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犬胫骨平台水平截骨术后手术部位感染相关因素的回顾性研究

Retrospective study of factors associated with surgical site infection in dogs following tibial plateau leveling osteotomy.

作者信息

Lopez Daniel J, VanDeventer Gretchen M, Krotscheck Ursula, Aryazand Yazdan, McConkey Marina J, Hayashi Kei, Todhunter Rory J, Hayes Galina M

出版信息

J Am Vet Med Assoc. 2018 Aug 1;253(3):315-321. doi: 10.2460/javma.253.3.315.

Abstract

OBJECTIVE To identify risk factors associated with surgical site infection (SSI) in dogs following tibial plateau leveling osteotomy (TPLO). DESIGN Retrospective cohort study. ANIMALS 320 dogs that underwent unilateral or bilateral TPLO (n = 405 procedures) between 2007 and 2015 and were reexamined by a veterinarian at least once ≥ 8 weeks after the procedure. PROCEDURES Data were extracted from medical records regarding signalment, TPLO procedure details, medical history of dermatitis, and SSI status. Logistic regression was performed to identify factors associated with SSI development. RESULTS An SSI developed following 34 (8.4%; 95% confidence interval [CI], 6.1% to 11.5%) procedures. Prophylactic antimicrobial administration was provided following 36.8% (n = 149) of procedures. For 71 (17.5%) procedures, the dog had dermatitis at the time of surgery; 12 of these procedures involved dermatitis at the surgical site. The incidence of SSI following the 12 procedures for dogs with dermatitis at the surgical site was 16.7% (2/12 [95% CI, 3.3% to 54.3%]) and was 10.2% (6/59 [95% CI, 4.5% to 21.3%]) for dogs with dermatitis elsewhere; however, these differences in incidence were not significant. On multivariable analysis, German Shepherd Dogs (vs other breeds), meniscectomy (vs no meniscectomy), and attending surgeon having performed ≤ 20 (vs > 20) procedures during the study period were associated with increased odds of SSI. CONCLUSIONS AND CLINICAL RELEVANCE SSI following TPLO was associated with the German Shepherd breed, meniscectomy, and surgeon. Prospective studies are needed to investigate the mechanisms underlying these associations.

摘要

目的 确定胫骨平台水平截骨术(TPLO)后犬手术部位感染(SSI)的相关危险因素。 设计 回顾性队列研究。 动物 2007年至2015年间接受单侧或双侧TPLO手术(n = 405例)且术后至少8周由兽医复查一次的320只犬。 方法 从病历中提取有关特征、TPLO手术细节、皮炎病史和SSI状态的数据。进行逻辑回归分析以确定与SSI发生相关的因素。 结果 34例(8.4%;95%置信区间[CI],6.1%至11.5%)手术发生了SSI。36.8%(n = 149)的手术进行了预防性抗菌药物给药。71例(17.5%)手术的犬在手术时患有皮炎;其中12例手术涉及手术部位的皮炎。手术部位有皮炎的犬在这12例手术后SSI的发生率为16.7%(2/12 [95% CI,3.3%至54.3%]),其他部位有皮炎的犬为10.2%(6/59 [95% CI,4.5%至21.3%]);然而,这些发生率差异无统计学意义。多变量分析显示,德国牧羊犬(与其他品种相比)、半月板切除术(与未行半月板切除术相比)以及在研究期间主刀医生进行的手术≤20例(与>20例相比)与SSI发生几率增加相关。 结论及临床意义 TPLO术后的SSI与德国牧羊犬品种、半月板切除术和主刀医生有关。需要进行前瞻性研究以探讨这些关联背后 的机制。

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