Ortopedik Operasyonlarda Cerrahi Alan Enfeksiyonlarının Zaman Bağımlı İncelenmesi: Prospektif Bir Çalışma

Abstract

Cerrahi alan enfeksiyonları (CAE), veteriner ortopedide morbidite, mortalite ve tedavi maliyetlerini artıran önemli komplikasyonlardır. Operasyon süresinin uzaması intraoperatif kontaminasyon için başlıca risk faktörlerinden biridir. Bu prospektif çalışmada, kedilerde uzun kemik osteosentez operasyonları sırasında zaman bağımlı bakteriyel kontaminasyonun değerlendirilmesi ve operasyon süresi ile ilişkisinin incelenmesi amaçlandı. Yüksekten düşme sonucu humerus, radius-ulna, femur veya tibia kırığı bulunan ve osteosentez uygulanan 92 kedi çalışmaya dahil edildi. Tüm olgularda standart anestezi ve asepsi protokolleri uygulandı. Kırık hattına ulaşıldığı an 0. dakika kabul edilerek, 0., 15., 30., 45., 60., 75. ve 90. dakikalarda insizyon hattından steril swap örnekleri alındı ve mikrobiyolojik kültür yapıldı. İlk 30 dakikada üreme saptanmadı. Pozitiflik oranları 45. dakikada %2,2, 60. dakikada %16,3, 75. dakikada %35,3 ve 90. dakikada %66,7 olarak bulundu. Fisher’s Exact ve Cochran-Armitage trend testleri 45. dakikadan sonra anlamlı bir artış olduğunu gösterdi (p < 0,05). Deri bütünlüğü bozulmamış olmasına rağmen ciddi yumuşak doku travması ve hematomu olan olgularda pozitiflik oranları ve postoperatif CAE gelişimi daha yüksek bulundu. Sonuç olarak, operasyon süresinin uzaması intraoperatif kontaminasyon riskini artıran önemli bir faktör olup, cerrahi sürenin gereksiz uzatılmaması, ameliyathane disiplinine dikkat edilmesi ve uzun süren operasyonlarda uygun profilaksi stratejilerinin uygulanması önerilmektedir.

Keywords

• Bakteriyel üreme
• Cerrahi alan enfeksiyonu
• İntraoperatif kontaminasyon
• Kedi osteosentezi
• Operasyon süresi

Time-Dependent Evaluation of Surgical Site Infections in Orthopedic Operations: A Prospective Study

Abstract

Surgical site infections (SSIs) remain a major concern in veterinary orthopedics, increasing morbidity, mortality, and healthcare costs. Prolonged operative time is recognized as a significant risk factor for intraoperative contamination. This prospective study aimed to evaluate the time-dependent pattern of bacterial contamination during feline long bone osteosynthesis and to determine its association with operative duration. Ninety-two cats undergoing osteosynthesis for humeral, radial-ulnar, femoral, or tibial fractures were included. Standardized anesthetic and aseptic protocols were applied in all cases. Sterile swab samples were collected from the surgical site at 0, 15, 30, 45, 60, 75, and 90 minutes after exposure of the fracture site. Samples were cultured on tryptic soy agar and MacConkey agar, and colony-forming units were counted. No bacterial growth was detected at 0–30 minutes. Culture positivity rates were 2.2% at 45 minutes, 16.3% at 60 minutes, 35.3% at 75 minutes, and 66.7% at 90 minutes. Fisher’s Exact and Cochran-Armitage trend tests confirmed a statistically significant increase in contamination rates after 45 minutes (p < 0.05). Notably, cases with severe soft tissue trauma and subcutaneous hematoma, even without skin disruption, exhibited higher contamination rates and developed postoperative SSIs more frequently. These results highlight operative time as a critical factor influencing intraoperative contamination in feline orthopedics and emphasize the importance of minimizing unnecessary surgical delays, maintaining strict aseptic discipline, and considering prophylactic strategies for prolonged surgeries.

Keywords

• Bacteriology
• Feline osteosynthesis
• Intraoperative contamination
• Operative time
• Surgical site infection

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