Characterization and impact of wound infection after pancreas transplantation.
OBJECTIVE
To characterize the incidence, microbial pathogenesis, risk factors, and impact of wound infection after pancreas transplantation.


METHODS
Retrospective analysis.


METHODS
A large university hospital.


METHODS
From January 1, 1990, to September 30, 1993, 197 patients underwent 207 consecutive pancreas transplantation procedures.


METHODS
Wound infection and patient and allograft survival rates at 1 year.


RESULTS
Sixty-nine patients (33%) suffered wound infections: 21 (10%) were superficial; 31 (15%), deep; and 17 (8%), combined. Most (74%) wound infections were monomicrobial. Staphylococcus epidermidis and Candida species were the most common pathogens. Prolonged operating time, older donors, and enteric drainage were associated with higher wound infection rates. Deep and combined wound infections led to allograft loss despite subsequent salvage procedures. Combined wound infection was associated with significantly higher mortality.


CONCLUSIONS
A deep wound infection should be an indication for allograft removal. Antifungal prophylaxis, stringent donor criteria, and delayed primary wound closure should lower the incidence of wound infection.
Everett
J E
JE
Division of Surgical Infectious Disease, University of Minnesota, Minneapolis.
Wahoff
D C
DC
Statz
C
C
Gillingham
K J
KJ
Gruessner
A
A
Gruessner
R W
RW
Gores
P F
PF
Sutherland
D E
DE
Dunn
D L
DL
D000328:Adult; D000367:Age Factors; D003428:Cross Infection / Q000145:classification / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D004322:Drainage / Q000009:adverse effects; D005260:Female; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D017053:Infection Control; D008297:Male; D016035:Pancreas Transplantation / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy; D012720:Severity of Illness Index; D013530:Surgical Wound Infection / Q000145:classification / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D015996:Survival Rate; D013997:Time Factors