University of Pennsylvania School of Veterinary Medicine Philadelphia, Pennsylvania
Risk Factors Associated with Increased Incidence of Surgical Site Infection Following Canine Thoracic and Pelvic Limb Amputations. Billas AR1, Grimes J1, Wallace M1, Schmiedt C1, Hollenbeck D2, Dickerson V2. 1University of Georgia Veterinary Teaching Hospital, Athens, GA; 2Texas A&M University Veterinary Teaching Hospital, College Station, TX.
Canine limb amputations have a higher incidence of surgical site infection (SSI; 8%–13%) than expected for a clean surgical procedure. This study evaluated the incidence of SSI following canine thoracic and pelvic limb amputations and identified risk factors for SSI. The hypothesis was that the incidence of SSI would be greater than 10% and prolonged durations of surgery and anesthesia would be associated with increased incidence of SSI. Medical records were reviewed for pre-, intra-, and postoperative variables. Univariable logistic regression compared incidence of SSI to variables of interest. Incidence of SSI was 12.5% for all surgical procedures and 10.9% for clean procedures exclusively. Dogs with surgical sites categorized as not clean (contaminated or dirty), and an infection or traumatic injury as their indication for amputation compared to neoplasia were significantly more likely to develop an SSI (P = 0.003 and P = 0.002, respectively). Prolonged durations of anesthesia and surgery were not significant risk factors. Incidence of SSI following clean procedures remained elevated, potentially secondary to increased operative time and muscle transection associated with amputations. These findings corroborate prior studies, underscoring the prognostic value of the current wound classification system for determining odds of developing an SSI post-limb amputation in dogs. Dogs with preoperative infections and trauma often had surgical sites classified as not clean. The major limitations were the retrospective design and low number of not clean surgical sites. The findings of this study emphasize appropriate and early management of not clean surgical sites in order to minimize risk of SSI.