Alison C Bidjarano, Wanda Gordon-Evans, Christopher Thomson
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引用次数: 0
Abstract
Objective: To determine the overall prevalence of surgical site infection (SSI) following tibial plateau leveling osteotomy (TPLO) in dogs and to evaluate associated risk factors across published studies.
Study design: Systematic review with meta-analysis.
Sample population: Client-owned dogs that underwent TPLO as described in the published literature.
Methods: A systematic review of studies reporting SSI following TPLO was conducted using PRISMA guidelines. Included studies were screened for quality, and pooled prevalence estimates were calculated using random-effects models. Subgroup and sensitivity analyses were performed. For risk factors, pooled ORs were calculated only when ≥3 comparable studies reported ORs with CIs (weight and postoperative antimicrobial administration).
Results: The meta-analysis included 30 studies encompassing 8820 dogs (9576 TPLOs). Only 5/30 studies were considered level I or II and then further divided into moderate and high level of evidence. The overall SSI rate, including superficial and deep infections, was 9.11% (range: 2.9%-25.9%) and an explant rate of 4.11% (range: 0%-33.36%). Heterogeneity was moderate to high across studies. In pooled analyses limited to comparable studies, postoperative antimicrobial administration was associated with lower odds of SSI, while bodyweight showed minimal association with SSI risk; both findings should be interpreted cautiously given limited comparability across studies.
Conclusion: TPLO SSI rates are higher than other clean orthopedic procedures. Current literature is mostly retrospective in nature. These findings emphasize the need for standardized reporting and infection prevention strategies in clinical practice.
Clinical significance: While higher-quality (higher-level) evidence is needed, trends seen in this large population can be used to start quality control measures in hospitals to reduce TPLO SSI rates.
期刊介绍：
Veterinary Surgery, the official publication of the American College of Veterinary Surgeons and European College of Veterinary Surgeons, is a source of up-to-date coverage of surgical and anesthetic management of animals, addressing significant problems in veterinary surgery with relevant case histories and observations.
It contains original, peer-reviewed articles that cover developments in veterinary surgery, and presents the most current review of the field, with timely articles on surgical techniques, diagnostic aims, care of infections, and advances in knowledge of metabolism as it affects the surgical patient. The journal places new developments in perspective, encompassing new concepts and peer commentary to help better understand and evaluate the surgical patient.
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