Abdominal Surgery Poses Greatest Risk Of Surgical Site Infection

As with human surgery, there is always a potential for infection during equine surgery, Drs. Kelmer, Paz, Tatz, Dahan, Bdolah-abram and Oreff reviewed 198 post-operative complications related to surgery procedures on 167 horses at the Koret School of Veterinary Medicine in Israel over a 15-month period.

The study reviewed 40 percent abdominal surgeries, 30 percent orthopedic surgery and the rest were general surgeries that had a 9 to 20 percent chance of developing a surgical site infection. The incidence of infection was 16.7 percent during the study period.

The study team noted that post-operative surgical site infections created difficulties with recovery, increased the length of stay in the hospital, increased client coats sand delayed return to work. It addition, surgical site infections caused an increase in equine morbidity and mortality.

Of all the surgeries performed, abdominal procedures had the highest risk of infection with 28 percent. This may be because of the length of the incision or the weight of the intestines on the incisions.

The scientists identified the following as factors that increase the risk for a surgical site infection:

Type of surgery.
Having a repeat surgery in less than 6 months in the same area or in an area near the original incision. Abdominal procedures are particularly at risk.
Weight of the horse. Heavier horses have more weight resting on the incision line in their abdomen.
Gender. In the study, only 2.3 percent of stallions developed infections, compared to 16.1 percent of geldings and 24.3 percent of mares; 50 percent of pregnant mares had surgical site complications.
Recovery from anesthesia. A horse that has a hard time recovering from anesthesia may increase his risk of infection development by four times.

Abdominal procedure infection rate ranges from 7 to 37 percent; arthroscopic surgery infection rate was less than 1 percent. Overall infection frequency in orthopedic procedures was around 10 percent.

The team found that other factors may amplify infection risk. These include time of day and season when the surgery takes place; the surgeon; and a horse’s breed and age. They also note that as this study looked at cases between 2011 and 2013, surgical techniques, bacterial resistance and bacterial populations have changes, so additional studies are needed.