Postoperative Antibiotics Do Not Prevent Surgical Site Infections After Routine Ophthalmic Soft Tissue Surgeries in...

To compare the incidence of surgical site infections (SSI) following routine ophthalmic soft tissue surgeries in dogs receiving (AB) and not receiving (noAB) postoperative antibiotics.

Clinical records of dogs that underwent enucleations, wedge resections, medial canthoplasties, and simple and complicated eyelid surgeries with at least 3 months follow-up were retrospectively reviewed. SSI were recorded when increased mucoid or purulent discharge was present postoperatively or wound dehiscence occurred. SSI were graded based on Clavien-Dindo's classification according to the therapeutic intervention required.

A total of 231 dogs (AB = 108; noAB = 123) met the inclusion criteria for enucleations, 135 for wedge resections (AB = 62; noAB = 73), 31 for medial canthoplasties (AB = 15; noAB = 16), and 30 and 22 for simple (AB = 13; noAB = 17) and complicated (AB = 7; noAB = 15) eyelid surgeries, respectively. There was no significant difference in SSI rates between patients receiving topical or systemic postoperative antibiotics and those not receiving antibiotics. Variables associated with an increased risk of SSI included a brachycephalic phenotype in eyelid wedge resections and high body weight in simple and complicated eyelid surgeries. The SSI were classified as grade 1 in 6/32 (18.8%) patients and grade 2 in 20/32 (62.5%) patients. 4/32 (12.5%) patients with SSIs were classified as grade 3b and required surgical intervention.

Postoperative systemic and topical antibiotics did not reduce SSI. The high incidence of SSI in medial canthoplasties and eyelid surgeries independent of postoperative antibiotic use highlights the need to reconsider pre-, peri- and postoperative protocols, including suture material selection and the implementation of wound cleaning routines.