1
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Korytárová N, Kramer S, Harms O, Volk HA. Clinical relevance of positive intraoperative bacterial culture in tibial plateau leveling osteotomy in dogs: a retrospective study. BMC Vet Res 2024; 20:175. [PMID: 38704532 PMCID: PMC11069177 DOI: 10.1186/s12917-024-04007-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 04/04/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Tibial plateau leveling osteotomy (TPLO) belongs to the most frequently used surgical method for the treatment of cranial cruciate ligament rupture in dogs. Surgical site infection (SSI) is one of the possible postoperative complications. The aim of this study was to evaluate the diagnostic value of intraoperative bacterial culture as a tool for the detection of intraoperative bacterial contamination progressing to infection development in canine TPLO. Electronic patient records from dogs who underwent TPLO between January 2018 to December 2020 were retrospectively reviewed. Intraoperative bacterial culture results, used antimicrobial drugs and presence of SSI were recorded. RESULTS Ninety-eight dogs were included in the study. SSI rate was 10.2%. All dogs who developed SSI (n = 10) had negative intraoperative bacterial cultures. None of the dogs with positive intraoperative bacterial culture (n = 6) developed SSI. The most cultured bacteria causing SSI was Staphylococcus pseudintermedius (n = 4). CONCLUSIONS Intraoperative bacterial culture in dogs undergoing TPLO is not suitable as a predictor of surgical site infection.
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Affiliation(s)
- Natália Korytárová
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - Sabine Kramer
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - Oliver Harms
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany
| | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
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2
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Sandness BM, Perry KL, Bruce M. Single institution retrospective study evaluating the frequency of implant removal and associated risk factors following open fracture fixation in 80 cases (2010-2020). BMC Vet Res 2023; 19:119. [PMID: 37563636 PMCID: PMC10413701 DOI: 10.1186/s12917-023-03687-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 08/04/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Open fractures occur commonly in small animals and are characterised by contamination of the fracture site. While never quantified, it is believed that open fractures stabilised with internal implants are at a higher risk for requiring explantation. This retrospective study determines the frequency and risk factors for explantation following use of internal fixation. Medical records of client-owned dogs and cats with an open fracture, between 2010 and 2020 stabilised using internal implants, were included. Data retrieved included signalment, cause and characterisation of the fracture, comorbidities, preexisting infections, and all details related to anesthesia and surgery. Pre-, Peri- and post-operative antibiotic use were detailed. All cases were followed to clinical union. Postoperative complications, including requirement for implant removal were recorded and classified as major or minor. Associations between potential risk factors and need for explantation were assessed. RESULTS Of 80 cases, 72 (90%) were dogs and eight (10%) cats. Major complications were encountered in 23 (28.75%) cases and minor complications in 16 (20%) cases. Explantation was performed in 17 cases (21.25%). Out of 72 dogs, 13 required explantation (18%) whereas four of the eight cats needed implants removed (50%). Only diagnosis of postoperative infection was associated with an increased risk of explantation (RR 2.77; 95% CI 1.25; 6.15; p = 0.045). CONCLUSION Approximately 1 in 5 open fractures stabilised using internal fixation can be anticipated to require explantation, with cats potentially being at a higher risk than dogs. Cases diagnosed with postoperative infection are at a higher risk for requiring implant removal.
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Affiliation(s)
- Brea M Sandness
- Department of Small Animal Clinical Sciences, Michigan State University, 736 Wilson Road, East Lansing, MI, 48824-1314, USA
| | - Karen L Perry
- Department of Small Animal Clinical Sciences, Michigan State University, 736 Wilson Road, East Lansing, MI, 48824-1314, USA.
| | - Mieghan Bruce
- School of Veterinary Medicine and Centre for Biosecurity and One Health, Murdoch University, Murdoch, 6150, Australia
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3
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Looi RCY, White JD, James DR. Effects of Angled Dynamic Compression Holes in a Tibial Plateau Levelling Osteotomy Plate on Cranially Directed Fragment Displacement. Vet Comp Orthop Traumatol 2023. [PMID: 36796431 DOI: 10.1055/s-0043-1761246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE To compare angled dynamic compression holes in a tibial plateau levelling osteotomy (TPLO) plate to a commercially available TPLO plate in an ovine cadaveric model. STUDY DESIGN Ovine tibias (40 bones) were mounted on a custom-made securement device and radiopaque markers were placed to aid radiographic measurements. A standard TPLO procedure was performed on each tibia with either a custom-made six-hole 3.5 mm angled compression hole plate (APlate) or a six-hole 3.5 mm standard commercial plate (SPlate). Radiographs were obtained before and after tightening of the cortical screws and evaluated by an observer blinded to the plate. Measurements of cranio-caudal displacement (CDisplacement), proximo-distal displacement (PDisplacement) in relation to the long axis of the tibia, and change in tibial plateau angle (TPA) were determined. RESULTS CDisplacement was significantly greater in APlate (median 0.85 mm, Q1-Q3: 0.575-1.325 mm) compared to SPlate (median 0.00 mm, Q1-Q3: -0.35-0.50 mm, p < 0.0001). There were no significant differences in the PDisplacement (median 0.55 mm, Q1-Q3: 0.075-1.00 mm, p = 0.5066) or TPA change (median -0.50°, Q1-Q3: -1.225-0.25°, p = 0.1846) between the two plate types. CONCLUSION APlate increases cranially directed displacement of the osteotomy in a TPLO procedure without causing TPA change. The reduced interfragmentary distance across the whole osteotomy could improve osteotomy healing compared to standard commercial TPLO plates.
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Affiliation(s)
- Richard C Y Looi
- Surgery Department, Small Animal Specialist Hospital, Sydney, Australia
| | - Joanna D White
- Internal Medicine Department, Small Animal Specialist Hospital, Sydney, Australia
| | - Daniel R James
- Surgery Department, Small Animal Specialist Hospital, Sydney, Australia
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4
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Choi CJ, Balara JM, Casale SA, Wendelburg KL. Implant removal rate after partial carpal arthrodesis in dogs: A retrospective analysis of 22 cases. Front Vet Sci 2023; 10:1160129. [PMID: 37082137 PMCID: PMC10110909 DOI: 10.3389/fvets.2023.1160129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/21/2023] [Indexed: 04/22/2023] Open
Abstract
Introduction The purpose of this study is to determine the rate of implant removal after partial carpal arthrodesis and to investigate factors associated with implant removal. Methods Case records of 22 dogs that underwent partial carpal arthrodesis at two private veterinary referral hospitals were reviewed. Details retrieved were body weight at time of surgery, sex, neuter status, breed, age, cause of carpal hyperextension injury, joint(s) involved in carpal hyperextension injury, laterality, type of implant, administration of post-operative antibiotics, post-operative outcome and indication for implant removal. Association between these factors and implant removal was evaluated. Results Of 22 partial carpal arthrodesis, 12 (55%) had implant removal due to persistent lameness and 9/12 (75%) returned to full and acceptable function after implant removal. Indications for implant removal were implant interference (8), infection (4), and migration (1). When comparing type of implant, there was a significant difference when observing implant removal rates (p = 0.04). All 5 dogs with pins and wires (100%) required implant removal. Of 17 dogs with a plate, 7 (41.2%) required implant removal. Implant removal was performed on average 114 days post-operative. Discussion Implant removal after partial carpal arthrodesis was frequent and was commonly indicated due to pin and wire fixation or plate implant interference. This study may impact how we prepare clients for potential post-operative complications and implant removal when recommending partial carpal arthrodesis.
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Affiliation(s)
- Caroline J. Choi
- Department of Surgery, VCA Animal Specialty Group, Los Angeles, CA, United States
- Department of Surgery, Angell Animal Medical Center, Boston, MA, United States
- *Correspondence: Caroline J. Choi
| | - Jason M. Balara
- Department of Surgery, VCA Animal Specialty Group, Los Angeles, CA, United States
| | - Sue A. Casale
- Department of Surgery, Angell Animal Medical Center, Boston, MA, United States
| | - Kirk L. Wendelburg
- Department of Surgery, VCA Animal Specialty Group, Los Angeles, CA, United States
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5
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Tikekar A, De Vicente F, McCormack A, Thomson D, Farrell M, Carmichael S, Chase D. Retrospective comparison of outcomes following tibial plateau leveling osteotomy and lateral fabello-tibial suture stabilisation of cranial cruciate ligament disease in small dogs with high tibial plateau angles. N Z Vet J 2022; 70:218-227. [DOI: 10.1080/00480169.2022.2052992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A Tikekar
- Veterinary Specialists Auckland, Mount Albert, Auckland, New Zealand
| | - F De Vicente
- Pride Veterinary Specialists, Derby, Derbyshire, UK
| | | | - D Thomson
- Chester Gates Veterinary Referrals, Chester, Cheshire, UK
| | | | - S Carmichael
- School of Veterinary Medicine, University of Surrey, Guildford, Surrey, UK
| | - D Chase
- Veterinary Specialists Auckland, Mount Albert, Auckland, New Zealand
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6
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Danielski A, Krekis A, Yeadon R, Solano MA, Parkin T, Vezzoni A, Pfeil I. Complications after proximal abducting ulnar osteotomy and prognostic factors in 66 dogs. Vet Surg 2021; 51:136-147. [PMID: 34370337 PMCID: PMC9292888 DOI: 10.1111/vsu.13697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 05/22/2021] [Accepted: 07/20/2021] [Indexed: 02/07/2023]
Abstract
Objective To report complications and prognostic factors in dogs undergoing proximal abducting ulnar osteotomy (PAUL). To evaluate the ability to predict complications on the basis of post‐operative radiographic examination. Study Design Retrospective cohort study. Animals Sixty‐six dogs. Methods Medical records of dogs treated with PAUL between 2014 and 2019 were reviewed for demographics, intraoperative findings, and post‐operative complications. Post‐operative radiographs were reviewed by two masked expert orthopedic surgeons, who were asked to predict the likelihood of major mechanical complications. The prognostic value of variables was tested with univariate and multivariable logistic regression. Inter‐investigator agreement to predict complications was evaluated with two‐by‐two tables and kappa coefficient. Results Seventy‐four PAULs in 66 dogs were included. Duration of follow‐up ranged from 12 to 75 months (median: 53 months). Post‐operative complications were documented in 19/74 limbs (16 dogs), including major complications in 13 limbs. These complications consisted mainly of non‐union (six limbs), implant failure (two limbs), and infection (two limbs) requiring revision surgery in nine limbs. Body weight was the only variable associated with an increased risk of post‐operative complications (p = .04). Agreement between expert predictions was low (respectively k = −0.08 and k = 0.11). Conclusion Major complications were reported in one fourth of limbs treated with PAUL and were more likely as body weight increased. Suboptimal plate and screw placement or osteotomy reduction on post‐operative radiographs were poorly predictive of complications. Clinical Significance Complications are fairly common after PAUL, particularly in heavier dogs, and post‐operative radiographic examination seems unreliable to predict those.
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Affiliation(s)
- Alan Danielski
- The Ralph Veterinary Referral Centre, Marlow, UK.,Department of Veterinary Medicine and Animal Sciences, University of Naples "Federico II", Naples, Italy
| | | | | | | | - Tim Parkin
- Bristol Veterinary School, University of Bristol, Langford, UK
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7
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Browne KL, Crowley JD, Tan CJ, O'Sullivan CB, Walsh WR. Effect of ultraviolet-C light on the environmental bacterial bioburden in various veterinary facilities. Am J Vet Res 2021; 82:582-588. [PMID: 34166087 DOI: 10.2460/ajvr.82.7.582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the effect of a mobile UV-C disinfection device on the environmental bacterial bioburden in veterinary facilities. SAMPLES 40 swab samples of surfaces from the operating theaters of 3 veterinary hospitals and 1 necropsy laboratory. PROCEDURES Various surfaces were swabbed, and collected material was eluted from the swabs in PBSS. Then, an aliquot of the sample fluid was processed with a bacteria-specific rapid metabolic assay to quantify bacterial bioburden. Each site was then treated with UV-C light with an automated disinfection device for approximately 45 minutes. The same surfaces were swabbed following UV-C treatment, and bioburden was quantified. The bioburden at additional time points, including after a second UV-C treatment, was determined for the small animal operating theater. RESULTS All surfaces at all sites had a persistent viable bacterial population following manual cleaning. Disinfection with UV-C achieved a mean bioburden reduction of 94% (SD, 5.2%; range, 91% to 95%) for all surfaces, compared with manual disinfection alone. Repeated UV-C treatment of the small animal operating theater reduced mean bioburden by 99% (SD, 0.8%), including no detectable bacteria on 4 of 10 surfaces. CONCLUSIONS AND CLINICAL RELEVANCE Disinfection with UV-C light may be a beneficial adjunct method for terminal disinfection of veterinary operating theaters to reduce environmental bioburden. (Am J Vet Res 2021;82:582-588).
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Affiliation(s)
- Katrina L Browne
- From the Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- From the School of Chemistry, University of New South Wales, Sydney, NSW 2052, Australia
| | - James D Crowley
- From the Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Sydney Veterinary Emergency and Specialists, Rosebery, NSW 2018, Australia
| | - Christopher J Tan
- From the Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Sydney Veterinary Emergency and Specialists, Rosebery, NSW 2018, Australia
| | | | - William R Walsh
- From the Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
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8
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McDougall RA, Spector DI, Hart RC, Dycus DL, Erb HN. Timing of and risk factors for deep surgical site infection requiring implant removal following canine tibial plateau leveling osteotomy. Vet Surg 2021; 50:999-1008. [PMID: 33826172 DOI: 10.1111/vsu.13634] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 03/10/2021] [Accepted: 03/24/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To identify demographic risk factors for deep surgical site infection (SSI) requiring tibial plateau leveling osteotomy (TPLO) implant removal and time to implant removal. ANIMALS Four hundred and thirty-three dogs that underwent a TPLO (144 that developed a deep SSI and required implant removal, 289 that did not). STUDY DESIGN Retrospective case-control study. METHODS Records of dogs undergoing implant removal due to a deep SSI after TPLO between 2006 and 2018 at two referral centers were reviewed. These records were frequency-matched by date to dogs undergoing TPLO that did not require implant removal. Multivariable analyses tested associations between demographics and implant removal as well as timing of implant removal. RESULTS Deep SSI and implant removal occurred in 144 of 4813 (3.0%; 95% CI: 2.5, 3.5) dogs treated with TPLO. Implant removal was performed at a median of 279 days (range 49-2394 days) postoperatively. Male dogs (OR 1.8; 95% CI: 1.2, 2.7) and German Shepherd dogs (GSDs) (OR 7.4; 95% CI: 2.6, 20.5) were associated with plate removal. Earlier TPLO plate removal was associated with GSDs only (HR 2.4; 95% CI: 1.4, 4.1). CONCLUSION Implant removal due to SSI after TPLO was uncommon, although male dogs and GSDs seemed predisposed to this complication. SIGNIFICANCE These demographic risk factors can be used to educate owners regarding perioperative management.
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Affiliation(s)
- Renee A McDougall
- Department of Surgery, The Animal Medical Center, New York, New York, USA
| | - Daniel I Spector
- Department of Surgery, The Animal Medical Center, New York, New York, USA
| | - Robert C Hart
- Department of Surgery, The Animal Medical Center, New York, New York, USA
| | - David L Dycus
- Department of Surgery, Veterinary Orthopedics and Sports Medicine Group, Annapolis Junction, Maryland, USA
| | - Hollis N Erb
- College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
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9
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Blondeau LD, Sanche S, Sauder DJ, Deneer H, Kanthan R, Rubin JE, Morrison BJ, Blondeau JM. Recovery of borderline oxacillin-resistant Staphylococcus pseudintermedius (BORSP) from bone and soft tissue of a rheumatoid arthritis patient with severe osteoporosis: transmission from the family dog. J Chemother 2021; 33:348-353. [PMID: 33517870 DOI: 10.1080/1120009x.2021.1879581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We report a case of borderline oxacillin-resistant S. pseudintermedius (BORSP) in a rheumatoid arthritis patient with severe osteoporosis. The organism is also resistant to erythromycin and clindamycin. We also present clear evidence on transmission from the family dog.
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Affiliation(s)
| | - Stephen Sanche
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Division of Clinical Microbiology, Royal University Hospital and Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada.,Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - David J Sauder
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Harry Deneer
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Rani Kanthan
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Joseph E Rubin
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Beverly J Morrison
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Joseph M Blondeau
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Division of Clinical Microbiology, Royal University Hospital and Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada.,Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Ophthalmology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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10
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Donati B, Fürst AE, Del Chicca F, Jackson MA. Plate Removal after Internal Fixation of Limb Fractures: A Retrospective Study of Indications and Complications in 48 Horses. Vet Comp Orthop Traumatol 2020; 34:59-67. [PMID: 32799311 DOI: 10.1055/s-0040-1714411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to determine the indications for, and complications of, plate removal surgery in horses that underwent internal fixation of limb fractures. STUDY DESIGN Medical records of horses presented to our hospital between 1990 and 2015 for the removal of plates after treatment of limb fractures were reviewed. Data collected at the time of initial presentation, including signalment, history, fracture features and treatment and information about the indications, timing and complications of implant removal were reviewed. RESULTS The most common bones involved were the ulna (n = 19) and third metacarpal and metatarsal bones (n = 14). A total of 63 plates were removed from 48 horses during 53 separate surgeries, and the complication rate was 6/48; six horses had complications related to implant removal, which included persistent infection (n = 1) and refracture (n = 5). Complications related to implant removal were associated with comminuted fractures (p = 0.002), age > 3 years (p = 0.016) and the presence of surgical site infection (p = 0.001). CONCLUSION Plate removal after fracture healing is necessary in patients with implant-associated clinical signs. There is a strong relationship between the complication rate and the degree of comminution of the original fracture, increasing age and the presence of surgical site infection. The surgeon must be aware of these risk factors when planning plate removal.
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Affiliation(s)
- Brice Donati
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Anton E Fürst
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Francesca Del Chicca
- Department of Small Animals, Section of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Michelle A Jackson
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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11
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Clark AC, Greco JJ, Bergman PJ. Influence of administration of antimicrobial medications after tibial plateau leveling osteotomy on surgical site infections: A retrospective study of 308 dogs. Vet Surg 2019; 49:106-113. [PMID: 31664725 DOI: 10.1111/vsu.13337] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 07/25/2018] [Accepted: 07/31/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the influence of prophylactic administration of oral antimicrobial medications after tibial plateau leveling osteotomy (TPLO) on surgical site infections (SSI) and antimicrobial-resistant infections. STUDY DESIGN Retrospective study. SAMPLE POPULATION Dogs treated with unilateral TPLO (n = 308) between January 2013 and December 2015. METHODS Medical records were reviewed for signalment, surgically treated limb, duration of surgery and anesthesia, postoperative administration of antimicrobial medications, antibiotic agent, surgeon, and development of SSI. Statistical analyses included descriptive statistics, simple linear regression, analysis of variance, Fisher's protected least significant difference, and χ2 testing. RESULTS Data were collected from records of 31 dogs that did not receive antimicrobial medications and 277 dogs that did receive oral antimicrobial medications for 14 days after TPLO. Superficial incisional SSI was detected in two of 31 dogs that did not receive antimicrobial medications and in 48 of 277 dogs that did receive antimicrobial medications (P = .1194). Deep incisional SSI occurred in two of 31 dogs that did not receive antimicrobial medications and in 27 of 277 dogs that did receive antimicrobial medications (P = .5513). Antibiotic-resistant deep incisional SSI occurred in two of 31 dogs that did not receive antimicrobial medications and in 18 of 277 dogs that did receive antimicrobial medications (P = .9920). Body weight correlated with deep incisional SSI and resistant infections. Prolonged duration of surgery and anesthesia were associated with superficial incisional SSI, deep incisional SSI, and antibiotic resistance. Surgeons influenced deep incisional SSI. CONCLUSION Previously reported predisposing factors for infection were confirmed, but postoperative administration of antimicrobial medications was not protective against SSI nor did it predispose to antibiotic resistance in our clinical setting. CLINICAL SIGNIFICANCE This study does not provide evidence to support administration of prophylactic oral antimicrobial medications after unilateral TPLO.
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Affiliation(s)
- Andrea C Clark
- VCA All-Care Animal Referral Center, Fountain Valley, California
| | | | - Philip J Bergman
- VCA Clinical Studies, Los Angeles, California.,VCA Katonah-Bedford Veterinary Center, Bedford Hills, New York
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12
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Lee SJ, Frederick SW, Cross AR. Use of an amikacin-infused collagen sponge concurrent with implant removal for treatment of tibial plateau leveling osteotomy surgical site infection in 31 cases. Vet Surg 2019; 48:700-706. [PMID: 31168817 DOI: 10.1111/vsu.13249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/03/2019] [Accepted: 05/16/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To report the use and long-term outcome of dogs with surgical site infection (SSI) after tibial plateau leveling osteotomy (TPO), treated with an amikacin-infused collagen sponge and implant removal. STUDY DESIGN Retrospective study. ANIMALS Thirty-one client-owned dogs. METHODS Medical records were reviewed for dogs with SSI after a TPLO that were treated with surgical implant removal and concurrent implantation of an amikacin-infused collagen sponge. Relevant clinical and surgical data were recorded. The TPLO implants were routinely removed; the surgical site was swabbed for culture. The sponge was aseptically infused with amikacin prior to implantation. Postprocedure examinations consisted of visual inspection of the incision by the surgeon and lameness scoring. RESULTS Thirty-one dogs met all inclusion criteria. Median follow-up time was 687 days. Short-term examination after implant removal and sponge implantation revealed uneventful incisional healing in 24 dogs. Six (19.4%) dogs exhibited inflamed incision sites a median of 4 days (range, 3-9) postoperatively that resolved without additional treatment. One (3.2%) dog required empirical antibiotic treatment 7 days postoperatively but was lost to long-term follow-up. Long-term follow-up examination revealed no clinical evidence of SSI recurrence and no lameness in the remaining 30 cases. CONCLUSION Surgical implant removal and implantation of an absorbable collagen sponge infused with amikacin alone was an effective treatment for postoperative TPLO SSI. CLINICAL SIGNIFICANCE This procedure had a 96.8% long-term resolution of SSI. It should be considered as a treatment option for TPLO SSI.
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Affiliation(s)
- Sylvia J Lee
- Surgery Department, BluePearl Veterinary Partners, Tampa, Florida
| | - Steven W Frederick
- Surgery Department, BluePearl Veterinary Partners, Sandy Springs, Georgia
| | - Alan R Cross
- Surgery Department, BluePearl Veterinary Partners, Sandy Springs, Georgia
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13
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McGaffey M, zur Linden A, Bachynski N, Oblak M, James F, Weese JS. Manual polishing of 3D printed metals produced by laser powder bed fusion reduces biofilm formation. PLoS One 2019; 14:e0212995. [PMID: 30811509 PMCID: PMC6392326 DOI: 10.1371/journal.pone.0212995] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 02/13/2019] [Indexed: 11/17/2022] Open
Abstract
Certain 3D printed metals and surface finishes may be better suited for canine patient specific orthopedic implants on the basis of minimizing potential bacterial biofilm growth. Thirty disks each of titanium alloy, stainless steel, and cobalt chromium alloy were 3D printed via laser powder bed fusion. Fifteen disks of each metal were subsequently polished. After incubation with a robust biofilm-forming methicillin-resistant Staphylococcus pseudintermedius isolate, disks were rinsed and sonicated to collect biofilm bacteria. Serial dilutions were plated on blood agar, and colony forming units were counted log (ln) transformed for analysis of variance. Interference microscopy quantified surface roughness for comparison to biofilm growth. Scanning electron microscopy on both pre- and post-sonicated disks confirmed biofilm presence and subsequent removal, and visualized surface features on cleaned disks. Significantly more bacteria grew on rough versus polished metal preparations (p < 0.0001). Titanium alloy had more bacterial biofilm growth compared to cobalt chromium alloy (p = 0.0001) and stainless steel (p < 0.0001). There were no significant growth differences between cobalt chromium alloy and stainless steel (p = 0.4737). Relationships between biofilm growth and surface roughness varied: positive with the rough preparations and negative with the smooth. Polished preparations had increased variance in surface roughness compared to rough preparations, and within disk variance predominated over between disk variance for all preparations with the exception of rough cobalt chromium alloy and rough stainless steel. Using scanning electron microscopy, bacterial biofilms tended to form in crevices. Overall, manual polishing of 3D printed surfaces significantly reduced biofilm growth, with preparation-specific relationships between surface roughness and biofilm growth. These results suggest that metallic implants produced by laser powder bed fusion should be polished. Further research will elucidate the optimal surface roughness per preparation to reduce potential biofilm formation and implant associated infection.
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Affiliation(s)
- Marissa McGaffey
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Alex zur Linden
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Nathanael Bachynski
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Michelle Oblak
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Fiona James
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - J. Scott Weese
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Chiu KW, Amsellem PM, Yu J, Ho PS, Radasch R. Influence of fixation systems on complications after tibial plateau leveling osteotomy in dogs greater than 45.4 kilograms (100 lb). Vet Surg 2019; 48:505-512. [PMID: 30614018 DOI: 10.1111/vsu.13151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 11/24/2018] [Accepted: 11/29/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the influence of 3 fixation systems on complications rate after tibial plateau leveling osteotomy (TPLO) in dogs >45.4 kg. STUDY DESIGN Retrospective case series. SAMPLE POPULATION Dogs (N = 287, 342 stifles) >45.4 kg with cranial cruciate ligament tear treated with TPLO. METHODS The medical records of dogs treated with TPLO were reviewed for fixation and postoperative complications, with a follow-up of at least 6 weeks. A random effects logistic regression model was used to evaluate the association between the type of TPLO fixation system and complications. RESULTS The fixation systems included a 3.5-mm broad TPLO plate alone (8P; 78.4%), a 3.5-mm broad TPLO plate with SOP (String of Pearls) plate (8AP; 14.9%), and a 3.5-mm standard TPLO plate (6P; 6.7%). Among the included stifles, 214 (62.6%) fixation systems were classified as locking, and 128 (37.4%) were classified as nonlocking. The fixation system was predictive of complications. The 8P had the lowest odds ratio for complication among the 3 fixation systems. Odds of developing complications were higher with the 8AP fixation system than with the 8P fixation system. Locking fixation eliminated the association between weight and complication rate. CONCLUSION Fixation of a TPLO with the 8AP increased the risk of complications compared with the 8P in this population of large dogs. CLINICAL SIGNIFICANCE Locking fixation of TPLO with a 3.5-mm broad TPLO plate alone should be considered in large dogs because it may reduce complications.
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Affiliation(s)
- King Wa Chiu
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Pierre M Amsellem
- Department of Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota
| | - Jenny Yu
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward, Canada
| | - Pui Shan Ho
- Melbourne School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
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Lopez DJ, VanDeventer GM, Krotscheck U, Aryazand Y, McConkey MJ, Hayashi K, Todhunter RJ, Hayes GM. Retrospective study of factors associated with surgical site infection in dogs following tibial plateau leveling osteotomy. J Am Vet Med Assoc 2018; 253:315-321. [DOI: 10.2460/javma.253.3.315] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Locking compression plate stabilization of 20 distal radial and ulnar fractures in toy and miniature breed dogs. Vet Comp Orthop Traumatol 2017; 28:441-7. [DOI: 10.3415/vcot-15-02-0042] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 07/07/2015] [Indexed: 11/17/2022]
Abstract
SummaryObjective: To evaluate retrospectively the effectiveness of the Locking Compression Plate® (LCP), in the form of either a straight or notched head T-plate, for the treatment of fractures of the distal radius and ulna in a series of 20 toy and miniature breed dogs.Methods: The medical records of toy and miniature breed dogs (<6 kg), greater than six months of age, with fractures of the distal radius and ulna from two veterinary hospitals were reviewed. The inclusion criteria included: fractures of the distal 1/3 of the radius and ulna and repair with open reduction and internal fixation utilizing an LCP (straight or notched head T-plate).Results: Twenty fractures (20 dogs) satisfied the inclusion criteria; eight straight and 12 notched head T-plates were used, either 2.0 mm (n = 13) or 2.4 mm (n = 7). Hybrid fixation was performed in all dogs in one or both fragments. Mean time to radiographic union was 6.9 ± 2.5 weeks (range: 4–12 weeks) in 18/20 dogs with radiographic follow-up. One complication was observed: infection that resolved with antibiotic medication and implant removal. No other major complications occurred by the time of last follow-up. In all cases (mean follow-up: 15 ± 7 months), the reported limb function as evaluated by the referring veterinarian or owner was excellent.Clinical significance: The LCP, used as a hybrid construct for the treatment of distal radial and ulnar fractures was shown to yield excellent clinical results with both uncomplicated healing and excellent functional outcomes in this series of toy and miniature breed dogs.
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Bi-institutional retrospective cohort study evaluating the incidence of osteosarcoma following tibial plateau levelling osteotomy (2000–2009). Vet Comp Orthop Traumatol 2017; 27:339-45. [DOI: 10.3415/vcot-14-01-0006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 07/09/2014] [Indexed: 11/17/2022]
Abstract
SummaryObjectives: To evaluate the incidence and risk factors for occurrence of osteosarcoma (OSA) following tibial plateau levelling osteotomy (TPLO).Methods: Medical records of client-owned dogs that underwent consecutive TPLO procedures at two institutions were retrospectively reviewed. Referring veterinarians and owners were contacted for follow-up. Each institutional cohort was assessed separately, and the incidence density rate and median time to occurrence of OSA at the TPLO site and at other sites were calculated. Marginal Cox regression was used to calculate hazard ratios and 95% confidence intervals for potential risk factors for occurrence of OSA.Results: There were 472 CLINIC A (Colorado State University Veterinary Teaching Hospital) and 1992 CLINIC B (SAGE Centers for Veterinary Specialty and Emergency Care) TPLO cases with over one year of follow-up available. There were five and six dogs within the cohorts that developed OSA at the site of TPLO, and seven and 22 dogs that developed OSA at other anatomical sites, respectively. The incidence density rates of OSA at the TPLO site were 30.4 and 10.2 per 10,000 dog-years at risk, and other sites were 42.6 and 37.5 per 10,000 dog-years at risk. The median time to occurrence of OSA of TPLO site OSA was 4.6 and 4.4 years, which was longer than that of other site OSA of 2.9 and 3.4 years.Clinical significance: There is a low incidence of OSA following TPLO surgery. The longer time to occurrence for TPLO site OSA is similar to that for fracture-associated sarcoma, and could indicate a similar underlying pathophysiology rather than spontaneous OSA occurrence.
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Outcome following removal of TPLO implants with surgical site infection. Vet Comp Orthop Traumatol 2017; 26:260-5. [DOI: 10.3415/vcot-11-12-0177] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 01/12/2013] [Indexed: 11/17/2022]
Abstract
SummaryObjective To evaluate the outcome of surgical site infection (SSI) associated with tibial plateau levelling osteotomy (TPLO) implants following treatment by medical management alone or implant removal with or without the administration of antibiotic medication.Animals Ninety dogs (104 TPLO surgical procedures).Methods Records of dogs that had undergone TPLO implant removal due to SSI were reviewed. Outcome following treatment with antibiotic medications without implant removal, and treatment with implant removal with and without the administration of antibiotic medications was evaluated.Results Treatment of SSI with antibiotic medication alone failed in 88.9% (64/72) of the dogs. The clinical signs of SSI resolved in 94.9% (74/78) of the dogs treated with implant removal (with and without the administration of antibiotic medication postimplant removal). The effect of administration of antibiotic medication on outcome of treatment of the SSI by implant removal was not significant. The rate of SSI associated with the Synthes implant was higher than with the Slocum implant, but not the New Generation implant.Conclusion Implant removal with or without the administration of antibiotic medication post-implant removal for treatment of TPLO SSI provided superior outcome compared to treatment with antibiotic medications without implant removal.Clinical significance Implant removal should be considered for TPLO SSI that have not responded to appropriate medical management. Further investigation of the various TPLO implants and their effects on postoperative infection rate is warranted.
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Complications of tibial plateau levelling osteotomy in dogs. Vet Comp Orthop Traumatol 2017; 25:349-58. [DOI: 10.3415/vcot-11-09-0122] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 03/10/2012] [Indexed: 11/17/2022]
Abstract
SummaryThe tibial plateau levelling osteotomy (TPLO) is one of the most common surgical procedures used to treat cranial cruciate ligament disease in dogs. Complications occurring during or after TPLO can range in severity from swelling and bruising to fracture and osteomyelitis. Ten to 34% of TPLO surgical procedures are reported to experience a complication and approximately two to four percent require revision surgery to address a complication. Although the risk factors for many complications have not been fully assessed, the best available evidence suggests that complications of TPLO can be reduced with increased surgeon experience, careful surgical planning, and accurate execution of the surgical procedure. Identification of known or suspected risk factors and intraoperative technical errors allow subsequent action to be taken that is aimed at decreasing postoperative morbidity. There is a need for prospective studies with consistent data reporting in order to fully reveal the incidence risk factors for complications associated with TPLO.
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Barnhart MD, Watson AT, Thatcher LG, Wotton H, Naber SJ. Prospective Randomized Clinical and Radiographic Evaluation of a Novel Bioabsorbable Biocomposite Tibial Tuberosity Advancement Cage Implant. Vet Surg 2016; 45:651-8. [PMID: 27357275 DOI: 10.1111/vsu.12502] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 12/28/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the suitability of a novel bioabsorbable biocomposite cage (BC) implant for use in tibial tuberosity advancement (TTA) surgery in dogs with cranial cruciate ligament (CrCL) disease and to compare radiographic osteotomy healing scores and complications between groups that received either a BC or stainless steel cage (SSC). STUDY DESIGN Prospective randomized clinical study. ANIMALS Dogs with unilateral CrCL rupture (n=56). METHODS TTA was performed in 60 consecutive dogs using either a BC (30 dogs) or SSC (30 dogs). Patient parameters, 6 week and 6 month postoperative radiographic osteotomy healing scores, time elapsed to postoperative rechecks, and complications were compared between groups. Osteotomy healing was graded using a 5-point (0-4) scale. Data were analyzed using Wilcoxon Rank Sum tests and χ(2) tests with significance set at P<.05. RESULTS Fifty-six dogs (30 BC, 26 SSC) had complete medical and radiographic records at 6 months for inclusion in data analysis. Three complications occurred in the BC group (1 major, 2 minor) and 2 occurred in the SSC group (2 minor). There was no statistical difference in patient parameters, 6 week healing scores, or complications between BC and SSC groups. Healing scores at 6 months were significantly higher in the BC group (3.3 ± 0.52) compared to the SSC group (2.9 ± 0.69; P=.04). CONCLUSION Based on improved BC osteotomy healing scores 6 months after surgery with no significant differences in complications compared to SSC, BC TTA cages are a viable alternative to SSC.
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Affiliation(s)
- Matthew D Barnhart
- MedVet Medical and Cancer Centers Clinical Studies Center, Worthington, Ohio
| | - Adam T Watson
- MedVet Medical and Cancer Centers Clinical Studies Center, Worthington, Ohio
| | | | | | - Steven J Naber
- Department of Statistics, The Ohio State University, Columbus, Ohio
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Brown G, Maddox T, Baglietto Siles MM. Client-assessed long-term outcome in dogs with surgical site infection following tibial plateau levelling osteotomy. Vet Rec 2016; 179:409. [DOI: 10.1136/vr.103688] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 12/16/2022]
Affiliation(s)
- G. Brown
- Grove Referrals; Grove Veterinary Group; Fakenham UK
| | - T. Maddox
- School of Veterinary Science; University of Liverpool; Leahurst Campus Neston Wirral CH43 5SQ UK
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Nazarali A, Singh A, Weese JS. Perioperative Administration of Antimicrobials During Tibial Plateau Leveling Osteotomy. Vet Surg 2014; 43:966-71. [DOI: 10.1111/j.1532-950x.2014.12269.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 12/01/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Alim Nazarali
- Department of Clinical Studies; University of Guelph; Guelph Canada
| | - Ameet Singh
- Department of Clinical Studies; University of Guelph; Guelph Canada
| | - J. Scott Weese
- Department of Pathobiology; Ontario Veterinary College; University of Guelph; Guelph Canada
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Turk R, Singh A, Weese JS. Prospective surgical site infection surveillance in dogs. Vet Surg 2014; 44:2-8. [PMID: 25196800 DOI: 10.1111/j.1532-950x.2014.12267.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 07/06/2014] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To 1) describe the incidence of surgical site infections (SSI) in dogs undergoing surgery at the Ontario Veterinary College Health Sciences Centre; 2) describe and compare procedure-specific SSI rates; and 3) identify factors associated with development of SSI. STUDY DESIGN Prospective, cohort study ANIMALS Dogs (n = 846) undergoing surgery during 45 weeks (September 2010-July 2011). METHODS Follow-up telephone conversation with dog owners was performed 30 days postoperatively, with additional 1-year follow-up performed for cases with surgical implants. A standardized questionnaire was administered to detect and characterize SSI. RESULTS SSI were identified in 26 (3.0%) dogs; 11 (42%) were classified as superficial SSI, whereas 13 were deep, and 2 were organ/space. Of the confirmed SSI, only 17 (65%) were documented in the medical records. Hypotension (P = .011), class of surgery (P = .029), and use of an implant (P = .001) increased the risk of SSI. Microbial cultures were submitted for 19 cases (73%) and of those, 74% were staphylococci. CONCLUSIONS SSI can result in devastating consequences in dogs and understanding risk factors is critical to target prevention practices. Whereas some risk factors such as hypotension are modifiable, others such as class of surgery are not. When possible, active surveillance should be used as part of a hospital infection control program.
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Solano MA, Danielski A, Kovach K, Fitzpatrick N, Farrell M. Locking Plate and Screw Fixation After Tibial Plateau Leveling Osteotomy Reduces Postoperative Infection Rate in Dogs Over 50 kg. Vet Surg 2014; 44:59-64. [DOI: 10.1111/j.1532-950x.2014.12212.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 03/01/2014] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Karla Kovach
- Fitzpatrick Referrals Ltd; Eashing United Kingdom
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Witte PG, Scott HW. Tibial Plateau Leveling Osteotomy in Small Breed Dogs With High Tibial Plateau Angles Using a 4-Hole 1.9/2.5 mm Locking T-Plate. Vet Surg 2014; 43:549-57. [DOI: 10.1111/j.1532-950x.2014.12202.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 01/01/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Philip G. Witte
- Southern Counties Veterinary Specialists; Ringwood United Kingdom
| | - Harry W. Scott
- Southern Counties Veterinary Specialists; Ringwood United Kingdom
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Nicoll C, Singh A, Weese JS. Economic Impact of Tibial Plateau Leveling Osteotomy Surgical Site Infection in Dogs. Vet Surg 2014; 43:899-902. [DOI: 10.1111/j.1532-950x.2014.12175.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 01/18/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Catherine Nicoll
- Department of Pathobiology; Ontario Veterinary College, University of Guelph; Guelph ON Canada
| | - Ameet Singh
- Department of Pathobiology and Clinical Studies; Ontario Veterinary College, University of Guelph; Guelph ON Canada
| | - J. Scott Weese
- Department of Pathobiology; Ontario Veterinary College, University of Guelph; Guelph ON Canada
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Olive J, Thiery M, Chailleux N, Blond L. A pitfall on postoperative radiographs in dogs after tibial plateau leveling osteotomy. Vet Surg 2014; 43:150-4. [PMID: 24400679 DOI: 10.1111/j.1532-950x.2014.12094.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Accepted: 02/18/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify the cause of an occasional radiolucent line in the tibia on postoperative radiographs after tibial plateau leveling osteotomy (TPLO) in dogs. STUDY DESIGN Retrospective case series and ex vivo experiment. SAMPLE POPULATION Dogs (n = 80; 87 stifles) with cranial cruciate ligament (CCL) rupture that had TPLO; and 4 canine tibia specimens. METHODS Medical records (2007-2010) and radiographs of dogs that had TPLO were reviewed and examined for presence of a radiolucent line on postoperative radiographs. The TPLO procedure was reproduced ex vivo to determine the origin of this line by use of metallic wires to identify bone contours. RESULTS A curvilinear radiolucent line was visible in 14 (16%) tibias and was 5.4 times more likely to be visible with lateral misalignment of the tibial diaphysis relative to the plateau and 2.6 times more likely visible on caudocranial radiographs with the stifle in outward rotation. Fracture complication rate was higher in dogs with this radiolucent line (P = .02) and with lateral misalignment of the tibial diaphysis relative to the plateau (risk ratio, 3.8). The line could be reproduced ex vivo and caused by superimposition of the craniomedial border of osteotomy with the tibial plateau. CONCLUSIONS The radiolucent line was a spurious fracture line created by the medial margin of the tibial osteotomy and confounding factors such as tibial misalignment may explain the apparently associated higher complication rate.
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Affiliation(s)
- Julien Olive
- Département des Sciences Cliniques, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Canada
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Characterization of the biofilm forming ability of Staphylococcus pseudintermedius from dogs. BMC Vet Res 2013; 9:93. [PMID: 23641755 PMCID: PMC3681638 DOI: 10.1186/1746-6148-9-93] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 05/01/2013] [Indexed: 11/18/2022] Open
Abstract
Background Staphylococcus pseudintermedius is an opportunistic pathogen of dogs and has emerged as a leading cause of skin, wound and surgical site infections worldwide. Methicillin resistance is common and clinical infections as a result of methicillin-resistant S. pseudintermedius (MRSP) pose a clinical challenge. In other staphylococci, biofilm formation has been shown to be a virulence factor for infection, however, it has received little attention in S. pseudintermedius. The objectives of this study were to evaluate the biofilm forming ability of clinical isolates of S. pseudintermedius obtained from dogs using phenotypic and genotypic techniques. Results 96% (136/140) of S. pseudintermedius isolates were classified as strong or moderate biofilm producers, with the majority of isolates being able to produce biofilm. There was no difference in biofilm formation between MRSP and MSSP (p=0.8), amongst isolates from clinical infections compared with isolates obtained from colonized dogs (p=0.08), and between isolates from sequence type (ST) 71 and ST 68 (P=0.09). icaA was detected in 77.9% (109/140) of isolates and icaD was detected in 75.7% (106/140) of isolates. Scanning electron microscopic evaluation of S. pseudintermedius biofilm production revealed aggregates of cocci and irregularly produced extracellular polymeric matrix. Conclusion The majority of S. pseudintermedius isolates evaluated in this study were able to produce biofilm and this may be an important virulence factor in the rapid emergence of this bacterium in veterinary hospitals worldwide. Further study into the mechanisms of biofilm formation by S. pseudintermedius is warranted.
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