J Equine Sci 2023 Sep;34(3):61-66.
    doi: 10.1294/jes.34.61pubmed: 37781565google scholar: lookup
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