Effectiveness of Pectin-Honey-Hydrogel to Reduce the Incidence of Surgical Site Infection following Laparotomy in Horses

Surgical site infection (SSI) is a common complication after celiotomy in horses, leading to increased morbidity and costs [1-3]. The contribution of perioperative antibiotics to antibiotic resistance underscores the necessity to evaluate alternative preventive approaches. The effectiveness of Manuka-honey in promoting wound healing has been recently demonstrated as well as the ability to reduce the risk of wound infections after colic surgery [1]. While the use of liquid honey has some limitations, the use of Pectin-Honey-Hydrogels (PHHs) may be warranted. The aim of the study was to evaluate the effectiveness of PHHs to reduce the incidence of surgical site infections (SSI) after laparotomy. The study received approval from the Ethical Committee of the Department (n.1514 21 st July 2020) and owner consent was signed for each horse. Horses undergoing laparotomy were randomly assigned to two groups. In Group 1, PHH was applied on the sutured linea alba before skin closure, in Group 2 no treatment was applied. Pre-, intra- and postoperative medications were the same for both groups. Horses that survived less than 5 days postoperatively were excluded. The incidence of SSI prior to discharge was compared between groups. Data were analyzed with the Fisher’s exact test or chi-square test. Eighteen horses per group were included in the study. One out of eighteen horses in group 1 and 6 out of eighteen horses in group 2 developed infection (p value = 0.035). Horses not treated with PHH have 8.5 times greater risk of incisional infection. Treatment with PHHs reduces the incidence of SSI in horses undergoing colic surgery. The use of alternative treatments may be beneficial towards the reduction of the use of antimicrobials and increase of antimicrobial resistance. [1] Isgren CM, Salem SE, Archer DC, Worsman FCF, Townsend NB. Risk factors for surgical site infection following laparotomy: Effect of season and perioperative variables and reporting of bacterial isolates in 287 horses. Equine Vet J, 49:39-44, 2017. [2] Bischofberger AS, Brauer T, Gugelchuk G, Klohnen A. Difference in incisional complications following exploratory celiotomies using antibacterial coated suture material for subcutaneous closure: Prospective randomized study in 100 horses. Equine Vet J,42:304-309, 2010. [3] Gandini M, Cerullo A, Giusto G. Scoping review: Occurrence and definitions of postoperative complications in equine colic surgery. Equine Vet J,55(4):563-572, 2023. [4] Gustafsson K, Tatz AJ, Slavin RA, et al. Intraincisional medical grade honey decreases the prevalence of incisional infection in horses undergoing colic surgery: A prospective randomised controlled study. Equine Vet J, 53(6):1112-1118, 2021.