Postoperative wound infections following myocutaneous flap surgery in spinal injury patients.
Severe pressure ulcers in patients with spinal cord injury are frequently treated by using musculocutaneous (m-c) flap surgery. There have been few studies of the use of perioperative antibiotics to prevent postoperative infection in this setting. We reviewed 74 m-c flap surgeries in 53 patients (41 male and 12 female) from October 1989 for one year. The sites involved were ischial (31), sacral (24), trochanteric (18), deltoid (2), olecranon (1) and posterior thigh (1). An antibiotic was usually administered perioperatively for 5 days. Patients were followed for a median of 30 (8-96) weeks. Postoperative infections occurred at a median of 12 (4-25) days in 6 of 74 (8%) surgeries. The organisms cultured from the 6 infected wounds were: Bacteroides sp. (4), Proteus mirabilis (2), E. coli (2), MRSA (2), and others (6--each isolated once). These results indicate that antibiotics did not prevent postoperative infection in approximately 8% of patients undergoing m-c surgery. The frequency of isolation of Bacteroides sp. from these infections suggests that anaerobic bacteria may persist in healing pressure ulcers and perioperative antibiotics might include coverage for anaerobic bacteria.
Garg
M
M
Department of Medicine, Rancho Los Amigos Medical Center, Downey, California 90242.
Rubayi
S
S
Montgomerie
J Z
JZ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011292:Premedication; D003668:Pressure Ulcer / Q000473:pathology; D013119:Spinal Cord Injuries / Q000150:complications / Q000601:surgery*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000382:microbiology / Q000473:pathology* / Q000517:prevention & control
D000900:Anti-Bacterial Agents