Chapter 10 Wound Infections and Antimicrobial Use

Question 1

Defien superficial, deep and organ/space SSI

Answer 1

Question 2

List 6 key risk factors for SSI that have been identified in several veterinary studies:

Answer 2

1. Duration of surgery (risk doubles with every hour)
2. Duration of anaethesia
3. Wound closure technique (?staples worse but no consensus)
4. Peri-op antibiotics
5. Surgery site prep
6. Co-morbidities

Question 3

What is the reported SSI rate for the following surgeries:

• All surgeries
• Clean ortho
• TPLO
• Clean-contaminated
• Dirty
• Laparaoscopic/thoracoscopic

Answer 3

• All surgeries 3%
• Clean ortho 7%
• TPLO 7-14%
• Clean-contaminated 6%
• Dirty 18%
• Laparaoscopic/thoracoscopic 2%

Question 4

What is the predominant bacterial types associted with following surgeries:

Skin

Head + neck

Ortho elective

Open fractures

Thorax/abdo

Upper GI

Hepatobiliary

Lower GI

Urogenital

Answer 4

Question 5

What 3 strategies are recommended re peri-op antimicrobials?

Answer 5

1. Base selection on anticipated pathogens
2. Ensure appropriate timing (peak concentration at time of first incision and repeat q x2 half-lives of antibiotic)
3. Discontinue within 24 hours

Question 6

Describe the wound classifications:

Clean

Clean-contaminated

Contaminated

Dirty

Answer 6

Question 7

List 4 potential diagnosic tests that could be run if SSI noted

Answer 7

Culture, haem, cytology, imaging

Question 8

In TPLO, how many infections failed to resolve with abx vs how many resolved after implant removal?

Answer 8

89% failed to resolve with abx

95% resolved after implant removal