Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere2018; 46(2); 81-86; doi: 10.15653/TPG-170491

Postoperative complications in equine elective, clean orthopaedic surgery with/without antibiotic prophylaxis.

Stöckle, SD
·
Failing, K
·
Koene, M
·
Fey, K

Abstract: Retrospective analysis of postoperative complications in equines after clean, orthopaedic surgical procedures in order to detect differences between animals treated with antibiotics and horses without receiving these drugs. Methods: Details on 652 patients, surgical procedures and surgery-associated complications were compiled from horses being operated between June 2011 and January 2015. Antibiotic-receiving patients (n = 259) were tested for differences in complication rates and characteristics to controls (n = 393). Results: The total complication rate was 39.1 %. Increased swelling was observed most often (25.6 %), followed by exudation (7.5 %), fever without incisional alterations (2.3 %), suture dehiscence (1.8 %), and seroma (0.8 %). Seven patients (five treated, two controls) developed septic arthritis within a total of 463 arthroscopies (1.5 %). There were no significant differences in the development of postoperative complications, which were seen in 97/259 (37.5 %) antibiotic receiving patients and in 158/393 (40.2 %) controls. The application of perioperative antibiotics was significantly influenced by surgeon (p 0,0001) und Art der Operation (p = 0,0007) beeinflusst und stieg mit der Anzahl chirurgischer Eingriffe pro Sitzung (p = 0,03). Eine perioperative Antibiose erfolgte seltener bei Tendovaginoskopie/Bursoskopie, Fasziotomie und Neurektomie (n = 98) als bei Kombinationen von Eingriffen, Griffelbeinextraktion, Desmotomie und Arthroskopie (n = 554). Unassigned: Schwere postoperative Komplikationen bei sauberen orthopädischen Eingriffen beim Pferd sind selten. Die Komplikationsraten von Patienten mit und ohne perioperative Antibiotikagaben differierten nicht statistisch signifikant. Klinische Relevanz: Den Resultaten zufolge scheint bei unkomplizierten elektiven orthopädischen Eingriffen beim Pferd auf den Einsatz von Antibiotika verzichtet werden zu können.

Schattauer GmbH.

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Publication Date: 2018-05-04 PubMed ID: 29727872DOI: 10.15653/TPG-170491Google Scholar: Lookup

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Summary

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The research was conducted to analyze the postoperative complications in horses following clean, orthopaedic operations and to detect differences in the incidence of these complications between horses that received antibiotics and those that did not. The results found no significant difference in the occurrence of postoperative complications between the two groups, suggesting antibiotics may not be necessary in uncomplicated elective orthopaedic surgeries in horses.

Study Methodology

The data used in this research encompasses 652 horses which underwent clean orthopaedic surgeries between June 2011 to January 2015. Out of these, antibiotics were administered to 259 horses, whereas 393 did not receive any antibiotics.
The study retrospectively analyzed details from patient records including their overall condition, surgical procedures performed, and any complications that arose postoperatively.
The researchers conducted tests to determine if there were any significant differences in complication rates and their characteristics between horses that were treated with antibiotics and those which were not.

Study Results

The total complication rate among all the subjects considered for this study was 39.1%, with increased swelling as the most frequently observed issue at 25.6%, followed by exudation at 7.5%, fever without any changes in the incision at 2.3%, suture dehiscence at 1.8%, and seroma at 0.8%.
Out of a total of 463 arthroscopies, septic arthritis developed in seven patients, five of which had received antibiotics.
There were no significant differences found in the development of postoperative complications between the group of horses that received antibiotics (37.5% incidence) and the untreated group (40.2% incidence).
It was found that the application of perioperative antibiotics was primarily influenced by the surgeon’s decision, type of surgery, and the number of surgical lesions handled during the procedure.
In surgeries involving tendovaginoscopy, bursoscopy, fasciotomy, and neurectomy, antibiotic prophylaxis was less frequently initiated compared to other surgeries such as combinations of surgeries, splint bone extraction, tenotomy, and arthroscopy.

Study Conclusions

The occurrence of dire complications in equine clean orthopaedic surgery was found to be rare, and no significant difference was detected in complication rates among patients treated with perioperative antibiotics and those who received no antibiotics.
The study concludes that the use of antibiotics seems to be non-essential in uncomplicated elective orthopaedic interventions in horses.

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APA

Stöckle SD, Failing K, Koene M, Fey K. (2018). Postoperative complications in equine elective, clean orthopaedic surgery with/without antibiotic prophylaxis. Tierarztl Prax Ausg G Grosstiere Nutztiere, 46(2), 81-86. https://doi.org/10.15653/TPG-170491