Will intra-incisional medical grade honey decrease the incidence of incisional infection in horses undergoing colic surgery? A multicentric study.
Haddad RH1, Gustafsson KG1, Sutton GS1, Boyar NB1, Martens AM*2, Flemings VF2, Merchiers AM2, Southwood LLS*3, Torcivia CT3, Aitken MRA*3, Reno LRR4, Epstein KLE*4, Hassel DH*5, Harmon BH5, Kelmer GK*1
1Hebrew University, Rehovot, Israel, 2University of Ghent, Ghent, Belgium, 3University of Pennsilvenia, Philladelphia, USA, 4University of Goergia, Athens, USA, 5University of Colorado, Fort Collins, USA.
Introduction:
Surgical site infection (SSI) in horses undergoing ventral midline celiotomy is a common complication of great importance. Application of medical grade honey has previously been shown to significantly reduce SSI in equine celiotomies. The objective of this study was to investigate whether intra-incisional application of medical grade honey, during surgery, would lower the incidence of SSI in a large and variable population of horses.
Materials and methods:
A multi-centric prospective randomized controlled clinical study, including horses undergoing ventral midline celiotomy that survived >2 weeks. Horses were allocated to treatment or control by block randomisation. Horses that underwent repeated celiotomy were excluded. Pre-, intra- and post-operative details were collected until three months post-operatively. Comparison of SSI rates between treatment and control group were performed using Pearson Chi Square test for categorical variables and Mann-Whitney U test for continuous data.
Results:
Five hundred and fifty-three horses were included (treatment n=280 and control n= 273). The rate of SSI was not significantly different between study groups (22.1% and 22%, respectively (P=0.73)). Longer surgery time was the only variable significantly associated with SSI (P=0.003). Median time to SSI diagnosis was similar between groups (10 days (P=0.063)). Survival rate three months post-operatively was 80.6% and was not significantly different between groups (P=0.51).
Discussion:
Although the use of medical grade honey was safe and caused no complications, it was not protective against SSI in horses undergoing exploratory celiotomy in this large multicentric study. Longer surgery time was associated with higher prevalence of SSI.