Post operative synovial sepsis following endoscopic surgery: Increased risk associated with the carpal sheath.

The research article is about a study on the incidence of synovial sepsis in horses after endoscopic surgery. The study found that certain surgical sites, specifically the carpal flexor tendon sheath, are more prone to post-operative infections.

Overview of the Research

• The research paper aimed to document and investigate the rate of post-operative synovial sepsis, which had not been extensively studied before. The researchers had an assumption based on clinical observations that tendon sheaths, especially the carpal flexor tendon sheath, were more prone to post-operative synovial sepsis than other synovial structures.
• The research was carried out as a retrospective case series, evaluating the medical records of horses that underwent arthroscopy, tenoscopy, or bursoscopy at Donnington Grove Veterinary Surgery between January 1999 and July 2012. Several factors were considered during the review of the records to determine if there was an association with synovial sepsis.

Methods Used in the Study

• As part of the study, the researchers recorded various pieces of information from the medical records of the horses. This included the horses’ particular vital stats, the anatomical structure involved in the surgery, the use of electrosurgery, tourniquet or motorised resector, the presence of a fracture, whether the surgery was performed while the horse was standing or under general anaesthesia, and the number of structures examined during the surgery.
• The investigators used a multivariable logistic regression to test the association between these selected variables and the likelihood of synovial sepsis. Odds ratios (OR) and 95% confidence intervals (CI) were also calculated to understand the probability of an outcome occurring.

Findings of the Research

• The records of 1670 horses that underwent endoscopic surgery of 3159 synovial structures between the specified period were reviewed. These surgeries included operations on 2517 joints, 583 tendon sheaths and 59 bursae.
• A total of 16 horses out of the 1670 developed post-operative sepsis, constituting an infection rate of one per 100 horses or 5 per 1000 procedures.
• Critical findings were that the odds of developing post-operative synovial sepsis for horses that underwent carpal sheath tenoscopy was 14.9 times higher in comparison to other procedures. Likewise, tendon sheath endoscopy had 5.21 times higher odds of developing post-operative synovial sepsis compared to other procedures.

Conclusion of the Research

• The researchers concluded that surgeons should be aware of the potentially higher risk of developing sepsis after endoscopic surgery involving tendon sheaths, and more specifically, the carpal sheath. This finding highlights the importance of preventive measures and careful post-operative care in such procedures.