Discussion

Prevoteau, S., Guidi, E. and Benamou-Smith, A.
le Equin, VetagroSup Lyon, 1 avenue Bourgelat, 69280 Marcy
L'Etoile, France. Email: agnes.benamou@vetagro-sup.fr
Aims: To assess prevalence and risk factors of incisional
abdominal infections; identify responsible bacterial organisms;
describe early clinical follow-up and treatment of these infections;
and suggest clinical procedure upon onset. Methods: A 3 year
retrospective study of surgical colics referred to the Lyon
Veterinary School, Equine Department was performed. A total of
123 horses were selected among animals surviving beyond one
month post operatively. Descriptive data was collected including:
nature of secretions, depth of infection, diagnostic methods of
the infection, bacterial culture results, treatment protocols. Risk
factors were assessed by studying correlations (univariate and
multivariate) between infections and preoperative, intraoperative
and post operative factors. Results: Among the 48 cases of
incisional infections, 67% were deep (muscular and involving
the linea alba) vs. 33% superficial (cutaneous and
subcutaneous). Half (50%) of all culture were pure and yielded
essentially 4 different species. Isolated bacteria were all resistant
to standard post operative antimicrobials, and 18% were
multiresistant species. We identified 11 factors significantly
associated with incisional infections, among which post operative
hyperthermia and leucocytosis and post operative peritonitis were
found, in the multivariate model, to increase odds of infection,
respectively, by 2.9, 10.4 and 9.5. Conclusions: Despite the lack
of accepted standard definition for an incisional infection, our
results on prevalence of these infections are consistent with the
international literature. Very few factors were found to be
significantly (P<0.01) linked with the onset of incisional infections,
and the factors identified were predictive factors rather than risk
factors. This study also highlights the importance of systematic
bacterial culture, as antimicrobial resistance is present and
multiresistance is frequent. Wound ultrasonographic examination
was paramount to confirm early signs of infection and facilitate
follow-up during wound management. Practical significance:
Abdominal incisional infections are among the most frequent post
operative complications of colics, and resistant bacterial strains
are frequent. Our study proposes a hospital surveillance protocol