The influence of antibiotics pre- and post-laparotomy and caesarean on the wound healing of cows, a random clinical trial report.

Abstract

Objective: This study was performed in order to investigate the influence of the use of antibiotics pre- and postoperatively, on whether or not surgical site infection would occur and thereby to implement a more evidence based way of metaphylactic antibiotic use in certain surgeries. Design, Setting, Participants: During 3 years, all cows that were submitted for a caesarean (n=83) or an exploratory laparotomy (n=89) were randomly allocated to treatment groups with different antibiotic treatment strategies. For each of these two surgical procedures, two different protocols with different antibiotic regimes were complemented. Cows submitted for a caesarean, received either a regime with only antibiotic prophylaxis (CAL) or a regime with prophylaxis as well as a post-surgical antibiotic treatment (CAH). Cows submitted for a laparotomy, received either a regime with no antibiotic treatment at all (LAPL) or a regime were antibiotic prophylaxis was used (LAPH). Interventions: The procedures were performed under hospital conditions in the department of farm animal health of the faculty of veterinary medicine Utrecht. The procedures also had an educational value, therefore the procedures were performed by 2 students under the supervision and with the aid of a clinic veterinarian and a clinic assistant. All cows were clinically monitored after the surgery for 10 days. Between days 10 and 12 post surgery the stitches were removed and the stitches and the surgical site were examined by an impartial clinic veterinarian for signs of inflammation or infection. Main Outcome Measure: Whether the surgical site was inflamed or infected was the main outcome measure. Results: No significant difference was found between the CAH and the CAL group and the development of wound infection (X2=0.721, p>0.05), nor was there any significant difference in whether the stitches were infected or not (X2= 0.059, p> 0.05). A significant difference was found between the LAPH and the LAPL group and the development of a wound infection (X2=6.716, p<0.05). On the other hand, between the LAPH and LAPL group no significant difference was found in the stitches being infected or not (X2=0.038, p>0.05). Conclusion: Antibiotic prophylaxis in laparotomies reduces the risk of developing a wound infection in a hospital setting. There was no significant difference in the percentage of stitches infected, nor in the amount of complications afterwards. This could not be concluded by the results from the caesarean procedures. Furthermore the amount of infected stitches was not an accurate measure point when it comes to measuring the influence of antibiotic treatment on the surgical site.