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2017 ; 13
(1
): 155
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A retrospective analysis of the risk factors for surgical site infections and
long-term follow-up after transpalpebral enucleation in horses
#MMPMID28578668
Huppes T
; Hermans H
; Ensink JM
BMC Vet Res
2017[Jun]; 13
(1
): 155
PMID28578668
show ga
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.