Bacterial culturing of ventral median celiotomies for prediction of postoperative incisional complications in horses

Objective- The purpose of this study was to determine whether detection of bacterial contamination of ventral midline incisions was predictive of postoperative incisional complications in horses undergoing exploratory celiotomy for colic. Study Design- Prospective study. Animal or Sample Population- Horses that had Ventral median celiotomies for colic at Colorado State University between May 1, 1991 and April 30, 1993 were studied prospectively. Complete information was obtained on 66 horses. Methods- Bacterial cultures were obtained from Ventral midline incisions at surgery. Information regarding the type of surgery performed (celiotomy vs celiotomy plus enterotomy or enterectomy), preoperative total nucleated cells and presence of a left shift, postoperative fever (>38.5 degrees C), incisional drainage, incisional herniation, and outcome were obtained from medical records. Additional information concerning incisional drainage, herniation, and survival was obtained at a minimum of 18 months after surgery. Results- Examination of odds ratio (ORs) and confidence intervals (CIs) revealed that a celiotomy plus enterotomy or enterectomy was positively, but not significantly, associated (OR > 1) with positive culture results, presence of incisional drainage and incisional herniation. A significant association between incisional drainage and hernia formation was found; odds of incisional herniation were 62.5 times greater in horses that had incisional drainage. Incisional drainage and herniation were negatively associated with patient survival. The later association was significant (OR = 0.18, P = .04). Conclusions- This study indicated that detection of bacterial contamination at incisional closure by the swab culture technique was not beneficial in the prediction of postoperative incisional problems in horses undergoing colic surgery. Incisional drainage or infection appeared to be associated with hernia formation. Clinical Relevance- Immediate treatment of incisional drainage or methods to prevent incisional infections may decrease hernia formation. (C) Copyright 1997 by The American College of Veterinary Surgeons