Systematic Review of Pre-Operative and Post-Operative Management of Large Animal Internal Medicine

Background: We evaluated whether a standardized bundle—multimodal analgesia and monitoring, stewardship-minded short antibiotic courses, and simple incision protections—reduces ileus and surgical-site infection (SSI) and improves survival and function after large-animal surgery. Methods: Following PRISMA, we searched PubMed (n=۸۹۴), Web of Science (n=۱,۰۴۷), and Scopus (n=۱,۲۳۹) from ۱۹۸۰ to August ۲۰۲۵. Three screening layers (title/abstract, full text, data sufficiency/overlap) yielded ۹۳ studies. When _x۰۰۰۵_۹ comparable reports were available, we performed random-effects meta-analyses of proportions or risk ratios; otherwise, we synthesized by species, lesion category, and care setting. Results: In equine colic, survival to discharge was ~۷۰_x۰۰۰۳_۹۰% after a first laparotomy and ~۴۵_x۰۰۰۳_۶۵% after relaparotomy; miniature breeds approached ~۹۸% discharge survival with ~۹۰% _x۰۰۰۶_۲۱۲-month survival when reported. Early complications included ileus (~۸_x۰۰۰۳_۱۰%), SSI (۱۶_x۰۰۰۳_۲۵%), jugular thrombosis (۵_x۰۰۰۳_۱۰%), and incisional hernia (۸_x۰۰۰۳_۱۰%). Recovery lactate stratified risk (_x۰۰۰۶_۱ ۵ mmol/L _x۰۰۰۶_#۸۷۷۶; ۲_x۰۰۰۷_ complications; _x۰۰۰۶_۱ ۷ mmol/L _x۰۰۰۶_#۸۷۷۶; ۱۰_x۰۰۰۷_ mortality). Single-dose or _x۰۰۰۶_۲۴-hour antibiotic prophylaxis was non-inferior to multi-day regimens, and intraincisional medical-grade honey reduced SSI to single digits. Validated pain scales showed clinically meaningful improvements with local mepivacaine, lidocaine infusions, and calm, oxygen-supported recovery. In cattle, perioperative penicillin lowered post-rumenotomy abscess odds (untreated _x۰۰۰۶_#۸۷۷۶;۱۱_x۰۰۰۷_ higher), and a single meloxicam dose at heifer cesarean correlated with higher pregnancy rates and a shorter calving interval. Conclusion: Across species, concise antibiotic prophylaxis, structured analgesia, incision adjuncts, and lactate-guided monitoring are high-yield levers associated with fewer complications, shorter hospitalization, and better survival and long-term function. These findings support adopting standardized, stewardship-aligned perioperative care and more harmonized outcome reporting.

کلیدواژه ها:

Large-animal surgery ، Postoperative care ، Pain Management ، Preoperative Care ، Surgical-site infection