Incidence and risk factors of surgical site infection in ruminant species following internal fixation for orthopedic injury: 81 cases (2010–2023)

Abstract

Objective: To determine the prevalence and risk factors of surgical site infection (SSI) following internal fixation in ruminants. Study design: Retrospective multicenter study across five veterinary teaching hospitals. Animals: A total of 81 ruminants undergoing internal fixation for orthopedic disease. Methods: Medical records over a 13-year period were analyzed for ruminants presenting with orthopedic disease that was surgically managed with internal fixation. Patient signalment, limb affected and type of injury, surgical method, orthopedic implants used, total anesthetic duration, antimicrobial use, development of SSI as well as short- and long-term survival were reported. Results: The incidence of SSI was 17.3% (14/81). Overall, 92.6% (75/81) of cases survived to discharge; 85.7% (12/14) of cases with SSI and 94% (63/67) of cases that did not develop SSI. Increased duration of antimicrobial use (p =.004) and fractures distal to the tarsus/carpus (p =.04) were associated with an increased risk of SSI but had no effect on overall survival. The use of intramedullary pins for surgical repair was associated with a reduced likelihood of survival to discharge (p =.008). Conclusion: In conclusion, the SSI incidence in ruminants following internal fixation was comparable to the infection risk in horses and camelids. SSI had a higher incidence in fractures distal to the tarsus/carpus and in animals that were administered antibiotics for a prolonged period. Clinical significance: The use of orthopedic implants in ruminants is associated with a good outcome with 92.6% of cases surviving to discharge and a comparable incidence of surgical site infection as other large animal species.