Risk factors for wound infection following celiotomy in horses

Objective-To determine the prevalence of wound infection following celiotomy in horses and to determine risk factors associated with the development of such infections. Design-Prospective study. Animals-210 horses that had 235 celiotomies. Procedure-All horses that had celiotomies between March 1990 and March 1992 were considered for this study. Only horses that survived greater than or equal to 10 days after surgery were included in analysis of risk factors for postoperative wound infection. Results-Of the 210 horses, 161 (76.7%) were discharged; of the horses discharged, 147 horses had a single celiotomy and 14 had multiple celiotomies. Twenty-six (12.4%) horses were euthanatized during surgery and were, therefore, excluded from further analysis. Twenty-three horses died during the postoperative period. Of these 23 horses, 15 that died within 10 days of surgery also were excluded from further analysis. Thus, 169 horses were included in the analysis of risk factors for developing incisional infection. Evidence of incisional infection was observed in 43 of 169 (25.4%) horses. Increased concentration of fibrinogen in peritoneal fluid obtained prior to surgery, performing an enterotomy, and use of polyglactin 910 to close the linea alba were all significantly (P less than or equal to 0.05) associated with increased risk of postoperative wound infection. Whether incisional herniation developed was recorded for 76 horses. The proportion of horses with hernias among those with postoperative wound infection was 19.1%, compared with 3.6% of horses without evidence of postoperative wound infection, indicating a significant association between postoperative wound infection and development of incisional hernias. Clinical Implications-Increased concentration of fibrinogen in peritoneal fluid prior to surgery, performing an enterotomy, and use of polyglactin 910 to close the linea alba is significantly associated with increased risk for wound infection following celiotomy in horses.