Outcome following removal of TPLO implants with surgical site infection

2013 ◽  
Vol 26 (04) ◽  
pp. 260-265 ◽  
Author(s):  
B. Beale ◽  
R. Murtaugh ◽  
J. Swiderski-Hazlett ◽  
M. Unis ◽  
R. Savicky
Keyword(s):  
Surgical Site Infection ◽  
Surgical Procedures ◽  
Medical Management ◽  
Postoperative Infection ◽  
Tibial Plateau ◽  
Clinical Signs ◽  
Implant Removal ◽  
Site Infection ◽  
New Generation ◽  
Postoperative Infection Rate

SummaryObjective To evaluate the outcome of surgical site infection (SSI) associated with tibial plateau levelling osteotomy (TPLO) implants following treatment by medical management alone or implant removal with or without the administration of antibiotic medication.Animals Ninety dogs (104 TPLO surgical procedures).Methods Records of dogs that had undergone TPLO implant removal due to SSI were reviewed. Outcome following treatment with antibiotic medications without implant removal, and treatment with implant removal with and without the administration of antibiotic medications was evaluated.Results Treatment of SSI with antibiotic medication alone failed in 88.9% (64/72) of the dogs. The clinical signs of SSI resolved in 94.9% (74/78) of the dogs treated with implant removal (with and without the administration of antibiotic medication postimplant removal). The effect of administration of antibiotic medication on outcome of treatment of the SSI by implant removal was not significant. The rate of SSI associated with the Synthes implant was higher than with the Slocum implant, but not the New Generation implant.Conclusion Implant removal with or without the administration of antibiotic medication post-implant removal for treatment of TPLO SSI provided superior outcome compared to treatment with antibiotic medications without implant removal.Clinical significance Implant removal should be considered for TPLO SSI that have not responded to appropriate medical management. Further investigation of the various TPLO implants and their effects on postoperative infection rate is warranted.

Plate Removal after Internal Fixation of Limb Fractures: A Retrospective Study of Indications and Complications in 48 Horses

2020 ◽  
Author(s):  
Brice Donati ◽  
Anton E. Fürst ◽  
Francesca Del Chicca ◽  
Michelle A. Jackson
Keyword(s):  
Surgical Site Infection ◽  
Internal Fixation ◽  
Complication Rate ◽  
Clinical Signs ◽  
Strong Relationship ◽  
Implant Removal ◽  
Site Infection ◽  
Plate Removal ◽  
Metatarsal Bones ◽  
Limb Fractures

Abstract Objectives The aim of this study was to determine the indications for, and complications of, plate removal surgery in horses that underwent internal fixation of limb fractures. Study Design Medical records of horses presented to our hospital between 1990 and 2015 for the removal of plates after treatment of limb fractures were reviewed. Data collected at the time of initial presentation, including signalment, history, fracture features and treatment and information about the indications, timing and complications of implant removal were reviewed. Results The most common bones involved were the ulna (n = 19) and third metacarpal and metatarsal bones (n = 14). A total of 63 plates were removed from 48 horses during 53 separate surgeries, and the complication rate was 6/48; six horses had complications related to implant removal, which included persistent infection (n = 1) and refracture (n = 5). Complications related to implant removal were associated with comminuted fractures (p = 0.002), age > 3 years (p = 0.016) and the presence of surgical site infection (p = 0.001). Conclusion Plate removal after fracture healing is necessary in patients with implant-associated clinical signs. There is a strong relationship between the complication rate and the degree of comminution of the original fracture, increasing age and the presence of surgical site infection. The surgeon must be aware of these risk factors when planning plate removal.

scholarly journals Incidence, Management and Outcome of Delayed Deep Surgical Site Infection Following Spinal Deformity Surgery: 20-Year Experience at a Single Institution

2020 ◽  
pp. 219256822097822
Author(s):  
Muyi Wang ◽  
Liang Xu ◽  
Bo Yang ◽  
Changzhi Du ◽  
Zezhang Zhu ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Spinal Deformity ◽  
Recurrent Infection ◽  
Implant Removal ◽  
Site Infection ◽  
Initial Surgery ◽  
Spinal Deformity Surgery ◽  
Solid Fusion ◽  
Deep Surgical Site Infection

Study Design: A retrospective study. Objectives: To investigate the incidence, management and outcome of delayed deep surgical site infection (SSI) after the spinal deformity surgery. Methods: This study reviewed 5044 consecutive patients who underwent spinal deformity corrective surgery and had been followed over 2 years. Delayed deep SSI were defined as infection involving fascia and muscle and occurring >3 months after the initial procedure. An attempt to retain the implant were initially made for all patients. If the infection failed to be eradicated, the implant removal should be put off until solid fusion was confirmed, usually more than 2 years after the initial surgery. Radiographic data at latest follow-up were compared versus that before implant removal. Results: With an average follow-up of 5.3 years, 56 (1.1%) patients were diagnosed as delayed deep SSI. Seven (12.5%) patients successfully retained instrumentation and there were no signs of recurrence during follow-up (average 3.4 years). The remaining patients, because of persistent or recurrent infection, underwent implant removal 2 years or beyond after the primary surgery, and solid fusion was detected in any case. However, at a minimum 1-year follow-up (average 3.9 years), an average loss of 9° in the thoracic curve and 8° in the thoracolumbar/lumbar curves was still observed. Conclusions: Delayed deep SSI was rare after spinal deformity surgery. To eradicate infection, complete removal of implant may be required in the majority of delayed SSI. Surgeons must be aware of high likelihood of deformity progression after implant removal, despite radiographic solid fusion.

Economic Impact of Tibial Plateau Leveling Osteotomy Surgical Site Infection in Dogs

2014 ◽  
Vol 43 (8) ◽  
pp. 899-902 ◽  
Author(s):  
Catherine Nicoll ◽  
Ameet Singh ◽  
J. Scott Weese
Keyword(s):  
Surgical Site Infection ◽  
Economic Impact ◽  
Tibial Plateau ◽  
Site Infection

Association of Timely Administration of Prophylactic Antibiotics for Major Surgical Procedures and Surgical Site Infection

2008 ◽  
Vol 206 (5) ◽  
pp. 814-819 ◽  
Author(s):  
Mary T. Hawn ◽  
Kamal M. Itani ◽  
Stephen H. Gray ◽  
Catherine C. Vick ◽  
William Henderson ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Surgical Procedures ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
Timely Administration
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