Incidence and risk factors of surgical site infections in dogs and cats at selected animal clinics in Kampala city, Uganda
Abstract
Surgical site infections (SSI) are a major threat in veterinary surgery. The occurrence of SSI is associated with an increased patient morbidity, mortality, prolonged hospitalization, increased treatment cost, and emotional strain on the pet owner. Today, there is emergency of antimicrobial resistance which further complicates the management of invasive surgical wounds. This study determined the incidence of SSI in dogs and cats that undergo invasive surgical procedures at selected small animal clinics in Kampala city and to establish the associated risk factors.
A prospective study was conducted by monitoring surgery cases handled at selected small animal clinics from 4th October 2019 to 4th March 2020. Data from medical records was used to obtain the history of each case. After the surgery, the patients were monitored for up to 10 days to track the healing process of the wound. In cases where it was impossible to reach the patient, the owner was contacted via phone call and requested to give a description of the surgical site using a questionnaire. Information gathered was compiled and analysed using SPSS software to determine the incidence and the respective predisposing factors of SSI.
A total of 90 surgery cases were included in this study; 84 were dogs and 6 were cats. SSI occurred in 29 (32.2%) patients all of which were dogs. Sex of the patient, duration of surgery, number of people in the surgery room during surgery, number of people that get into contact with the surgical field, hospitalisation post-surgery, duration of post-surgery antibiotic treatment and skin closure pattern were found to be the significant risk factors for development of SSI at 95% CI. Multivariable analysis revealed that the suture pattern used to close the skin was important for the development of SSI. Intradermal suture pattern had the lowest incidences of SSI compared to the simple interrupted and the horizontal mattress pattern.
The incidence of SSI in small animals that undergo surgery at selected clinics in Kampala (32.2%) is significantly higher than that of their counterparts in developed countries (3%) such as USA, Canada and UK. SSI in small animals therefore remains a serious challenge in developing countries with distressing consequences to the surgery patients, pet owners and veterinarians. Skin closure suture pattern is a major risk factor for development of SSI with intradermal pattern safest and simple interrupted most risky.