Comparison of Two Surgical Site Protocols for Cattle in a Field Setting Clara Bourel, Dr Vét, IPSAV, Sébastien Buczinski, Dr Vét, MSc, Diplomate ACVIM, André Desrochers, DMV, MS, Diplomate ACVS & ECBHM, and Denis Harvey, DMV, PhD Faculté de Médecine Vétérinaire, Département des sciences cliniques, Université de Montréal, Saint‐Hyacinthe, Quebec, Canada Corresponding Author Dr. Sébastien Buczinski, Faculté de Médecine Vétérinaire Département des sciences cliniques Université de Montréal, CP 5000 Saint‐Hyacinthe, QC, Canada J2S 7C6. E‐mail: s.buczinski@umontreal.ca Submitted July 2011 Accepted November 2011 DOI:10.1111/j.1532-950X.2013.01089.x Objective: To compare 2 preoperative surgical site protocols for standing laparotomy in cattle in a field setting. Study Design: Cohort study. Animals: Dairy cows (n ¼ 73) undergoing a clean standing laparotomy (no visceral perforation during surgery). Methods: Cows were randomly assigned to 1 of 2 preoperative skin‐preparations protocols with chlorhexidine used as an antiseptic. A standard protocol (3 minutes [min] cleansing scrub, tap water rinse, 3 minutes surgical scrub with a sterile one‐use chlorhexidine scrub and alternate passage of alcohol and 2% chlorhexidine solution (7 minutes; n ¼ 32) was compared with a 3 minutes abbreviated preoperative protocol, consisting of two 90 seconds period of cleansing scrub and 3 passages of 0.5% chlorhexidine gluconate in 70% in isopropyl alcohol solution (4 minutes; n ¼ 32). Pre‐ and postoperative skin bacterial counts and clinical assessment of wounds 10–15 days after surgery, as well as standardized interview with the producers focused on wound infection 30 days after the surgery were used to compare both protocols. Results: There was no difference between protocols for absolute colony forming units (CFU) and percentage CFU reduction perioperatively as well as for surgical wound clinical score 10–15 days after the surgery. The infection rate at 30 days was 10.5% (6/57) but no significant difference was observed between protocols 10% (3/30) versus 11.5% (3/27). Conclusions: An abbreviated preoperative protocol using nonsterile reusable material can be as effective as a standard protocol using sterile one‐use brush in reducing skin microflora and preventing surgical wound infection. Standing paralumbar fossa laparotomy in cattle is frequently performed in the field. 1,2 Most of these interventions are clean surgeries 1,2 because the gastrointestinal lumen is not invaded. 3 Despite a contaminated surgical theatre, the standard rules of asepsis and preoperative preparation must be respected. Studies in a university hospital setting with cattle reported a wound infection rate of 2.4–4.3% 4,5 while another study reported 8.9% after omentopexy by the right flank approach in a field setting. 2 A recent survey showed that the surgical practices in the farm markedly differ from those generally recommended in veterinary schools. 6 In Bedard’s protocol, 5 which consisted of 3 minutes [min] cleaning scrub followed by a 3 minutes scrub using a one‐use sterile scrub brush (either with chlorhexidine or povidone‐iodine, the percentage of reduction of colony forming units (CFU) after the sterile preparation was not significantly different than those after the cleansing scrub. So we hypothesized that both standard 4,5 and shorter protocols that are commonly used in bovine veterinary practices will be effective in decreasing the rate of surgical site infection. Our purpose was to compare an abbreviated surgical skin preparation protocol to a standard preoperative protocol derived from Bedard’s protocol 5 for clean bovine standing surgery in an on farm setting. MATERIALS AND METHODS This prospective study protocol was reviewed and accepted by the institutional Animal Use and Care Committee. Dairy cows included in this study were owned by dairy producer clients of the ambulatory clinic. Cows had a clean standing laparotomy for treatment or diagnostic purposes and were all administered procaine penicillin G (22,000 U/kg, intramuscularly [IM] Presented in part at the European Buiatric Forum, Marseille, France, December 2009. Study partially funded by the Pfizer Clinical Research Fund of the Bovine Ambulatory Clinic, University of Montreal. Veterinary Surgery 42 (2013) 223–228 © Copyright 2013 by The American College of Veterinary Surgeons 223