Savicky R, Beale B, Murtaugh R, Swiderski-Hazlett J, Unis M
VCA Veterinary Referral and Emergency Center, of Westbury, Westbury, NY 11590, USA.
Vet Comp Orthop Traumatol. 2013;26(4):260-5. doi: 10.3415/VCOT-11-12-0177. Epub 2013 Apr 10.
To evaluate the outcome of surgical site infection (SSI) associated with tibial plateau levelling osteotomy (TPLO) implants following treatment by medical management alone or implant removal with or without the administration of antibiotic medication.
Ninety dogs (104 TPLO surgical procedures).
Records of dogs that had undergone TPLO implant removal due to SSI were reviewed. Outcome following treatment with antibiotic medications without implant removal, and treatment with implant removal with and without the administration of antibiotic medications was evaluated.
Treatment of SSI with antibiotic medication alone failed in 88.9% (64/72) of the dogs. The clinical signs of SSI resolved in 94.9% (74/78) of the dogs treated with implant removal (with and without the administration of antibiotic medication post-implant removal). The effect of administration of antibiotic medication on outcome of treatment of the SSI by implant removal was not significant. The rate of SSI associated with the Synthes implant was higher than with the Slocum implant, but not the New Generation implant.
Implant removal with or without the administration of antibiotic medication post-implant removal for treatment of TPLO SSI provided superior outcome compared to treatment with antibiotic medications without implant removal.
Implant removal should be considered for TPLO SSI that have not responded to appropriate medical management. Further investigation of the various TPLO implants and their effects on postoperative infection rate is warranted.
评估单纯药物治疗或植入物取出（无论是否使用抗生素）后，与胫骨平台水平截骨术（TPLO）植入物相关的手术部位感染（SSI）的治疗结果。
90只犬（104例TPLO手术）。
回顾因SSI而接受TPLO植入物取出的犬的记录。评估不取出植入物仅用抗生素治疗、取出植入物并使用或不使用抗生素治疗后的结果。
仅用抗生素治疗SSI，88.9%（64/72）的犬治疗失败。取出植入物（取出植入物后使用或不使用抗生素）治疗的犬中，94.9%（74/78）的犬SSI临床症状得到缓解。抗生素给药对通过取出植入物治疗SSI的结果影响不显著。与Synthes植入物相关的SSI发生率高于Slocum植入物，但低于新一代植入物。
对于TPLO SSI，取出植入物（取出植入物后使用或不使用抗生素）治疗比不取出植入物仅用抗生素治疗效果更好。
对于对适当药物治疗无反应的TPLO SSI，应考虑取出植入物。有必要进一步研究各种TPLO植入物及其对术后感染率的影响。
