Lack of association between arterial oxygen tensions in horses during exploratory coeliotomy and post-operative incisional complications: A retrospective study.
Authors: Robson Katherine, Cripps Peter, Bardell David
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary Incisional complications following ventral midline coeliotomy in horses remain a significant clinical concern, yet uncertainty exists about which intra-operative factors contribute to their development. Robson and colleagues conducted a retrospective analysis of 278 horses undergoing exploratory coeliotomy between 2010 and 2013, examining whether low arterial oxygen tensions (PaO2) during anaesthesia predicted post-operative incisional problems; despite a considerable complication rate of 32%, multivariable logistic regression revealed no significant association between minimum recorded PaO2 and subsequent incisional complications. Several other perioperative variables did emerge as statistically significant risk factors: intestinal resection carried the highest risk (OR 4.06), followed by penicillin monotherapy versus penicillin-gentamicin combination prophylaxis (OR 4.15), use of hypertonic saline (OR 3.17), increased body mass, and elevated pre-operative total plasma protein concentration. These findings challenge the assumption that vigilant maintenance of intra-operative oxygenation is a primary driver of wound healing outcomes in equine abdominal surgery, whilst highlighting that surgical severity, antimicrobial selection, fluid choices, and patient factors warrant greater attention in complication prevention strategies.
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Practical Takeaways
- •Clinicians should not assume that modest decreases in arterial oxygen during colic surgery will inevitably lead to incisional complications; focus monitoring and intervention efforts on the identified risk factors instead
- •Consider the combination of penicillin and gentamicin pre-operatively rather than penicillin alone, and be cautious with hypertonic saline use in colic patients to minimize incisional complication risk
- •Heavier horses and those requiring intestinal resection have substantially elevated complication risk and may warrant enhanced post-operative wound care and monitoring
Key Findings
- •Incisional complications occurred in 32.0% (89/278) of horses undergoing ventral midline coeliotomy
- •Intra-operative arterial oxygen tension (PaO2) was not significantly associated with post-operative incisional complications (P=0.351)
- •Risk factors for incisional complications included: hypertonic saline use (OR 3.167), increased total plasma protein (OR 1.061 per g/L), intestinal resection (OR 4.056), increased body mass (OR 1.004 per kg), and penicillin monotherapy versus penicillin-gentamicin combination (OR 4.145)
- •Low intra-operative oxygen tension alone does not increase risk of post-operative wound complications in horses undergoing coeliotomy