Monitoring surgical site infections

Surgical site infection (SSI) is a patient safety event that cause unnecessary harm and suffering for the animal, increased treatment costs and emotional strain on the pet owner. Additionally, SSI is a healthcare associated infection that is to a large extent preventable if the right protective measures are undertaken.

The first step to be able to reduce the SSI rate in the clinic is to start monitoring them and finding out how many SSIs (%) you have. Without knowing the SSI rate, the clinic will not know if they are improving or not. Scientific research shows that this must be done actively. If you only rely on that the owner comes back if there are issues, there are studies from human medicine showing that you miss more than 30% of your SSIs.

Active surveillance is also directly associated with monitoring your inhouse bacterial flora and controlling the risk of outbreaks of antimicrobial resistant pathogens. For these reasons, and for targeting our surgical antibiotic prophylaxis, it is important to sample all SSIs for bacteriology analyses and to register the results. Of course, this does not imply that the patient needs antibiotic treatment.

This is the reasons why AniCura for the fourth time performed a study on SSI. In total 115 AniCura clinics and hospitals from nine different countries participated and 2,197 dogs were examined for SSIs after surgery. 4% of the dogs developed an SSI within 30 days after surgery. Country specific data and use of surgical antibiotic prophylaxis (SAP) is shown in Figure 1. In conclusion, the countries SSI rates do not vary much, but the use of surgical antibiotic prophylaxis (SAP) differs greatly.

 

THE STUDY IN BRIEF:

  • Surgical site infections at AniCura clinics decreased from 5.5% in 2018 to 4.4% in 2020.
  • Too many patients undergoing clean surgery received antibiotic prophylaxis (44%).
  • 58% of patients received antibiotics at the correct time (60 minutes before incision) and with correct length that is only first 24 hours after surgery.
  • 70% of the patients had a body temperature above 37°C, which is similar to the 2018 survey results. Too low body temperature during surgery increases
    risk for complications afterwards.
  • 41% of clinics use surgery safety checklist, which is a higher proportion compared to the 2018 results (33%). It is scientifically shown that the use of such a list reduces the risk of surgical complications.
  • 95% of clinics use an anaesthetic protocol, which is a higher proportion compared to the 2018 results (83%).