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Evaluation of a stent dressing for anaesthetic recovery on surgical site infection following emergency equine laparotomy: A Randomised controlled trial
  • +4
  • Cajsa Isgren,
  • Gina Pinchbeck,
  • S.E. Salem,
  • Michelle Hann,
  • Neil Townsend,
  • M.D Cullen,
  • Debra Archer
Cajsa Isgren
University of Liverpool Institute of Infection Veterinary and Ecological Sciences
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Gina Pinchbeck
University of Liverpool Institute of Infection Veterinary and Ecological Sciences
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S.E. Salem
Zagazig University Faculty of Veterinary Medicine
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Michelle Hann
University of Liverpool Institute of Infection Veterinary and Ecological Sciences
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Neil Townsend
University of Liverpool Institute of Infection Veterinary and Ecological Sciences
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M.D Cullen
University of Liverpool Institute of Infection Veterinary and Ecological Sciences
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Debra Archer
University of Liverpool Institute of Infection Veterinary and Ecological Sciences

Corresponding Author:[email protected]

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Abstract

Background: Surgical site infection (SSI) is a frequent complication following emergency equine laparotomy. It negatively impacts equine welfare, increases treatment costs and is a hospital biosecurity risk justifying investigations of ways to reduce SSI incidence. Objectives: To determine if a sutured-on stent dressing for anaesthetic recovery reduces SSI in horses following emergency laparotomy. Study design: Randomised controlled trial. Methods: Eligible horses undergoing emergency exploratory laparotomy were enrolled. Horses were randomised to have a sutured-on stent dressing (intervention) or standard adhesive textile dressing (control) placed for incisional protection during anaesthetic recovery. Horses were followed up to 90 days postoperatively. Data were analysed according to intention-to-treat principles. Time to SSI (primary outcome) for each group was analysed using a Cox proportional hazard model. Secondary outcomes (SSI during hospitalisation, pyrexia during hospitalisation, days hospitalisation and incisional hernia formation at 90 days) were analysed using Chi-squared tests and a univariable logistic regression model (categorical data) or by comparing means between groups (continuous data). Results: The study included 352 horses (167 intervention group, 185 control group). SSI developed in 101 horses (28.7%) at a mean of 9.7 days (SD 4.6 days). Rate of SSI was not significantly different between intervention and control groups unadjusted (Hazard Ratio [HR] 0.83, 95% CI 0.56 - 1.23, P=0.36) or adjusted for variables significantly associated with rate of SSI (HR 0.88, 95% CI 0.59 – 1.30, P=0.51). There were no significant differences in secondary outcomes between intervention and control groups. Main limitations: This study was performed at a single centre and only evaluated incisional protection for anaesthetic recovery. Conclusions: Use of a sutured-on stent dressing for anaesthetic recovery did not reduce the rate of SSI compared to a textile adhesive dressing. Further RCT are required to investigate efficacy of other interventions on reduction of SSI following emergency laparotomy
Submitted to Equine Veterinary Journal
12 Apr 2024Review(s) Completed, Editorial Evaluation Pending
31 May 2024Editorial Decision: Revise Minor
30 Aug 20241st Revision Received
30 Aug 2024Submission Checks Completed
30 Aug 2024Assigned to Editor
30 Aug 2024Review(s) Completed, Editorial Evaluation Pending
04 Sep 2024Reviewer(s) Assigned
14 Oct 2024Editorial Decision: Revise Minor