SSI associated with Stifle Sx

Question 1

Ferrell
Impact of PO abs on rates of infection and implant removal after TTA
VetSurg 2019

Answer 1

PO infection 5%

The rate did not differ w/ or w/o PO abs

PO abs tended to oxacillin-resistant infections
~associated with the requirement for implant removal to achieve resolution

Question 2

Lopez
Retrospective: factors associated with SSI after TPLO
JAVMA 2018

Answer 2

SSI 8%

GSD
Meniscectomy
The surgeon doing less than 20 Sx in the study

Question 3

Cox
Variables associated with SSI after Lateral Suture
VCOT 2020

Answer 3

SSI 17%
increased body weight
induction with propofol

Question 4

Giannetto
Wound dressing and SSI in TPLO
VCOT 2019

Answer 4

SSI 2%
MRSP most common

Bodyweight increased the risk of infection

Question 5

Hagen
Contributing factors to SSI after TPLO
VetSurg 2020

Answer 5

SSI 11%
MRSP 28%

Protective against
~PO abs
~Timing of pre-op abs administration (>60 min b/f incision vs. >30 min b/f)

Question 6

Clark
Influence of abs after TPLO
VetSurge 2020

Answer 6

Deep incisional SSI
~BW
~Prolonged Sx
~Surgeon

Resistance
~BW
~Prolonged Sx

Superficial incision SSI
~Prolonged Sx

PO admin abs
~not protective against SSI
~did not predispose to antibiotic resistance

Question 7

Stine
Protocol changes to reduce implant TPLO
VetSurg 2018

Answer 7

The odds ratio decreased by 88% after the protocol change
~more MRSP noted

Protocol
~Iodophore-impregnated adhesive drape
~Cefazolin q90m & q4h PO
~Ortho gloves
~Triclosan-coated intradermal suture
~SPB with mupirocin ointment
~Use of single-use gloves PO
~Placemnt of E-collar

Question 8

Lopez et al VetSurg 2020
What was the conclusion regarding subcutaneous closure in cats?

Answer 8

Quilting pattern had less serum formation than simple continuous or no SQ closure.
Decreased pain with SQ closure vs not

Question 9

Stickney et al VetSurg 2018
What percentage of SSI were identified after discharge from the hospital

Answer 9

28% - infections diagnosed after discharge from the hospital
Overall infection rate - 2.83%

Question 10

Kuvaldina et al VetSurg 2018
What is the mechanism of failure of the LigaSure after multiple uses?

Answer 10

First - increased tissue adherence, then blade problems, then vascular seal problems

Question 11

Kuvaldina et al VetSurg 2018
How many times can the LigaSure be resteralized?

Answer 11

Impact - 16 cycles
Small Jaw - 9 cycles