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Phase II Journals > Ch. 10: ORTHO Wound Infn > Flashcards

Ch. 10: ORTHO Wound Infn Flashcards

1
Q

Spencer Vet Sx 2018

A prospective, randomized, double-blinded, placebo-controlled clinical study on postop antibiotherapy in 150 arthroscopy- assisted TPLO in dogs

  • Sig factor for SSI?
  • MC bacteria?
A

Risk Factor for SSI = Body weight
- with each 1 unit increase in kg = increased odds of developing SSI by 5%

Most common isolate: Staph aureus

–> think MV/VV TPLO Case Spencer - chunky, infection

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2
Q

Ferrell Vet Sx 2019 PQ

Impact of postop antibiotics on rates of infection and implant removal after tibial tuberosity advancement in 1768 canine stifles

  • post op infn rate?
  • implant removal %? how many needed cage vs plate/screw removal?
  • effect of abx on infn?
  • effect of abx on oxacillin R infn? 2 points
A

Post op infections in 5%

Implant removal in 40% only - of those, cage needed to be removed in only 20% (80% had only plate/screws removed)

Effect of post op abx: rate of infection did NOT differ between dogs with or without postop abx

Postop abx increased risk for developing an oxacillin-resistant infection
Oxacillin-resistant infections were associated with a requirement for implant removal

–> FERAL ANIMALS need CAGES for RESISTANT INFECTIONS
Ferrell / TTA / kept their cage / abx increased risk for resistance / SSI

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3
Q

Giannetto VCOT 2019

Prospective evaluation of surgical wound dressings and the incidence of SSI in dogs undergoing a TPLO

  • SSI rate? Did dressing type matter?
  • MC bacteria?
  • risk factor for SSI?
  • what other author found same risk factor?
A

SSI rate 2% - dressing type was NOT significant

MC bacteria isolate: MR Staph pseudintermedius

SSI RF: Increasing body weight = only significant risk factor - increased risk of overall infection (OR 1)

–> Giannetto = fat Italian Johnny
remember: Spencer - BW increased SSI risk 5% (MV/VV TPLO Case Spencer - chunky, infection)

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4
Q

Lee Vet Sx 2019 PQ

Use of an amikacin-infused collagen sponge concurrent with implant removal for treatment of TPLO SSI in 31 cases

  • what did Lee do?
  • minor comp?
  • success rate %?
  • Recurrence / lameness?
A

Tx: implant removal + implantation of an absorbable collagen sponge infused with amikacin alone
= effective treatment for postoperative TPLO SSI

minor self limiting comp: incisional inflammation 20%

Success in 75%

No recurrence, lameness resolution in all

–> Holla at LEE he placed those BEADS! (rhymes)
ie. holla = collagen; amikacin beads (except it was a sponge)

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5
Q

Clark Vet Sx 2020 PQ

Influence of administration of antimicrobial medications after TPLO on SSI: A retrospective study of 308 dogs

  • do they support post-TPLO abx?
  • were abx related to resistance?
  • RF for deep SSI & resistance?
  • effect of prolonged anx/sx time?
A

Findings do NOT SUPPORT post op abx
Abx were NOT related to resistance
(contrary to Ferrell)

Body weight correlated with deep incisional SSI and resistant infections
(BW same as Spencer & Giannetto!!)

Prolonged duration of surgery and anesthesia = associated with superficial SSI, deep SSI, and antibiotic resistance.

Extra: “Surgeons influenced deep incisional SSI.”

–> JOHNNY CLARK SPENCER = BW = TPLO INFN
(Giannetto = Johnny, fat Italian; MV/VV chunky Spencer TPLO)

–> CLARK BARK - yelled at us for taking too long in sx

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6
Q

Hagen VSURG 2020

Contributing factors to surgical site infection after tibial plateau leveling osteotomy: A follow-up retrospective study

  • SSI rate?
  • MC bacteria?
  • 2 protective factors?
  • effect of abx?
A

TPLO SSI 10% TPLO

Infn: methicillin-resistant Staphylococcus pseudintermedius 30%
(same bug as Giannetto VCOT 2019)

Protective factors =
1 post op abx !!
2 timing of preoperative antimicrobial administration = when it was administered >60 minutes before the first incision

First study to say periop ABX PROTECT!

Hagen = study out of OVC. Those dirty Canadians need abx

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7
Q

Budsberg Vet Sx 2021

Efficacy of postoperative antibiotic use after tibial plateau leveling osteotomy in dogs: A systematic review

  • range of TPLO SSI rates?
  • What effect of BW reported by which 3 authors we studied?
  • who said abx protect?
  • who said abx not supported?
  • who said abx increased risk of resistant infn?
A

SSI reported for TPLO ranges from 5-25%

data suggest greater risk of post-op infections in dogs >50 kg
(JOHNNY CLARK SPENCER)

HAGEN = abx protective
(Dirty Canadians)

CLARK = Abx not supported
(Clark Barked)

FERRELL = Postop abx increased risk for developing an oxacillin-resistant infection
(Feral animals need cages for their resistant infections!)

FYI Budsberg concludes: there is currently limited & conflicting data to aid in clinical decision making regarding postop antibiotic use for the reduction of SSI in dogs after TPLO

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8
Q

McDougall Vet Sx 2021

Timing of and risk factors for deep surgical site infection requiring implant removal following canine TPLO

  • rate of deep SSI needing implant removal?
  • 2 RF for implant removal & ORs?
  • RF for earlier implant removal & HR?
A

(huge study, almost 5000 cases)

Deep SSI and implant removal occurred in 3% dogs treated with TPLO.

Risk factors for plate removal:
Male dogs (OR 2)
German Shepherd dogs (OR 7) !!!

Earlier TPLO plate removal was associated with GSDs only (HR 2)

Think of me and all my catastrophic GSD TPLOs… lol

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9
Q

Cox VCOT 2020

Investigation of variables associated with surgical site infection following the management of canine cranial cruciate ligament rupture with a lateral fabellotibial suture

  • SSI rate with LFS?
  • % needing suture removal?
  • 2 RF for SSI?
A

SSI rate 20%
- 50% of these had LFS removal!

RF for SSI:
bodyweight
induction using propofol

Extra: obviously infected dogs were more lame at recheck compared to non infected

–> COX = only lateral suture study
BW is a consistent RF for SSI in all
Unique to them = propofol

(JOHNNY CLARK SPENCER = TPLO BW RF for infn)

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10
Q

Morgera VSURG 2022

Surgical site infection-inflammation in dogs draped with a single-layer Kraton elastic seal extremity drape for stifle surgery

  • Kraton drape vs standard double drapes?
A

No difference in postoperative infection-inflammation was detected between stifle sx draped with a single-layer Kraton extremity patient drape vs standard double-layer drapes.

single-layer Kraton extremity patient drape is a viable alternative to conventional double-layer drapes

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11
Q

Peterson Vet Sx 2021

Calcium sulfate antibiotic-impregnated bead implantation for deep surgical site infection associated with orthopedic surgery in small animals

  • SSI resolution %? what was found in majority of the cases that resolved?
  • SSI rate in the prophylactic cases?
  • complication reported?
A

Lindsey from our study group!

Calcium sulfate antibiotic-impregnated bead implantation

SSI resolved in 60% dogs
- of those that resolved, vast majority were the cases that the bacteria were susceptible to the implanted abx

SSI did not occur in 100% dogs treated prophylactically

only “complication” was beads extruding from pin tract site 7 days post-op

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Phase II Journals (48 decks)

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