RESUMEN
OBJECTIVE: To estimate the frequency of undetected perforations in surgical gloves during equine surgery and to identify risk factors associated with occurrence. STUDY DESIGN: Observational cohort study. SAMPLE POPULATION: Surgical gloves-292 pairs. METHODS: Water leak tests were performed on gloves after equine surgery to detect perforations. Fifty pairs of unused gloves were also tested. Potential risk factors were recorded. Logistic regression was used to explore associations between putative risk factors and perforation. RESULTS: No perforations were detected in the unused gloves. Of 292 pairs of used gloves tested, 80 (27%) had at least one glove perforation per pair. The frequency of perforations was not different between surgery diplomates and residents (P=.69). The length and type of surgery were significantly associated with the likelihood of undetected glove perforation with surgeries longer than 60 minutes approximately 2.5 times more likely to result in glove perforation (P=.005). Surgery classified as soft tissue, orthopedic or exploratory celiotomy was 3 times more likely to result in glove perforation than minimally invasive surgery. The perforations occurred significantly more frequently in the nondominant hand (19%) than the dominant hand (11%) (P=.009). CONCLUSION: There is a high occurrence of undetected glove perforation in equine surgery. Precautions can be suggested based on this study although further investigation is required to assess whether glove perforations are associated with surgical site infections.
Asunto(s)
Falla de Equipo/veterinaria , Guantes Quirúrgicos , Caballos/cirugía , Cirugía Veterinaria/instrumentación , Animales , Estudios de Cohortes , Quebec , Factores de Riesgo , Cirugía Veterinaria/clasificaciónRESUMEN
Post operative surgical wound infection rates were determined 452 cases of equine orthopaedic surgery performed at the Western College of Veterinary Medicine, Saskatoon, Saskatchewan, between January 1, 1981 and December 31, 1990. Only surgical procedures classified as clean or clean-contaminated by the National Research Council were included in this study. The overall post operative infection rate was 10.0% (45 of 452). Clean surgeries (n = 433) had an 8.1% infection rate while clean-contaminated surgeries (n = 19) had a 52.6% infection rate. Information collected from the medical records was used in univariate and multivariate logistic regression models to evaluate significant determinates of post operative infection. Significant determinates of post operative infection were: surgical classification, orthopaedic involvement, duration of surgery, administration of preoperative antibiotics and gender. Clean-contaminated surgeries had an increased risk of infection compared to clean surgeries (odds ratio (OR) = 24.3), procedures involving long bones had an increased risk of infection compared to procedures involving articular surfaces (OR = 5.1), surgeries lasting 90 minutes or longer had an increased risk of infection compared to those less than 90 minutes (OR = 3.6), administration of preoperative antibiotics was associated with an increased risk of infection (OR = 4.6) and female patients were 2.6 times more likely to develop post operative infection than male patients.