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Billas et al: Incidence of and risk factors for surgical site infection following canine limb amputation
Veterinary Surgery 3, 2022

🔍 Key Findings

  • 12.5% overall incidence of SSI after limb amputation, and 10.9% for clean procedures.
  • Bipolar vessel sealing device use for muscle transection significantly increased SSI risk (OR 2.5; P = .023).
  • Monopolar electrosurgery and sharp transection were not associated with increased SSI risk.
  • Non-clean wound classification increased SSI odds (OR 8.2; P = .003).
  • Amputation for infection (OR 5.7) or trauma (OR 4.5) significantly increased SSI risk compared to neoplasia.
  • Preoperative infections at distant sites did not significantly increase SSI risk.
  • Neither surgery/anesthesia duration, hypothermia, hypotension, nor skin closure method significantly affected SSI risk.
  • Study supports avoiding bipolar sealing devices for muscle transection in limb amputations to reduce SSI risk.

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← Articles

Billas et al: Incidence of and risk factors for surgical site infection following canine limb amputation
Veterinary Surgery 3, 2022

🔍 Key Findings

  • 12.5% overall incidence of SSI after limb amputation, and 10.9% for clean procedures.
  • Bipolar vessel sealing device use for muscle transection significantly increased SSI risk (OR 2.5; P = .023).
  • Monopolar electrosurgery and sharp transection were not associated with increased SSI risk.
  • Non-clean wound classification increased SSI odds (OR 8.2; P = .003).
  • Amputation for infection (OR 5.7) or trauma (OR 4.5) significantly increased SSI risk compared to neoplasia.
  • Preoperative infections at distant sites did not significantly increase SSI risk.
  • Neither surgery/anesthesia duration, hypothermia, hypotension, nor skin closure method significantly affected SSI risk.
  • Study supports avoiding bipolar sealing devices for muscle transection in limb amputations to reduce SSI risk.

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Multiple Choice Questions on this study

In Billas 2022 et al., on SSI risk after limb amputation, which variable was **not** associated with increased SSI risk?

A. Use of bipolar sealing device
B. Other-than-clean wound classification
C. Use of sharp dissection
D. Amputation due to infection
E. Amputation due to trauma

Answer: Use of sharp dissection

Explanation: Only bipolar sealing device, trauma, infection, and non-clean wounds were significant predictors.
In Billas 2022 et al., on SSI risk after limb amputation, what was concluded regarding use of electrosurgery for muscle transection?

A. It significantly increased SSI risk
B. It had no association with SSI
C. It significantly decreased SSI risk
D. It was associated with longer surgeries
E. It reduced thermal spread

Answer: It had no association with SSI

Explanation: Monopolar electrosurgery was not associated with increased SSI risk (*P* > .05).
In Billas 2022 et al., on SSI risk after limb amputation, what was the SSI incidence following clean limb amputation procedures?

A. 2.5%
B. 5.2%
C. 8.0%
D. 10.9%
E. 14.3%

Answer: 10.9%

Explanation: SSI occurred in 10.9% of clean amputations, higher than expected for clean surgeries.
In Billas 2022 et al., on SSI risk after limb amputation, which muscle transection method was associated with increased infection odds?

A. Sharp scalpel transection
B. Monopolar electrosurgery
C. Bipolar vessel sealing device
D. Ligature with non-absorbable suture
E. Blunt dissection

Answer: Bipolar vessel sealing device

Explanation: Use of bipolar vessel sealing devices significantly increased the odds of SSI (OR 2.5; *P* = .023).
In Billas 2022 et al., on SSI risk after limb amputation, which amputation indication significantly increased SSI odds compared to neoplasia?

A. Neurologic disease
B. Implant failure
C. Trauma
D. Primary osteosarcoma
E. Other neoplasia

Answer: Trauma

Explanation: Trauma had a 4.5x increased SSI risk compared to neoplasia (*P* = .003).

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