Complications in Equine Surgery

Luis M. Rubio-Martinez, Dean A. Hendrickson

• Publisher: Wiley-Blackwell
• Year: 2021
• ISBN:
  9781119190158
• Edition: 1
• Topic: Medicine
• Subtopic: Veterinary Medicine

Complications in Equine Surgery is the first reference to focus exclusively on understanding, preventing, recognizing, managing, and prognosing, technical and post-procedural complications in equine surgery. Edited by two noted experts on the topic, the book presents evidence-based information using a clear approach, organized by body system. Featuring color images, the book contains detailed coverage of the gastrointestinal, respiratory, musculoskeletal, urogenital, and neurological systems.

Each chapter contains a short introduction of the procedure with explanations of when and how the procedure is to be performed. All chapters review how to recognize and prevent technical complications and explain how to manage post-operative complications. This important text:

• Offers the first resource specifically focused on complications encountered in equine surgery
• Takes a helpful format organized by body system
• Provides consistently formatted chapters for ease of use
• Covers clinically relevant information for dealing with technical and post-operative complications
• Presents more than 350 color images to illustrate the concepts described

Written for general practitioners and specialists, Complications in Equine Surgery is an essential resource to decreasing morbidity and mortality and increasing surgical success in horses.

1
Surgical Complications

Luis M. Rubio‐Martinez DVM, DVSc, PhD, DACVS, DECVS, DACVSMR, MRCVS¹ and Dean A. Hendrickson DVM, MS, DACVS²

¹ Sussex Equine Hospital, Ashington, West Sussex, United Kingdom and CVet Ltd. Equine Surgery and Orthopedics, United Kingdom

² College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado

Overview

The term “surgical complication” is frequently used in the medical profession, but its definition in the medical literature has been inconsistent over the years. The World Journal of Surgery defines “surgical complication” as “any undesirable, unintended, and direct results of an operation affecting the patient that would not have occurred had the operation gone as well as could reasonably be hoped” [1]. This definition suggests that a surgical complication is dependent on the surgical skill of the surgeon, the facilities and equipment available and the condition of the patient.

List of Complications Associated with Surgery:

• Morbidity and mortality
• Surgical checklists
• Perioperative consequences of surgical trauma
• Metabolic and nutritional effects
• Neuroendocrine
• Systemic inflammatory response
• Pain
• Impact of host factors and comorbid conditions

“Surgical complications,” otherwise referred to as “operative complications,” are not restricted to the time window of the surgical procedure itself but comprise both intra‐ and postoperative complications [2]. The duration of surgery defines the time window for intraoperative complications; meanwhile, postoperative complications are not restricted to those occurring during hospitalization but are defined according to a time period. A 30‐day period after the surgical procedure, either during or after hospitalization, has been used in human medicine [2].

All surgical procedures are associated with a degree of risk and the benefits of any procedure need to be weighed against any potential complications so that the clinician and the patient or animal owner can make a balanced and informed decision. This discussion should also cover complementary techniques that augment results to optimize physical, occupational and societal goals [3]. In veterinary medicine, owners’ expectations, engagement and commitment, animal welfare and economics need also to be balanced.

Surgical complications can be classified into patient‐related complications (related to patient‐specific characteristics, rather than to a procedural error), and practitioner‐related complications (arising from errors that directly lead to undesirable and unintended results affecting the patient, but also as a result of a faulty technique) [3]. Although surgical errors may be frequently linked to complications, some errors may not result in complications.

Recognition of errors and complications provide unique instances to learn from and to work toward avoiding or preventing their re‐occurrence [4]. To maximize this process the following practitioner's goals have been defined in human medicine [3, 5]:

1. Minimize errors by applying an appropriate surgical technique.
2. Identify and manage errors in a timely manner and in a way that would prevent ensuing complications.
3. Identify and manage complications in a timely manner and appropriately.
4. Identify and consider patient‐related complications in the decision‐making process, so that they can be anticipated, prevented or managed correctly.

It is not uncommon for clinicians to adopt routines that prevent and manage complications on the basis of personal experience. However, in some cases this may be associated with “making the same mistakes with increasing confidence over an impressive number of years” [6]. In human medicine, standards of expected outcomes for groups of patients require evidence‐based practice, making seniority and individual experience less important [7]. Evidence‐based literature in this area has quickly developed over the last decades, and several textbooks and journals dedicated to surgical complications are available in the human field. The application of an evidence‐based approach for prevention, identification and management of surgical complications should result in a reduction in mistakes in the clinical decision‐making process. In addition, it will also identify areas on which further research is warranted.

Morbidity and Mortality

Morbidity (from Latin morbidus, meaning sick, unhealthy) is a diseased state, disability, or poor health due to any cause [8]. Surgical morbidity relates to those morbid states that are related to a surgical procedure performed on a patient. Although traditionally defined by the presence or absence of specific postoperative complications, surgical morbidity represents any clinically significant, non‐fatal, adverse outcome associated with a surgical procedure [9]. Morbidity can be divided into local (associated with operation site, e.g. wound dehiscence) or general (related to any operation, e.g. acute renal failure). It can also be subdivided based on timely occurrence as intraoperative or postoperative; the latter being further considered as immediate, early, late or long‐term, although these are based on arbitrary time thresholds [9]. These categories overlap and are closely interconnected, as for example a specific, local complication such as surgical site infection may have general or systemic effects such as pyrexia, inappetence and motor dysfunction, which are not procedure specific [9].

Surgical mortality is any death regardless of cause, occurring: (1) within 30 days after surgery in or out of the hospital; or (2) after 30 days during the same hospitalization period subsequent to the operation [10, 11]. In patients undergoing more than one surgical procedure during a single hospitalization, mortality is assigned to the first operation during hospitalization [10].

In human medicine, postoperative morbidity has been shown to have a significant effect on mortality in patients undergoing major surgery; [12] however, the association between general postoperative morbidity and long‐term outcome or functionality is not well established [9]. This stems from the inconsistent reporting of morbidity in relation to definition, type and criteria, ...

Table of contents

• Cover
• Table of Contents
• Title Page
• Copyright Page
• Dedication Page
• Foreword
• Preface
• Acknowledgements
• List of Contributors
• 1 Surgical Complications
• 2 Complications of Parenteral Administration of Drugs
• 3 Complications of Intravascular Injection and Catheterization
• 4 Complications of Endoscopy
• 5 Complications of Nasogastric Intubation
• 6 Complications of Fluid Therapy
• 7 Complications Associated with Hemorrhage
• 8 Complications of Blood Transfusion
• 9 Complications Associated with Sutures
• 10 Complications of Bone Graft Harvesting, Handling, and Implantation
• 11 Complications of Cryosurgery
• 12 Complications of Laser Surgery
• 13 Complications of Systemic Analgesic Drugs
• 14 Complications of Loco‐Regional Anesthesia
• 15 Complications of Sedative and Anesthesia Medications
• 16 Complications During Recovery from General Anesthesia
• 17 Complications Associated with Surgical Site Infections
• 18 Complications of Reconstructive Surgery
• 19 Complications of Excessive Granulation Tissue
• 20 Complications of Skin Neoplasia
• 21 Complications of Skin Grafting
• 22 Complications of Oral and Salivary Gland Surgery
• 23 Complications of Esophageal Surgery
• 24 Complications of Stomach Surgery
• 25 Complications of Splenic Surgery
• 26 Complications of Abdominal Approaches
• 27 Complications of the Intraoperative Colic Patient
• 28 Complications of the Postoperative Colic Patient
• 29 Complications of Surgery of the Rectum and Anus
• 30 Complications of Abdominal Surgery: Incisional Hernia
• 31 Complications of Equine Laparoscopy
• 32 Complications of Endoscopic Laser Surgery
• 33 Complications Following Surgery of the Equine Nasal Passages and Paranasal Sinuses
• 34 Complications in Pharynx Surgery
• 35 Complications in Larynx Surgery
• 36 Complications of Surgery for Diseases of the Guttural Pouch
• 37 Complications of Equine Tracheal Surgery
• 38 Complications of Equine Thoracic Surgery
• 39 Complications of Testicular Surgery
• 40 Complications of Penile and Preputial Surgery
• 41 Complications of Ovarian and Uterine Surgery
• 42 Complications of Vulvar, Vestibular, Vaginal, and Cervical Surgery
• 43 Complications of Urinary Surgery
• 44 Complications of Diagnostic Tests for Lameness
• 45 Complications of Synovial Endoscopic Surgery (Arthroscopy, Tenoscopy, Bursoscopy)
• 46 Complications of Equine Orthopedic Surgery
• 47 Complications of Surgery of the Equine Foot
• 48 Complications of Surgical Correction of Angular Limb Deformities
• 49 Complications of Surgical Correction of Flexural Limb Deformities
• 50 Complications of Splint Bone Fractures
• 51 Complications of Craniomaxillary and Mandible Fractures
• 52 Complications of Tendon Surgery
• 53 Complications of Muscle Surgery
• 54 Complications of Regenerative Medicine
• 55 Complications of Osseous Cyst‐Like Lesions
• 56 Complications of Equine Ophthalmic Surgery
• 57 Complications of Diagnostic Procedures of the Nervous System
• 58 Complications of Anterior Cervical Fusion
• 59 Complications of Surgery for Impingement of Dorsal Spinous Processes
• 60 Complications of Peripheral Nerve Surgery
• Index
• End User License Agreement