Economic impact of tibial plateau leveling osteotomy surgical site infection in dogs.

Abstract

OBJECTIVE: To evaluate the economic impact of surgical site infection after tibial plateau leveling osteotomy (TPLO) in dogs. STUDY DESIGN: Retrospective study STUDY POPULATION: Dogs that had unilateral TPLO and did (n&#x2009;=&#x2009;32) or did not (controls; 32) develop a surgical site infection. METHODS: Medical and billing records were reviewed to identify postoperative care and costs, which were compared between groups. RESULTS: Age, weight, gender, and initial surgical costs did not differ between groups. Postoperative costs were higher for dogs that developed SSIs ($1559) than for controls ($212, P&#x2009;<&#x2009;.0001), as were number of postoperative recheck visits (P&#x2009;<&#x2009;.0001) and time until final case closure (P&#x2009;=&#x2009;.0002). Dogs with surgical site infection (SSI) returned for a mean (&#xb1;SD) 4.1&#x2009;&#xb1;&#x2009;2.9 (range, 1-13) postoperative visits attributable to SSI management: mean outpatient visits 3.0&#x2009;&#xb1;&#x2009;2.5; mean inpatient stays, 1.2&#x2009;&#xb1;&#x2009;0.74; and mean hospitalization, 4.3&#x2009;&#xb1;&#x2009;4.1 days. Postoperative costs attributable to SSI management ranged from $145 to $5022. Implants were removed in 22 (69%) dogs with SSIs. Bacteria were isolated from the surgical site or implant of 23 (72%) dogs with SSIs. There was a significant difference in cost when bacteria were isolated ($1836 versus $853, P&#x2009;=&#x2009;.002), but no impacts on likelihood of implant removal (16/23, 70% versus 6/9, 67%, P&#x2009;=&#x2009;0.87). Staphylococcus pseudintermedius was predominant. CONCLUSIONS: SSI after TPLO are associated with a significant cost. These data help quantify those costs, to facilitate a greater understanding of the impact of SSI, and the need for infection control.