The association of propofol usage with postoperative wound infection rate in clean wounds: A retrospective study

Objective-To determine if the use of propofol influences the postoperative infection rate of clean surgical wounds in dogs and cats. Study Design-Retrospective study. Sample Population-863 dogs and cats undergoing clean surgical procedures. Methods Medical and anesthetic records of surgical cases used as part of a previously described epidemiologic study on postoperative wound infection r ates were reviewed. The records of all animals with clean surgical wounds w ere reviewed to determine if propofol had been used for anesthetic inductio n or maintenance during the procedure. To determine the effect of propofol use on wound infection rate, data were analyzed using Fisher's exact test, followed by multiple logistic regression to adjust for various factors, inc luding surgery time, time from clipping to surgery, antibiotic usage, coexi sting distant infection, endocrine disease, and the use of immunosuppressiv e drugs in the perioperative period. Results and Conclusions-Of 863 dogs and cats with clean surgical wounds, 46 received propofol as part of the anesthetic protocol. A total of 6 of 46 a nimals (13%) receiving propofol developed postoperative wound infections, c ompared with 33 of 817 animals (4%) not receiving propofol (P = .014; % dif ference = 9%; 95% CI = 0.5% to 24%). Adjusting for all other factors evalua ted, animals receiving propofol were 3.8 times more likely to develop posto perative wound infections compared to animals not given propofol (95% CI = 1.5-9.9). Clinical Implications-Propofol is a lipid-based emulsion capable of support ing microbial growth. Administration of a potentially contaminated solution may contribute to surgical wound infection or other patient morbidity or m ortality. Strict aseptic technique in the preparation of the solution and p rompt disposal of unused drug are imperative to curtail the potential for e xtrinsic contamination. (C)Copyright 1999 by The American College of Veteri nary Surgeons.