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Vet Comp Orthop Traumatol 2008; 21(02): 99-105
DOI: 10.3415/VCOT-07-11-0105
Review Article
Schattauer GmbH

A review of post-operative infections in veterinary orthopaedic surgery

J. S. Weese
1   Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
› Author Affiliations
Further Information

Publication History

Received 28 November 2007

Accepted 06 January 2007

Publication Date:
17 December 2017 (online)

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Summary

Surgical site infections are an inherent risk in orthopaedic surgery and many of the infections that develop are likely to be non-preventable. However, a variety of measures can be undertaken to reduce the risk and impact of surgical site infections. The development and implementation of an infection control program, including surgical site infection surveillance, can be an important tool for patient management. All veterinary practices should have some form of infection control program in order to address surgical site infections, among other issues, and to provide the optimal and expected level of care.

Keywords

Surgical site infections - nosocomial - orthopaedic
 

  • References

  • 1 Garrett L. Betrayal of trust: the collapse of global public health. New York: Hyperion; 2000
    Google Scholar
  • 2 Horan TC, Gaynes RP, Martone WJ. et al. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Am J Infect Control 1992; 20: 271-274.
    CrossrefPubMedGoogle Scholar
  • 3 Mangram AJ, Horan TC, Pearson ML. et al. The Hospital Infection Control Practices Advisory Committee. Guidelines for prevention of surgical site infection. Infect Control Hosp Epidemiol 1999; 20: 247-278.
    PubMedGoogle Scholar
  • 4 Barie Barie, Eachempati SR. Surgical site infections. Surg Clin N Am 2005; 85: 1115-1135.
    CrossrefPubMedGoogle Scholar
  • 5 Muilwijk J, van den Hof S, Wille JC. Associations between surgical site infection risk and hospital operation volume and surgeon operation volume among hospitals in the Dutch nosocomial infection surveillance network. Infect Control Hosp Epidemiol 2007; 28: 557-563.
    CrossrefPubMedGoogle Scholar
  • 6 Cruse Cruse, Foord R. The epidemiology of wound infection. A 10-year prospective study of 62,939 wounds. Surg Clin North Am 1980; 60: 27-40.
    PubMedGoogle Scholar
  • 7 MacDonald DG, Morley PS, Bailey JV. et al. An examination of the occurrence of surgical wound infection following equine orthopaedic surgery (1981-1990). Equine Vet J 1994; 26: 323-326.
    CrossrefPubMedGoogle Scholar
  • 8 Eugster S, Schawalder P, Gaschen F. et al. A prospective study of postoperative surgical site infections in dogs and cats. Vet Surg 2004; 33: 542-550.
    CrossrefPubMedGoogle Scholar
  • 9 Brown D, Conzemius M, Shofer F. et al. Epidemi- ologic evaluation of postoperative wound infections in dogs and cats. J Am Vet Med Assoc 1997; 210: 1302-1306.
    PubMedGoogle Scholar
  • 10 Nicholson M, Beal M, Shofer F. et al. Epidemi- ologic evaluation of postoperative wound infection in clean-contaminated wounds: A retrospective study of239 dogs and cats. Vet Surg 2002; 31: 577-581.
    CrossrefPubMedGoogle Scholar
  • 11 Heldmann E, Brown D, Shofer F. The association of propofol usage with postoperative wound infection rate in clean wounds: a retrospective study. Vet Surg 1999; 28: 256-259.
    CrossrefPubMedGoogle Scholar
  • 12 Whittem T, Johnson A, Smith C. et al. Effect of perioperative prophylactic antimicrobial treatment in dogs undergoing elective orthopedic surgery. J Am Vet Med Assoc 1999; 215: 212-216.
    PubMedGoogle Scholar
  • 13 Vasseur PB, Levy J, Dowd E. et al. Surgical wound infection rates in dogs and cats. Data from a teaching hospital. Vet Surg 1988; 17: 60-64.
    CrossrefPubMedGoogle Scholar
  • 14 Vasseur PB, Paul HA, Enos LR. et al. Infection rates in clean surgical procedures: a comparison of ampicillin prophylaxis vs a placebo. J Am Vet Med Assoc 1985; 187: 825-827.
    PubMedGoogle Scholar
  • 15 Lee JT. Surgical site infection surveillance: accomplishments and pitfalls. Surg Infect 2006; 7: S43-S55.
    CrossrefPubMedGoogle Scholar
  • 16 National Association of State Public Health Veterinarians. Compendium of Veterinary Standard Precautions. 2006 doc. 2006 [cited September 4, 2007]; Available from: http://www.nasphv.org/ documentsCompendia.html
    PubMedGoogle Scholar
  • 17 Haley RW, Quade D, Freeman HE. et al. The SENIC Project. Study on the efficacy of nosocomial infection control (SENIC Project). Summary of study design. Am J Epidemiol 1980; 111: 472-485.
    PubMedGoogle Scholar
  • 18 Babcock HM, Matava MJ, Fraser V. Postarthro- scopy surgical site infections: review of the literature. Clin Infect Dis 2002; 34: 65-71.
    CrossrefPubMedGoogle Scholar
  • 19 Wilson J. Surveillance of surgical site infection in orthopaedic surgery is useful in tackling hospital- acquired infections in England. Euro Surveill. 2005 10. E051117.3.
    PubMedGoogle Scholar
  • 20 Condon RE, Schulte WJ, Malangoni MA. et al. Effectiveness of a surgical wound surveillance program. Archives of surgery (Chicago, IL: 1960) 1983; 118: 303-307.
    CrossrefPubMedGoogle Scholar
  • 21 Thomlinson J. Aseptic surgical principles and techniques. In: Whittick WG. editor. Canine orthopedics. Philadelphia: Lea and Febiger; 1990: 123-145.
    Google Scholar
  • 22 Kelkar U, Bal AM, Kulkarni S. Monitoring of steam sterilization process by biologic indi- cators-a necessary surveillance tool. Am J Infect Control 2004; 30: 512-513.
    PubMedGoogle Scholar
  • 23 Freeman DE. Sterilization and antiseptics. In: Auer JA, Stick JA. editors. Equine surgery. Phildelphia: Saunders Elsevier; 2006: 112-122.
    Google Scholar
  • 24 Rutala Rutala, Weber DJ. Infection control: the role of disinfection and sterilization. J Hosp Infect 1999; 43: S43-S55.
    CrossrefPubMedGoogle Scholar
  • 25 Giguere Giguere, Walker RD. Antimicrobial prophylaxis for surgery. In: Giguere S, Prescott JF, Baggot JD, Walker RD, Dowling PM. editors. Antimicrobial therapy in veterinary medicine. Ames, Iowa: Blackwell Publishing; 2006: 340-344.
    Google Scholar
  • 26 Waguespack RW, Burba DJ, Moore RM. Surgical site infection and the use of antimicrobials. In: Auer JA, Stick JA. editors. Equine Surg. Philadelphia: Saunders Elsevier; 2006: 70-87.
    Google Scholar
  • 27 Bert JM, Giannini D, Nace L. Antibiotic prophylaxis for arthroscopy of the knee: is it necessary?. Arthroscopy 2007; 23: 4-6.
    CrossrefPubMedGoogle Scholar
  • 28 Wieck JA, Jackson JK, O'Brien TJ. et al. Efficacy of prophylactic antibiotics in arthroscopic surgery. Orthopedics 1997; 20: 133-134.
    PubMedGoogle Scholar
  • 29 Kurzweil P. Antibiotic prophylaxis for arth- roscopic surgery. Arthroscopy 2006; 22: 452-454.
    CrossrefPubMedGoogle Scholar
  • 30 Weese Weese, Halling K. Perioperative administration of antimicrobials associated with elective surgery for cranial cruciate ligament rupture in dogs: 83 cases (2003-2005). J Am Vet Med Assoc 2006; 229: 92-95.
    CrossrefPubMedGoogle Scholar
  • 31 Stick JA. Preparation of the surgical patient, the surgery facility, and the operating team. In: Auer JA, Stick JA. editors. Equine Surgery. Philadelphia: Saunders Elsevier; 2006: 123-140.
    Google Scholar
  • 32 Winston KR. Hair and neurosurgery. Neurosurgery 1992; 31: 320-329.
    CrossrefPubMedGoogle Scholar
  • 33 Hamilton HW, Hamilton KR, Lone FJ. Preoperative hair removal. Can J Surg 1977; 20: 269-271 274-275.
    PubMedGoogle Scholar
  • 34 Seropian Seropian, Reynolds BM. Wound infections after preoperative depilatory versus razor preparation. Am J Surg 1971; 121: 251-254.
    CrossrefPubMedGoogle Scholar
  • 35 Masterson TM, Rodeheaver GT, Morgan RF. et al. Bacteriologic evaluation of electric clippers for surgical hair removal. Am J Surg 1984; 148: 301-302.
    CrossrefPubMedGoogle Scholar
  • 36 Osuna DJ, DeYoung DJ, Walker RL. Comparison of three skin preparation techniques. Part 2: Clinical trial in 100 dogs. Vet Surg 1990; 19: 20-23.
    PubMedGoogle Scholar
  • 37 Mathews KA, Brooks MJ, Valliant AE. A prospective study of intravenous catheter contamination. J Vet Emerg Crit Care 1996; 6: 33-43.
    CrossrefPubMedGoogle Scholar
  • 38 Wan PY, Blackford JT, Bemis DA. et al. Evaluation of surgical scrub methods for large animal surgeons. Vet Surg 1997; 26: 382-385.
    CrossrefPubMedGoogle Scholar
  • 39 Hsieh HF, Chiu HH, Lee FP. Surgical hand scrubs in relation to microbial counts: systematic literature review. J Adv Nurs 2006; 55: 68-78.
    CrossrefPubMedGoogle Scholar
  • 40 Mulberrry G, Snyder AT, Heilman J. et al. Evaluation of a waterless, scrubless chlorhexidine glu- conate/ethanol surgical scrub for antimicrobial efficacy. Am J Infect Control 2001; 29: 377-382.
    CrossrefPubMedGoogle Scholar
  • 41 Hobson DW, Woller W, Anderson L. et al. Development and evaluation of a new alcohol-based surgical hand scrub formulation with persistent antimicrobial characteristics and brushless application. Am J Infect Control 1998; 26: 507-512.
    CrossrefPubMedGoogle Scholar
  • 42 Corder K, Knowles T, Holt P. Factors affecting bacterial counts during preparation of the hands for aseptic surgery. Vet Rec 2007; 160: 897-901.
    CrossrefPubMedGoogle Scholar
  • 43 Larson EL. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995; 23: 251-269.
    CrossrefPubMedGoogle Scholar
  • 44 Pottinger J, Burns S, Manske C. Bacterial carriage by artificial versus natural nails. Am J Infect Control 1989; 17: 340-344.
    CrossrefPubMedGoogle Scholar
  • 45 Lidwell OM, Elson RA, Lowbury EJ. et al. Ultra- clean air and antibiotics for prevention of postpoe- rative infections. A multicenter study of 8,052 joint replacement operations. Acta Orthop Scan 1987; 58: 4-13.
    PubMedGoogle Scholar
  • 46 Binnet M, Başarir K. Risk and outcome of infection after different arthroscopic anterior cruciate ligament reconstruction techniques. Arthroscopy 2007; 23: 862-868.
    CrossrefPubMedGoogle Scholar
  • 47 Gastmeier P, Sohr D, Brandt C. et al. Reduction of orthopaedic wound infections in 21 hospitals. Arch Orthop Trauma Surg 2005; 125: 526-530.
    CrossrefPubMedGoogle Scholar
  • 48 Hollenbeak C, Lave J, Zeddies T. et al. Factors associated with risk of surgical wound infections. Am J Med Qual 2006; 21 (Suppl. 07) S29S-34.
    CrossrefPubMedGoogle Scholar
  • 49 Williams RJ, Laurencin CT, Warren RF. et al. Septic arthritis after arthroscopic anterior cruciate ligament reconstruction. Diagnosis and management. Am J Sports Med 1997; 25: 261-267.
    CrossrefPubMedGoogle Scholar
  • 50 Billings L, Vasseur PB, Fancher C. et al. Wound infection rates in dogs and cats after use of cotton muslin or disposable impermeable fabric as barrier material: 720 cases (1983-1989). J Am Vet Med Assoc 1990; 197: 889-892.
    PubMedGoogle Scholar
  • 51 Olmstead ML, Hohn RB, Turner TM. A five-year study of 221 total hip replacements in the dog. J Am Vet Med Assoc 1983; 183: 191-194.
    PubMedGoogle Scholar
  • 52 Paul Paul, Bargar WL. A modified technique for canine total hip replacement. J Am Animal Hosp Assoc 1987; 23: 16-17.
    PubMedGoogle Scholar
  • 53 Parker RB, Bloomberg MS, Bitetto W. et al. Canine total hip arthroplasty: a clinical review of 20 cases. J Am Animal Hosp Assoc 1984; 20: 97-103.
    PubMedGoogle Scholar
  • 54 Lafaver S, Miller N, Stubbs W. et al. Tibial tuberosity advancement for stabilization of the canine cranial cruciate ligament-deficient stifle joint: surgical technique, early results, and complications in 101 dogs. Vet Surg 2007; 36: 573-586.
    CrossrefPubMedGoogle Scholar
  • 55 Bergh M, Gilley R, Shofer F. et al. Complications and radiographic findings following cemented total hip replacement: a retrospective evaluation of 97 dogs. Vet Comp Orthop Traumatol 2006; 19: 172-179.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 56 Smith Smith, Ross MW. Postoperative infection with Actinobacillus spp in horses: 10 cases (1995-2000). J Am Vet Med Assoc 2002; 221: 1306-1310.
    CrossrefPubMedGoogle Scholar
  • 57 Hance SR, Bramlage LR, Schneider RK. et al. Retrospective study of 38 cases of femur fractures in horses less than one year of age. Equine Vet J 1992; 24: 357-363.
    CrossrefPubMedGoogle Scholar
  • 58 McIlwraith CW, Yovich JV, Martin GS. Arth- roscopic surgery for the treatment of osteochon- dral chip fractures in the equine carpus. J Am Vet Med Assoc 1987; 191: 531-540.
    PubMedGoogle Scholar