Objective: To compare 2 preoperative surgical site protocols for standing laparotomy in cattle in a field setting.
Study Design: Cohort study.
Animals: Dairy cows (n = 73) undergoing a clean standing laparotomy (no visceral perforation during surgery).
Methods: Cows were randomly assigned to 1 of 2 preoperative skin-preparations protocols with chlorhexidine used as an antiseptic. A standard protocol (3 minutes [min] cleansing scrub, tap water rinse, 3 minutes surgical scrub with a sterile one-use chlorhexidine scrub and alternate passage of alcohol and 2% chlorhexidine solution (7 minutes; n = 32) was compared with a 3 minutes abbreviated preoperative protocol, consisting of two 90 seconds period of cleansing scrub and 3 passages of 0.5% chlorhexidine gluconate in 70% in isopropyl alcohol solution (4 minutes; n = 32). Pre- and postoperative skin bacterial counts and clinical assessment of wounds 10-15 days after surgery, as well as standardized interview with the producers focused on wound infection 30 days after the surgery were used to compare both protocols.
Results: There was no difference between protocols for absolute colony forming units (CFU) and percentage CFU reduction perioperatively as well as for surgical wound clinical score 10-15 days after the surgery. The infection rate at 30 days was 10.5% (6/57) but no significant difference was observed between protocols 10% (3/30) versus 11.5% (3/27).
Conclusions: An abbreviated preoperative protocol using nonsterile reusable material can be as effective as a standard protocol using sterile one-use brush in reducing skin microflora and preventing surgical wound infection.
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