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A Journal on Physiopathology and Therapy of Chronic Cutaneous Ulcers
Official Journal of the Italian Association for Cutaneous Ulcers
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Acta Vulnologica 2014 December;12(4):165-75
language: English, Italian
Infections and pressure sores
Brenta F. 1, Vischio M. 2, Scalise A. 3, Jaber O. 1, Scevola D. 4, Nicoletti G. 2, 5
1 School of Specialization in Plastic Reconstructive Esthetic Surgery, Department of Clinical Surgical Sciences, University of Pavia, Pavia, Italia;
2 Unit of Plastic Reconstructive Surgery, Department of Clinical Surgical Sciences, University of Pavia, Pavia, Italia;
3 Clinic of Plastic Reconstructive Surgery, Università Politecnica delle Marche, Ancona, Italy;
4 Unit of Infective Diseases, Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy;
5 Unit of Plastic Surgery, IRCCS Salvatore Maugeri, Pavia, Italy
AIM: The aim of this study was the identification of bacterial populations in pressure sores treated at the Plastic and Reconstructive Surgery Unit of the University of Pavia, Salvatore Maugeri Research and Care Institute between 2001 and 2013 and correlation with the clinical course.
METHODS: Analysis of the bacterial cultures from 126 wound swabs, 14 tissue biopsies and 23 blood cultures in 56 patients suffering from 69 pressure sores.
RESULTS: The most frequently isolated bacteria were bowel derived or nosocomial. The Gram-positive/Gram-negative ratio demonstrated a progressive trend with increase of the Gram-positive populations moving from the wound swabs, to the wound tissue biopsies to the blood stream. Only 15% of the positive blood stream cultures matched the wound cultures, although they were sharing the same bacterial populations (Staphylococcus haemoliticus, MRSA and Proteus mirabilis). No deaths were directly related to wound infection although it complicated the clinical course. Administration of just 7 traditional antibiotic families allowed the infection control. Nevertheless infection per se did not contraindicate both surgical debridement and tissue transfer reconstruction.
CONCLUSION: The severity of a pressure sore infection should not be considered the cause of deterioration in patients’ general conditions but a predictive sign of an unfavorable clinical evolution. Local infection in a pressure sore does not contraindicate reconstructive surgery.