Incidence and Risk Factors of Surgical Site Infection in 376 Mastectomy Procedures in Female Dogs: A Retrospective Cohort Study
Simple Summary
Abstract
1. Introduction
2. Materials and Methods
3. Results
3.1. Epidemiological and Clinical Preoperative Findings
3.2. Surgical Findings
3.3. Postoperative Findings
3.4. Incidence of Surgical Site Infection
3.5. Risk Factors for Surgical Site Infection: Univariate and Multivariate Analysis
4. Discussion
Risk Factors
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
SSI | Surgical site infection |
CDC | Centers for Disease Control |
WSCs | Wound soaker catheters |
VTH | Veterinary Teaching Hospital |
MOU | Mammary Oncology Unit |
ASA | American Society of Anesthesiologists |
AUC | Area under the curve |
Appendix A
Appendix A.1. Clinical Management Protocol for Dogs, Mammary Oncology Unit (MOU), Veterinary Teaching Hospital, Complutense University of Madrid
Appendix A.1.1. Preoperative Evaluation
Appendix A.1.2. Tumour Staging
Appendix A.1.3. Surgical Planning and Procedures
Appendix A.1.4. Immediate Postoperative Care and Monitoring
Appendix A.1.5. Histopathology
Appendix A.1.6. Long-Term Follow-Up
Breed | N (n = 306) | % |
---|---|---|
Crossbreed | 98 | 32.0 |
Yorkshire Terrier | 37 | 12.1 |
German Shepherd | 17 | 5.6 |
Labrador Retriever | 12 | 4.0 |
Cocker Spaniel | 10 | 3.3 |
Maltese | 10 | 3.3 |
West Highland White Terrier | 9 | 2.9 |
Poodle | 9 | 2.9 |
Miniature Schnauzer | 9 | 2.9 |
Beagle | 8 | 2.6 |
French Bulldog | 8 | 2.6 |
Weimaraner | 8 | 2.6 |
Golden Retriever | 6 | 2.1 |
Shih-tzu | 6 | 2.1 |
Boxer | 5 | 1.7 |
Bichon Frise | 4 | 1.4 |
Chihuahua | 3 | 0.9 |
Greyhound | 3 | 0.9 |
Jack Russel Terrier | 3 | 0.9 |
Belgium Shepherd | 3 | 0.9 |
Miniature Pinscher | 3 | 0.9 |
Dachshund | 3 | 0.9 |
Siberian Husky | 3 | 0.9 |
Cairn Terrier | 2 | 0.7 |
Fox Terrier | 2 | 0.7 |
Briard | 2 | 0.7 |
Basque Shepherd | 2 | 0.7 |
Pekingese | 2 | 0.7 |
Portuguese Podengo | 2 | 0.7 |
Ratonero Bodeguero Andaluz | 2 | 0.7 |
Shar Pei | 2 | 0.7 |
Brittany Spaniel | 2 | 0.7 |
Bearded Collie | 1 | 0.3 |
Bull Terrier | 1 | 0.3 |
English Bulldog | 1 | 0.3 |
Pug | 1 | 0.3 |
Cavalier King Charles Spaniel | 1 | 0.3 |
Catalan Sheepdog | 1 | 0.3 |
Irish Terrier | 1 | 0.3 |
Spanish Mastiff | 1 | 0.3 |
Pomeranian | 1 | 0.3 |
Staffordshire Bull Terrier | 1 | 0.3 |
Whippet | 1 | 0.3 |
General and Clinical Variables of the Surgical Procedures | ||||||
---|---|---|---|---|---|---|
Variables | No Infection | Infection | OR (CI 95%) | p | ||
n | % | n | % | |||
Weight (kg) | ||||||
≤10 kg | 178 | 93.7 | 12 | 6.3 | 1 | |
>10 kg | 165 | 88.7 | 21 | 11.3 | 1.8 (0.9–3.9) | 0.092 |
Body Score Condition (1/9) | ||||||
<5 out of 9 | 188 | 90.0 | 21 | 10.0 | 1 | |
≥5 out of 9 | 106 | 91.4 | 10 | 8.6 | 0.8 (0.3–1.8) | 0.675 |
Age (years) | ||||||
≤10 years | 170 | 90.9 | 17 | 9.1 | 1 | |
>10 years | 173 | 91.5 | 16 | 8.5 | 0.9 (0.4–1.8) | 0.830 |
Concurrent disease | ||||||
No | 321 | 91.5 | 30 | 8.5 | 1 | |
Yes | 22 | 88.0 | 3 | 12 | 1 (0.9–1.2) | 0.391 |
Endocrine disease | ||||||
No | 338 | 91.1 | 33 | 8.9 | 1 | |
Yes | 5 | 100.0 | 0 | 0.0 | 0 (0–0) | 0.999 |
Skin disease | ||||||
No | 333 | 91.2 | 32 | 0.1 | 1 | |
Yes | 10 | 90.0 | 1 | 0.1 | 1 (0.1–8.3) | 0.970 |
Leishmaniasis | ||||||
No | 336 | 91.6 | 31 | 0.1 | 1 | |
Yes | 7 | 77.8 | 2 | 0.2 | 3 (0.6–12.5) | 0.170 |
ASA status | ||||||
ASA 2 | 326 | 91.1 | 4 | 8.9 | 1 | |
ASA 3 | 17 | 91.2 | 29 | 8.8 | 0.9 (0.6–2.7) | 0.977 |
Surgical variables of the surgical procedures | ||||||
Variables | No Infection | Infection | OR (CI 95%) | p | ||
n | % | n | % | |||
Experience of the surgeons | ||||||
Senior surgeons | 41 | 91.1 | 4 | 8.9 | 1 | |
Surgeons-in-training | 302 | 91.2 | 29 | 8.8 | 0.9 (0.6–2.7) | 0.977 |
Type of mastectomy | ||||||
Regional mastectomies | 140 | 90.3 | 15 | 9.7 | 1 | |
Radical mastectomies | 175 | 91.1 | 17 | 8.9 | 1.1 (0.6–2.0) | 0.700 |
Reproductive status | ||||||
Previously sterilized | 140 | 90.3 | 15 | 9.7 | 1 | |
Sterilization performed concurrently | 200 | 91.7 | 18 | 8.3 | 0.8 (0.4–1.7) | 0.634 |
Number of mammary tumours | ||||||
≤2 | 189 | 90.4 | 20 | 9.6 | 1 | |
>2 | 140 | 92.1 | 12 | 7.9 | 0.810 (0.3–3.4) | 0.581 |
Maximum size of each nodule | ||||||
≤1.5 | 159 | 92.4 | 13 | 7.6 | 1 | |
1.5 | 163 | 90.1 | 18 | 9.9 | 1.3 (0.6–2.8) | 0.430 |
Duration of anaesthesia | ||||||
≤174 | 161 | 94.2 | 10 | 5.8 | 1 | |
>174 | 152 | 86.9 | 23 | 13.1 | 2.4 (1.1–5.2) | 0.024 |
Duration of surgery | ||||||
≤106 | 156 | 91.2 | 15 | 8.8 | 1 | |
>106 | 157 | 89.7 | 18 | 10.3 | 1.1 (0.5–2.4) | 0.632 |
Adhesion to deep plane | ||||||
No | 304 | 91 | 30 | 9.0 | 1 | |
Yes | 35 | 92.1 | 3 | 7.9 | 0.8 (0.2–2.9) | 0.823 |
Ulcer | ||||||
No | 330 | 91.2 | 32 | 8.8 | 1 | |
Yes | 9 | 90.0 | 1 | 10.0 | 1.1 (0.1–9.3) | 0.120 |
Hypotension | ||||||
No | 226 | 91.5 | 21 | 8.5 | 1 | |
Yes | 108 | 90.8 | 11 | 9.2 | 1 (0.5–2.3) | 0.814 |
Hypothermia | ||||||
No | 103 | 95.4 | 5 | 4.6 | 1 | |
Yes | 189 | 87.5 | 27 | 12.5 | 2.9 (1.1–7.8) | 0.032 |
Analgesic diffusion catheters | ||||||
No | 153 | 92.2 | 13 | 7.8 | 1 | |
Yes | 190 | 90.5 | 20 | 9.5 | 0.5 (0.5–2.5) | 1.239 |
Postoperative variables of the surgical procedures | ||||||
Variables | No Infection | Infection | OR (CI 95%) | p | ||
n | % | n | % | |||
Analgesic diffusion catheters | ||||||
No | 153 | 92.2 | 13 | 7.8 | 1 | |
Yes | 190 | 90.5 | 20 | 9.5 | 0.5 (0.5–2.5) | 1.239 |
Postoperative antibiotics | ||||||
No | 23 | 88.5 | 3 | 11.5 | 1 | |
Yes | 296 | 90.8 | 30 | 9.2 | 0.7 (0.2–2.7) | 0.695 |
Malignant tumour | ||||||
Benign | 176 | 91.7 | 16 | 8.3 | 1 | |
Malignant | 167 | 91.2 | 17 | 8.8 | 0.8 (0.2–3.1) | 0.654 |
Histopathological malignancy grade | ||||||
I | 109 | 93.3 | 8 | 6.7 | 1 | |
II | 33 | 84.6 | 6 | 15.4 | 2 (0.6–6.3) | 0.199 |
III | 22 | 88.0 | 3 | 12.0 | 1.6 (0.4–6.6) | 0.710 |
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General Variables of the Surgical Procedures | ||
---|---|---|
Variable | N | % |
Concurrent disease | ||
No | 351 | 93.4 |
Yes | 25 | 6.6 |
Endocrine disease | ||
No | 371 | 98.7 |
Yes | 5 | 1.3 |
Skin disease | ||
No | 365 | 97.1 |
Yes | 11 | 2.4 |
Leishmaniasis | ||
No | 367 | 97.3 |
Yes | 9 | 2.4 |
Kidney disease | ||
No | 366 | 97.3 |
Yes | 10 | 2.7 |
Anaemia | ||
No | 363 | 97.8 |
Yes | 8 | 2.2 |
Leukopenia | ||
No | 367 | 98.9 |
Yes | 4 | 1.1 |
Leucocytosis | ||
No | 367 | 98.9 |
Yes | 4 | 1.1 |
Thrombocytosis | ||
No | 360 | 97.0 |
Yes | 11 | 3.0 |
Thrombocytopenia | ||
No | 367 | 98.9 |
Yes | 4 | 1.1 |
Blood Proteins | ||
Normal | 351 | 94.1 |
Hypoproteinaemia | 4 | 1.1 |
Hyperproteinaemia | 18 | 4.8 |
Total | 373 | 100 |
Hyperglycaemia | ||
No | 364 | 99.5 |
Yes | 2 | 0.5 |
Total | 366 | 100 |
Hypoglycaemia | ||
No | 366 | 100 |
Yes | 0 | 0.0 |
Total | 366 | 100 |
Hypoalbuminemia | ||
No | 364 | 99.5 |
Yes | 2 | 0.5 |
Total | 366 | 100 |
Azotaemia | ||
No | 363 | 99.2 |
Yes | 3 | 0.8 |
Total | 366 | 100 |
Surgical procedure variables | ||
Variable | N | % |
Type of mastectomy | ||
Nodulectomy | 26 | 7.0 |
Regional mastectomies | 155 | 41.6 |
Radical mastectomies | 192 | 51.5 |
Reproductive status | ||
Previous sterilization | 155 | 41.6 |
Concurrent sterilization | 218 | 58.4 |
Number of mammary tumours | ||
0 | 1 | 0.3 |
1 | 112 | 31.0 |
2 | 96 | 26.6 |
3 | 59 | 16.3 |
4 | 35 | 9.7 |
5 | 21 | 5.8 |
6 | 27 | 7.5 |
7 | 5 | 1.4 |
8 | 1 | 0.3 |
9 | 3 | 0.8 |
12 | 1 | 0.3 |
Anaesthetic block | ||
No | 255 | 70.6 |
Yes | 106 | 29.4 |
Type of block | ||
Epidural | 48 | 45.3 |
Tap-block | 58 | 54.7 |
Hypotension | ||
No | 247 | 67.5 |
Yes | 119 | 32.5 |
Hypothermia | ||
No | 320 | 87.4 |
Yes | 46 | 12.6 |
Surgical variables of the surgical procedures | ||
Variable | Median (25th–75th Percentile) | N |
Maximum size of each nodule | ||
1.5 (0.6–3.0) | 323 | |
Variable | Mean (SD) | N |
Duration of anaesthesia | ||
173.5 (54.7) | 346 | |
Duration of surgery | ||
106 (45.8) | 346 | |
Minimum temperature during surgery | ||
36.1 (1.0) | 323 | |
Postoperative variables of the surgical procedures | ||
Variable | N | % |
Postoperative complications | ||
No | 251 | 69.0 |
Yes | 113 | 31.0 |
Seroma | ||
No | 292 | 88.0 |
Yes | 40 | 12.0 |
Dehiscence | ||
No | 331 | 99.1 |
Yes | 3 | 0.9 |
Haematoma | ||
No | 321 | 86.5 |
Yes | 50 | 13.5 |
Necrosis | ||
No | 368 | 98.9 |
Yes | 4 | 1.1 |
Subcutaneous emphysema | ||
No | 370 | 99.7 |
Yes | 1 | 0.3 |
Pain | ||
No | 357 | 96.0 |
Yes | 15 | 4.0 |
Vomit | ||
No | 353 | 94.9 |
Yes | 19 | 5.1 |
Diarrhoea | ||
No | 365 | 98.4 |
Yes | 6 | 1.6 |
Postoperative antibiotic administration | ||
No | 22 | 6.3 |
Yes | 327 | 93.7 |
Clavulanate amoxicillin | 210 | 60.5 |
Cefazolin | 109 | 31.4 |
Marbofloxacin | 6 | 1.7 |
Postoperative anti-inflammatory treatment | ||
No | 12 | 6.4 |
Yes | 352 | 93.6 |
Meloxicam | 83 | 23.6 |
Carprofen | 239 | 67.9 |
Robenacoxib | 30 | 8.5 |
Histological type of tumour | ||
Benign | 192 | 51.1 |
Malignant | 184 | 48.9 |
Grade of malignancy | ||
I | 117 | 31.9 |
II | 39 | 10.4 |
III | 25 | 6.6 |
Surgical site infection of the surgical procedures | ||
Variable | N | % |
Presence of SSI | ||
No | 343 | 91.2 |
Yes | 33 | 8.8 |
Type of SSI | ||
SSI superficial | 31 | 93.9 |
SSI deep | 2 | 6.1 |
Variables | OR (CI 95%) | p |
---|---|---|
Median duration of anaesthesia | ||
≤173.53 | 1 | |
>173.53 | 2.2 (1–5.2) | 0.041 |
Hypothermia | ||
No | 1 | |
Yes | 3.1 (1.1–8.3) | 0.026 |
Hosmer–Lemeshow test, p = 0.888 and area under the ROC curve: 0.657; 95% CI: 0.564–0.750 |
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Fuertes-Recuero, M.; Penelo, S.; Suarez-Redondo, M.; Eceiza-Zubicaray, A.; Arenillas, M.; Valdivia, G.; García San José, P.; Peña, L.; Pérez-Alenza, D.; Ortiz-Díez, G. Incidence and Risk Factors of Surgical Site Infection in 376 Mastectomy Procedures in Female Dogs: A Retrospective Cohort Study. Vet. Sci. 2025, 12, 553. https://doi.org/10.3390/vetsci12060553
Fuertes-Recuero M, Penelo S, Suarez-Redondo M, Eceiza-Zubicaray A, Arenillas M, Valdivia G, García San José P, Peña L, Pérez-Alenza D, Ortiz-Díez G. Incidence and Risk Factors of Surgical Site Infection in 376 Mastectomy Procedures in Female Dogs: A Retrospective Cohort Study. Veterinary Sciences. 2025; 12(6):553. https://doi.org/10.3390/vetsci12060553
Chicago/Turabian StyleFuertes-Recuero, Manuel, Silvia Penelo, María Suarez-Redondo, Alba Eceiza-Zubicaray, Mario Arenillas, Guillermo Valdivia, Paula García San José, Laura Peña, Dolores Pérez-Alenza, and Gustavo Ortiz-Díez. 2025. "Incidence and Risk Factors of Surgical Site Infection in 376 Mastectomy Procedures in Female Dogs: A Retrospective Cohort Study" Veterinary Sciences 12, no. 6: 553. https://doi.org/10.3390/vetsci12060553
APA StyleFuertes-Recuero, M., Penelo, S., Suarez-Redondo, M., Eceiza-Zubicaray, A., Arenillas, M., Valdivia, G., García San José, P., Peña, L., Pérez-Alenza, D., & Ortiz-Díez, G. (2025). Incidence and Risk Factors of Surgical Site Infection in 376 Mastectomy Procedures in Female Dogs: A Retrospective Cohort Study. Veterinary Sciences, 12(6), 553. https://doi.org/10.3390/vetsci12060553