1. Einfluss präoperativer Antibiotikagaben auf die Häufigkeit postoperativer Komplikationen bei Pferden, bei denen unter Allgemeinanästhesie saubere chirurgische Eingriffe und diagnostische Bildgebung durchgeführt wurden.
- Author
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Hanimann, Annina, Wiederkehr, Alexandra, Fürst, Anton, and Bischofberger, Andrea
- Subjects
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RESPIRATORY infections , *SURGICAL complications , *OPERATIVE surgery , *LEUKOCYTE count , *ANTIBIOTIC prophylaxis , *FEVER - Abstract
This retrospective study investigated the effect of preoperative antibiotic prophylaxis on postoperative complications in equids admitted to the Clinic for Equine Surgery, University of Zurich, for clean surgical procedures and diagnostic imaging. The medical records were searched for equids that were healthy and had a rectal temperature within the reference range preoperatively and were admitted between June 1, 2020 to December 1, 2020 for a surgical procedure performed under general anesthesia. The search yielded 46 equids, which were divided into two groups: Group 1 (no AB) did not receive prophylactic antibiotics and Group 2 (AB) received prophylactic antibiotics. The same surgical procedure was selected for comparative purposes, yielding 23 pair-matched equids. All equids underwent a thorough clinical examination and daily monitoring of the rectal temperature one day before to two days after the operation. In addition, hematological testing including the measurement of serum amyloid A (SAA), collection of nasal swab samples for microbiological analysis, ultrasono graphic examination of the lungs and jugular veins and endoscopy of the airways were carried out postoperatively. The differences between the groups were statistically analyzed. Eight of the 23 surgical procedures per group were primary castrations and 6 were arthroscopies. An inguinal approach was chosen for the primary castrations, whereby all layers were sutured again. The aim of this closed castration was to achieve primary healing, that’s why they are called primary castrations. Fever (rectal temperature > 38.5 °C) was one of the most common postoperative complications. The incidence of fever after general anesthesia was 21.7% (n = 5 of 23 equids) in the no AB group and 4.3% (n = 1 of 23 equids) in the AB group, but the difference was not significant (p = 0.09). The only horse in the AB group with a fever postoperatively developed a local wound infection. Fever in the five horses in the no AB group occurred within two days after the surgical procedure. The maximum temperature recorded was 40.6 °C. Of the five horses in the no AB group, three underwent primary-closure castration and two underwent an orthopedic procedure. All horses were successfully treated with postoperative systemic antibiotics. The most frequent cause of fever was attributable to respiratory tract infection. There were no significant differences between the two groups with regard to breed (p = 0.7), gender (p = 0.4) or age (p = 0.77). The surgeon (p = 0.72), the mean duration of anesthesia (p = 0.20) and the duration of surgery (p = 0.57) had no effect on postoperative complications. The number of cases per group (n = 23) was small, which may have contributed to a lack of a significant difference between the two groups (p = 0.09). Clinically, however, several horses in the no AB group had postoperative complications associated with the respiratory tract. One developed severe bacterial pleuropneumonia with abscessation and pleural effusion. The results of this study showed that administering antibiotics before a clean surgical procedure under general anesthesia is generally not necessary, but it may reduce postoperative complications such as the incidence of fever. Perioperative antibiotics should no longer be routinely administered because of widespread antibiotic resistance and instead should be reserved for cases in which the risk of postoperative complications is high. This entails thorough preoperative assessment of horses with attention to factors such as age and husbandry to prevent postoperative complications, particularly respiratory tract infections. In unclear cases, a blood test (leukocyte count, fibrinogen and SAA) is also required. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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