Scalpel blade contamination and risk of postoperative surgical site infection following abdominal incisions in dogs

Christina G Lioce,Christopher P Bloch,Elizabeth C Davis,Julie W Bennett,Forrest I Townsend

doi:10.1186/s13104-019-4494-7

Christina G Lioce, Christopher P Bloch + Show 3 more

Open Access

https://doi.org/10.1186/s13104-019-4494-7

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Abstract

ObjectiveThis prospective observation sought to determine if scalpel blades used for abdominal skin incisions in dogs are a significant source of bacterial contamination, and if these blades should be changed prior to use in deeper dissection.ResultsScalpel blades were swabbed for culture prior to skin incision as a control, and then again following ventral midline abdominal skin incision in a total of 75 dogs. Culture and sensitivity results were compared with review of medical records for any evidence of pre- or postoperative incisional surgical site infection/inflammation (SSI). Of the 75 blades swabbed after skin incision, only 2 (2.7%) had positive culture results. Of the 69 patients that survived to suture removal, there was evidence of SSI in 6 patients (8.7%), only one of which had a positive scalpel blade culture (16.7%). Neither the use of postoperative antibiotics nor positive scalpel blade culture results were good predictors of whether a patient would develop a SSI. Results of this pilot study suggest that there is no bacteriological evidence to support the use of a separate blade for deep dissection in routine surgical procedures.

Highlights

Postoperative infections are an inherent risk of any surgical procedure despite preventative measures
The purpose of this study was to determine if scalpel blades used for ventral midline abdominal skin incisions are a significant source of bacterial contamination for deeper structures in dogs, and if they should be changed prior to deeper dissection
Results of the informal survey of veterinary surgeons revealed that 36.1% of them change their scalpel blades after initial skin incision, as they feel the skin blade could

Summary

Results

Results of the informal survey of veterinary surgeons revealed that 36.1% of them change their scalpel blades after initial skin incision, as they feel the skin blade could. Purulent discharge Organisms isolated from an aseptically collected sample of fluid or tissue One or more: pain/tenderness, localized swelling, redness, heat, and incision is deliberately opened by surgeon unless culture negative a One or more must be present. The second positive blade culture grew Staphylococcus pseudintermedius; that patient had an erythemic previous spay incision present at the time of surgery and went on to develop incisional erythema and purulent discharge. Of the 69 dogs that survived to suture removal, six (8.7%) reportedly developed and were treated for a SSI but only two (2.9%) were confirmed with positive culture results. One of those incisions was infected with Eschericia coli and Enteroccocus sp., and the other infected with Eschericia coli and Streptococcus sp. There was no significant association between the frequency of SSI and any of the observed discrete variables (P > 0.05 in all cases; Additional file 1 Table S2)

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