title: Does intraoperative low arterial partial pressure of oxygen increase the risk of surgical site infection following emergency exploratory laparotomy in horses?
abstract: Decreased tissue oxygenation is a critical factor in the development of wound infection as neutrophil mediated oxidative killing is an essential mechanism against surgical pathogens. The objective of this prospective case series was to assess the impact of intraoperative arterial partial pressure of oxygen (PaO2) on surgical site infection (SSI) in horses undergoing emergency exploratory laparotomy for acute gastrointestinal disease. The anaesthetic and antibiotic protocol was standardised. Demographic data, surgical potential risk factors and PaO2, obtained 1h after induction of anaesthesia were recorded. Surgical wounds were assessed daily for infection during hospitalisation and follow up information was obtained after discharge. A total of 84 adult horses were included. SSI developed in 34 (40.4%) horses. Multivariate logistic regression showed that PaO2, anaesthetic time and subcutaneous suture material were predictors of SSI (AUC=0.76, sensitivity=71%, specificity=65%). The use of polyglycolic acid sutures increased the risk and horses with a PaO2 value < 80 mm Hg [10.6 kPa] and anaesthetic time >2h had the highest risk of developing SSI (OR=9.01; 95% CI 2.28-35.64). The results of this study confirm the hypothesis that low intraoperative PaO2 contributes to the development of SSI following colic surgery.
authors.affiliation: Departament de Medicina i Cirurgia Animal, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain. Electronic address: cristina.costa@uab.cat.
authors.forename: Cristina
authors.initials: C
authors.lastname: Costa-Farré
authors.affiliation: Departament de Medicina i Cirurgia Animal, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Prades
authors.affiliation: Departament de Medicina i Cirurgia Animal, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain.
authors.forename: Thaïs
authors.initials: T
authors.lastname: Ribera
authors.affiliation: Servei d'estadística aplicada, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain.
authors.forename: Oliver
authors.initials: O
authors.lastname: Valero
authors.affiliation: Departament d'Anestesiologia, Hospital Clínic de Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Taurà
mesh_terms: D000818:Animals; D003085:Colic / Q000382:microbiology / Q000601:surgery / Q000662:veterinary*; D004638:Emergency Treatment / Q000662:veterinary*; D005260:Female; D006734:Horse Diseases / Q000382:microbiology* / Q000601:surgery; D006736:Horses; D007813:Laparotomy / Q000662:veterinary; D008297:Male; D010100:Oxygen; D010313:Partial Pressure; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000382:microbiology / Q000662:veterinary*
chemical_list: D010100:Oxygen
keywords: Anaesthesia; Horses; Hypoxaemia; Surgical site infection