Stöckle Sabita Diana, Failing Klaus, Koene Marc, Fey Kerstin
Tierarztl Prax Ausg G Grosstiere Nutztiere. 2018 Apr;46(2):81-86. doi: 10.15653/TPG-170491. Epub 2018 May 4.
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.
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).
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) and type of surgery (p = 0.0007) and increased with the number of surgical lesions (p = 0.03). In patients undergoing tendovaginoscopy/ bursoscopy, fasciotomy and neurectomy (n = 98), antibiotic prophylaxis was initiated less frequently than in other surgeries, e. g. combinations of surgeries, splint bone extraction, tenotomy, and arthroscopy (n = 554).
Severe complications in equine clean orthopaedic surgery are rare and complication rates in patients either receiving perioperative antibiotics or not were not significantly different.
Based on the results the use of antibiotics appears to be non-essential in uncomplicated elective orthopaedic interventions in the horse.
对马进行清洁骨科手术后的并发症进行回顾性分析,以检测使用抗生素治疗的动物与未接受这些药物治疗的马之间的差异。
收集了2011年6月至2015年1月间接受手术的马匹的652例患者、手术过程及手术相关并发症的详细信息。对接受抗生素治疗的患者(n = 259)与对照组(n = 393)的并发症发生率和特征进行差异检测。
总并发症发生率为39.1%。肿胀增加最为常见(25.6%),其次是渗出(7.5%)、无切口改变的发热(2.3%)、缝线裂开(1.8%)和血清肿(0.8%)。在总共463例关节镜检查中,7例患者(5例治疗组,2例对照组)发生了化脓性关节炎(1.5%)。术后并发症的发生在97/259例(37.5%)接受抗生素治疗的患者和158/393例(40.2%)对照组中无显著差异。围手术期抗生素的应用受外科医生(p < 0.0001)和手术类型(p = 0.0007)的显著影响,并随手术损伤数量的增加而增加(p = 0.03)。在接受肌腱阴道镜/滑囊镜检查、筋膜切开术和神经切除术的患者(n = 98)中,抗生素预防的启动频率低于其他手术,如联合手术、籽骨摘除术、腱切断术和关节镜检查(n = 554)。
马清洁骨科手术中的严重并发症很少见,接受围手术期抗生素治疗或未接受治疗的患者的并发症发生率无显著差异。
基于这些结果,在马的非复杂性择期骨科手术中,抗生素的使用似乎并非必要。