A retrospective analysis of the risk factors for surgical site infections and long-term follow-up after transpalpebral enucleation in horses
Abstract Background Implants are often used to improve the cosmetic appearance of horses after enucleation of the eye. When surgical site infection (SSI) occurs, the implant will almost always be lost. The aim of this study is to collect data on the risk factors for SSIs and report long-term follow-...
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| Format: | Article |
| Language: | English |
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BMC
2017-06-01
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| Series: | BMC Veterinary Research |
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| Online Access: | http://link.springer.com/article/10.1186/s12917-017-1069-5 |
| _version_ | 1818827740474769408 |
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| author | Tsjester Huppes Hanneke Hermans Jos M. Ensink |
| author_facet | Tsjester Huppes Hanneke Hermans Jos M. Ensink |
| author_sort | Tsjester Huppes |
| collection | DOAJ |
| description | Abstract Background Implants are often used to improve the cosmetic appearance of horses after enucleation of the eye. When surgical site infection (SSI) occurs, the implant will almost always be lost. The aim of this study is to collect data on the risk factors for SSIs and report long-term follow-up (cosmetic results and return to work) after transpalpebral enucleations. In this retrospective study, records of horses undergoing transpalpebral enucleation were reviewed (2007–2014) and telephone interviews were used to obtain long term follow-up. The potential risk factors for SSIs (indication for enucleation, use of an implant, standing procedures, duration of surgery, opening of the conjunctival sac and prolonged use of antimicrobials) were analysed for their association with the outcome measure ‘SSI’ vs ‘no SSI’ by multivariable binary logistic regression testing. Indications for enucleation were grouped as follows: Group 1 (clean) included equine recurrent uveitis, too small or too large globes, and intraocular tumours, Group 2 (non-clean) included corneal perforation/rupture and infected ulcers and Group 3 (tumour) included extraocular tumours. Results One hundred and seven cases of enucleation were evaluated. An implant was used in 49 horses. The overall number of SSIs was 8 (7.5%). Multivariable logistic regression testing showed implants (OR 7.5, P = 0.04) and standing procedures (OR 12.1; P = 0.03) were significantly associated with the percentage of SSIs and increased the risk of SSI. The eyes of horses in Groups 2 and 3 trended towards a larger risk for developing SSIs (OR 4.9; P = 0.09 and OR 5.9; P = 0.1, respectively). Prolonged use of antimicrobials, long surgery times and the opening of the conjunctival sac during dissection did not show significant associations with SSI risk. Conclusions The risk of SSI after enucleation is low in clean eyes and when no implant is used. Placing an implant or performing a standing enucleation significantly increases the risk of SSIs. Although implants can be used for eyes that fall into Groups 2 and 3, 17% of the horses in these two groups developed an SSI leading to loss of the implant. |
| first_indexed | 2024-12-19T00:48:22Z |
| format | Article |
| id | doaj.art-e094196cd81f402f9c158f2256ad802b |
| institution | Directory Open Access Journal |
| issn | 1746-6148 |
| language | English |
| last_indexed | 2024-12-19T00:48:22Z |
| publishDate | 2017-06-01 |
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| spelling | doaj.art-e094196cd81f402f9c158f2256ad802b2022-12-21T20:44:12ZengBMCBMC Veterinary Research1746-61482017-06-011311910.1186/s12917-017-1069-5A retrospective analysis of the risk factors for surgical site infections and long-term follow-up after transpalpebral enucleation in horsesTsjester Huppes0Hanneke Hermans1Jos M. Ensink2Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht UniversityDepartment of Equine Sciences, Faculty of Veterinary Medicine, Utrecht UniversityDepartment of Equine Sciences, Faculty of Veterinary Medicine, Utrecht UniversityAbstract Background Implants are often used to improve the cosmetic appearance of horses after enucleation of the eye. When surgical site infection (SSI) occurs, the implant will almost always be lost. The aim of this study is to collect data on the risk factors for SSIs and report long-term follow-up (cosmetic results and return to work) after transpalpebral enucleations. In this retrospective study, records of horses undergoing transpalpebral enucleation were reviewed (2007–2014) and telephone interviews were used to obtain long term follow-up. The potential risk factors for SSIs (indication for enucleation, use of an implant, standing procedures, duration of surgery, opening of the conjunctival sac and prolonged use of antimicrobials) were analysed for their association with the outcome measure ‘SSI’ vs ‘no SSI’ by multivariable binary logistic regression testing. Indications for enucleation were grouped as follows: Group 1 (clean) included equine recurrent uveitis, too small or too large globes, and intraocular tumours, Group 2 (non-clean) included corneal perforation/rupture and infected ulcers and Group 3 (tumour) included extraocular tumours. Results One hundred and seven cases of enucleation were evaluated. An implant was used in 49 horses. The overall number of SSIs was 8 (7.5%). Multivariable logistic regression testing showed implants (OR 7.5, P = 0.04) and standing procedures (OR 12.1; P = 0.03) were significantly associated with the percentage of SSIs and increased the risk of SSI. The eyes of horses in Groups 2 and 3 trended towards a larger risk for developing SSIs (OR 4.9; P = 0.09 and OR 5.9; P = 0.1, respectively). Prolonged use of antimicrobials, long surgery times and the opening of the conjunctival sac during dissection did not show significant associations with SSI risk. Conclusions The risk of SSI after enucleation is low in clean eyes and when no implant is used. Placing an implant or performing a standing enucleation significantly increases the risk of SSIs. Although implants can be used for eyes that fall into Groups 2 and 3, 17% of the horses in these two groups developed an SSI leading to loss of the implant.http://link.springer.com/article/10.1186/s12917-017-1069-5HorseTranspalpebralEnucleationRisk factorsSurgical site infection |
| spellingShingle | Tsjester Huppes Hanneke Hermans Jos M. Ensink A retrospective analysis of the risk factors for surgical site infections and long-term follow-up after transpalpebral enucleation in horses BMC Veterinary Research Horse Transpalpebral Enucleation Risk factors Surgical site infection |
| title | A retrospective analysis of the risk factors for surgical site infections and long-term follow-up after transpalpebral enucleation in horses |
| title_full | A retrospective analysis of the risk factors for surgical site infections and long-term follow-up after transpalpebral enucleation in horses |
| title_fullStr | A retrospective analysis of the risk factors for surgical site infections and long-term follow-up after transpalpebral enucleation in horses |
| title_full_unstemmed | A retrospective analysis of the risk factors for surgical site infections and long-term follow-up after transpalpebral enucleation in horses |
| title_short | A retrospective analysis of the risk factors for surgical site infections and long-term follow-up after transpalpebral enucleation in horses |
| title_sort | retrospective analysis of the risk factors for surgical site infections and long term follow up after transpalpebral enucleation in horses |
| topic | Horse Transpalpebral Enucleation Risk factors Surgical site infection |
| url | http://link.springer.com/article/10.1186/s12917-017-1069-5 |
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