NEW – Bovine surgery guidelines
The surgical guidelines have been developed in response to a survey we completed in 2016 that identified a need for widely accessible antimicrobial guidelines for surgical prophylaxis.
National Research Council’s risk index for surgical infection:
| Clean | Non-traumatic, uninfected. No break in aseptic technique, no inflammation encountered. Elective, closed primarily and no drain used |
| Clean-contaminated | Controlled entering of a hollow muscular viscus, minor break in aseptic technique |
| Contaminated | Open, fresh traumatic wound. Incision into a site with acute, non-purulent inflammation. Major break in aseptic technique. |
| Dirty | Pus encountered during surgery. Perforated viscus found. Traumatic wound with devitalised tissue, foreign material or faecal contamination, or of more than 4-hour duration |
Guidelines
| Surgical conditions | Mitigating factors | Antimicrobial recommendation | Duration of therapy |
| Clean | None | N/A | |
| Uncomplicated hernia repair75 | None | N/A | |
| Rumenotomy76,77 | Oxytetracycline | Preoperatively only | |
| Unsanitary conditions | Oxytetracycline | Preoperatively only78 | |
| Periparturient79,80 | Oxytetracycline | Preoperatively only78 | |
| Surgery >1.5h | Oxytetracycline | No evidence, in other species preoperatively only | |
| Clean-contaminated | Oxytetracycline | No evidence, in other species stop by 24h | |
| Contaminated | Oxytetracycline | No evidence, in other species 24-48h | |
| Dirty | Choose appropriate to infection | Choose appropriate to infection |
Timing of prophylactic antimicrobials:
Tissue levels of antimicrobials are required at the time of first incision to confer protection from surgical site infection.
Intravenous antimicrobials: Administer 30-60 mins prior to surgery
Intramuscular procaine penicillin: 2h prior to surgery
Intramuscular oxytetracycline: ~8 h prior to surgery
Tmax for individual drugs given by different routes can be used to assess optimal timing to achieve peak serum levels at the time of first incision.
Repeat dosing:
Dosing interval should be measured from the time of the preoperative dose. The dosing interval can be calculated as twice the elimination half-life of the antimicrobial.
Intravenous oxytetracycline: 6 hours
THE EVIDENCE
- Klein WR, Firth EC. Infection rates in clean surgical procedures with and without prophylactic antibiotics. Vet Rec 1988;19:542-543.
- Haven ML, Wichtel JJ, Bristol DG, et al. Effects of antibiotic prophylaxis on postoperative complications after rumenotomy in cattle. JAVMA 1992;200:1332-1335.
- Hartnack AK, Niehaus AJ, Rousseau M, et al. Indications for and factors relating to outcome after rumenotomy or rumenostomy in cattle: 95 cases (1999-2011). JAVMA 2015;247:659-664.
- Klein WR, van der Velden MA, Ensink JM. Single intraoperative administration of antibiotic to cows with caecal torsion: Wound infection and postoperative performance. A retrospective and prospective study. Vet Q 1994;16:111-113.
- Roy J, Harvey D, Belanger A, et al. Comparison of 2-step laparoscopy-guided abomasopexy versus omentopexy via right flank laparotomy for the treatment of dairy cows with left displacement of the abomasum in on-farm setting. JAVMA 2008;232:1700-1706.
- Fubini SL, Ducharme NG, Erb HN, et al. A comparison in 101 dairy cows of right paralumbar fossa omentopexy and right paramedian abomasopexy for treatment of left displacement of the abomasum. Can Vet J 1992;33:318-324.
- Sloss V, Dufty JH. Elective caesarean operation in Hereford cattle. Aust Vet J 1977;53:420-424
