Does intraoperative low arterial partial pressure of oxygen increase the risk of surgical site infection following emergency exploratory laparotomy in horses?
Authors: Costa-Farré Cristina, Prades Marta, Ribera Thaïs, Valero Oliver, Taurà Pilar
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary: Intraoperative Oxygenation and Surgical Site Infection Following Emergency Colic Surgery in Horses Adequate tissue oxygenation during surgery is fundamental to immune function, as oxygen-dependent neutrophil killing mechanisms are essential for controlling bacterial contamination at the surgical site. Costa-Farré and colleagues conducted a prospective case series of 84 adult horses undergoing emergency exploratory laparotomy for acute gastrointestinal disease, measuring arterial partial pressure of oxygen (PaO₂) one hour post-induction and tracking surgical site infection (SSI) outcomes during hospitalisation and follow-up. Surgical site infection developed in 40.4% of cases, and multivariate analysis identified low intraoperative PaO₂, prolonged anaesthetic duration, and polyglycolic acid suture material as significant risk factors; horses with PaO₂ below 80 mm Hg (10.6 kPa) combined with anaesthetic time exceeding 2 hours faced a nine-fold increased odds of SSI (OR 9.01). For practitioners involved in colic case management, these findings emphasise the critical importance of optimising ventilation strategies and oxygen delivery during emergency abdominal surgery, particularly for extended procedures, and suggest reconsidering polyglycolic acid as a closure material in high-risk cases, as maintaining PaO₂ above 80 mm Hg may substantially reduce post-operative infection complications.
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Practical Takeaways
- •Maintain intraoperative arterial oxygen at ≥80 mm Hg during colic surgery to significantly reduce infection risk — monitor PaO2 at 1 hour post-induction and adjust ventilation/FiO2 accordingly
- •Minimize surgical time where possible, as procedures exceeding 2 hours combined with low oxygen levels create substantially higher infection risk
- •Reconsider polyglycolic acid for subcutaneous closure in colic cases; alternative suture materials may reduce SSI incidence
Key Findings
- •Surgical site infection developed in 40.4% (34/84) of horses undergoing emergency colic surgery
- •Intraoperative PaO2 < 80 mm Hg was a significant predictor of SSI with odds ratio of 9.01 (95% CI 2.28-35.64)
- •Anaesthetic time > 2 hours combined with low PaO2 dramatically increased SSI risk
- •Polyglycolic acid subcutaneous sutures increased SSI risk compared to other materials