犬肢截肢术后手术部位感染的发生率及危险因素分析。

Veterinary surgery : VS Pub Date : 2022-04-01 Epub Date: 2022-01-10 DOI:10.1111/vsu.13762
Alison R Billas, Janet A Grimes, Danielle L Hollenbeck, Vanna M Dickerson, Mandy L Wallace, Chad W Schmiedt
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引用次数: 0

摘要

目的:探讨犬胸盆腔截肢术后手术部位感染的发生率及危险因素。研究设计:回顾性、多中心研究。动物:狗(248)。方法:回顾术前、术中和术后的医疗记录,包括截肢指征、截肢类型、肌肉横断方法、手术和麻醉时间以及伤口分类。随访≥30天或直至SSI发展。使用逻辑回归和Fisher精确检验比较SSI发生率与感兴趣的变量。结果:所有手术的SSI发生率为12.5%,清洁手术的SSI发生率为10.9%。增加SSI发生几率的因素是双极血管密封装置的肌肉横断(所有手术P = 0.023,清洁手术P = 0.025),手术分类为非清洁(P = 0.003),以及与肿瘤相比,细菌感染(P = 0.041)或创伤性损伤(P = 0.003)的截肢指征。结论:使用双极血管密封装置进行肌肉横断增加了发生SSI的几率,而使用电手术和/或尖锐横断则没有。手术部位不干净、细菌感染和/或创伤性损伤的狗也增加了SSI的几率。临床意义:为了降低截肢犬发生SSI的几率,应考虑采用电手术或锋利横断进行肌肉横断,而不是使用双极血管密封装置。鉴于这些设备在兽医学中的日益普及,需要对各种程序进行进一步的研究来验证这些发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incidence of and risk factors for surgical site infection following canine limb amputation.

Objective: To determine the incidence of and risk factors for surgical site infection (SSI) following canine thoracic and pelvic limb amputations.

Study design: Retrospective, multicenter study.

Animals: Dogs (n = 248).

Methods: Medical records were reviewed for preoperative, intraoperative, and postoperative variables including indication for amputation, amputation type, method of muscle transection, duration of surgery and anesthesia, and wound classification. Follow up was ≥30 days or until SSI development. Logistic regression and Fisher's exact tests were used to compare SSI incidence to variables of interest.

Results: The incidence of SSI was 12.5% for all procedures and 10.9% for clean procedures. Factors increasing odds of SSI were muscle transection with a bipolar vessel sealing device (P = .023 for all procedures, P = .025 for clean procedures), procedure classified as other than clean (P = .003), and indication for amputation of bacterial infection (P = .041) or traumatic injury (P = .003) compared to neoplasia.

Conclusion: Use of bipolar vessel sealing devices for muscle transection increased the odds of developing an SSI whereas use of electrosurgery and/or sharp transection did not. Dogs with surgical sites that were other than clean, or with bacterial infection and/or traumatic injury were also at increased odds of SSI.

Clinical significance: Use of electrosurgery or sharp transection for muscle transection should be considered rather than use of bipolar vessel sealing devices to decrease odds of SSI in dogs undergoing limb amputation. Further studies across a variety of procedures are needed to validate these findings given the increasing popularity of these devices in veterinary medicine.

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