The "lex artis" of selected routine procedures in equine surgery

Publikationen als Autor:in / Herausgeber:in der Vetmeduni

Jenner, Florien; Haralambus, Rhea

Abstrakt

Infections arising as a complication of routine castrations and of diagnostic and intrasynovial injections in equine practice frequently lead to lawsuits. It is important even for routine procedures to inform the owner about the procedure, including its risk, complications and any alternatives, and to obtain signed informed consent to document the conversation. Prophylactic antimicrobial use in patients undergoing surgical procedures has greatly reduced the incidence of postoperative infection and has saved many lives. However, in the interest of preventing the rise of antimicrobial resistance it should be limited as much as possible without compromising patient care. Prophylactic perioperative antimicrobials should never replace Halsted's surgical principles and aseptic technique and should be restricted to surgical patients in which the incidence of infection exceeds 5 %, to high-risk patients and to cases where the development of infection would be potentially devastating. When planning a castration procedure, it is essential to perform a thorough physical examination, to ascertain the vaccination status of the animal and to choose a professionally recognized castration technique appropriate for the individual animal to reduce the likelihood of malpractice claims. Should complications such as eventration or haemorrhage arise, the veterinarian must be prepared to deal with them correctly and promptly to prevent further morbidity, mortality or malpractice claims. The general guidelines for stallion castration published by the Society for Equine Medicine of the German Veterinary Association (Gesellschaft fur Pferdemedizin der deutschen Veterinarmedizinischen Gesellschaft) give a closed or semi-closed technique under general anaesthesia with ligature of the spermatic cords and primary wound closure as the method of choice with the lowest risk of complications and the shortest convalescence time. To avoid complications after diagnostic anaesthesia and intrasynovial treatment, a precise injection technique, up-to-date knowledge of anatomic details and the relevant literature, adherence to a strict hygiene protocol and adequate restraint of the horse are important. The clinician should be aware of possible diffusion of local anaesthetics and unintended puncture of synovial structures when carrying out diagnostic anaesthesia and should take them into account when performing the injection and interpreting the results. The risk of iatrogenic infection is higher during intrasynovial treatment than with intrasynovial anaesthesia, so it is essential to adhere meticulously to aseptic technique.

Dokumententyp

Originalarbeit

WoS ID

WOS:000383732700006