Infection of surgical wounds in the maxillofacial region and free flap donor sites with methicillin-resistant Staphylococcus aureus

Avery, C.M.E.; Ameerally, Philip; Castling, B.; Swann, R. A.

doi:10.1016/j.bjoms.2005.05.020

Cited by 32 publications

(26 citation statements)

References 24 publications

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“…Pseudomonas aeruginosa was the most commonly isolated pathogens from theatre and on the ward while Staphylococcus aureus, E. coli and coagulase negative Staphylococcus were commonly isolated from patients recovering in the wards. Patients who were septic before coming to hospital had more complications from infection as observed in this study, also in similar studies (Avery et al, 2006;Isibor et al, 2008). Isolates from pus obtained during surgery were mainly Enterobacter sp and Pseudomonas sp.…”

Section: Discussionsupporting

confidence: 76%

Detecting Nosocomial Intrinsic Infections through Relating Bacterial Pathogens of Incision

Niemogha¹,

Atoyebi²,

Ogunsola³

et al. 2011

Sierra Leone j. biomed. res.

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Surgical procedures often lead to both intrinsic and extrinsic infections. In order to improve on recovery of patients, investigations were carried out on samples collected from patients during and after surgery. Laboratory analysis was performed on wound swabs from incision, colon segments, scrapes, tissues, pus and catheter specimen urine. The samples were cultured on MacConkey and Blood agar and incubated aerobically at 37 0 C for 16-24 hours. Thereafter, isolates were identified using standard microbiological methods. Results showed that isolates from wound were also found on endogenous indicators of surgery. Klebsiella species from incision was 15 (18.75%) while those from colon segment was 30(37.6%), scrapes 8(16%) and pus 3(7.5%). Acinetobacter species found on incision was 15(7.5%) and pus 7(2.3%). Pseudomonas species was distributed on incision 5(2.5%), colon segment 4(5%), tissue 3(1.6%), scrapes 5(10%) and pus was 5(12.5%). Staphylococcus aureus which was isolated from incision was 2(1%), while scrapes and pus were 5(10%) and 7(17.5%) respectively. Catheter associated urinary tract infections yielded significant bacteriuria (64.7%), almost twice the rate of non-significant bacteriuria (35.3%); indicating the need to remove all catheters as soon as possible. Antibiogram of isolates of Klebsiella pneumoniae with resistance pattern: ApGnNaNt, Escherichia coli (ApCtNaTtCm) and S. aureus (ApChCxErPn) with plasmid sizes in the range (30.2-52.51Kb) were common to both indicators and wound, showing that the pathogens were the same clusters. This study demonstrated surgical procedures as precursory to intrinsic infections and that bacterial pathogens found on wounds and endogenous indicators of surgery are links to intrinsic infection. The study therefore emphasizes the need to culture wounds promptly to effect speedy recovery of patients who have undergone surgery.

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Section: Discussionsupporting

confidence: 76%

Detecting Nosocomial Intrinsic Infections through Relating Bacterial Pathogens of Incision

Niemogha¹,

Atoyebi²,

Ogunsola³

et al. 2011

Sierra Leone j. biomed. res.

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“…Published data regarding the effectiveness of prophylactic antibiotics in the surgical treatment of maxillofacial fractures is scarce, and the level of evidence is low (Martin et al, 2003;Andreasen et al, 2006). In our series 97% (75/77) of patients who received implants also received antibiotic prophylaxis, of which, one patient went on to (Avery et al, 2006). In our series, 74% (99/134) of patients received perioperative antibiotics, and of those, 13% (13/99) received a prolonged course Tables 2 and 3.…”

Section: Discussionmentioning

confidence: 82%

Outcomes of prophylactic antibiotics following surgery for zygomatic bone fractures

Knepil

Loukota

2010

Journal of Cranio-Maxillofacial Surgery

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“…The duration of hospital admission with the PPM flap and free tissue transfer are similar. The long mean duration of admission and high incidence of reoperation reported by O'Neill et al (Ireland) 16 with the radial (34.3 days) and PPM flap (29.6 days) are unusually prolonged compared with other recent reports (radial 18-24 days and PPM flap 23-25 days) 15,25,45 and the Leicester experience (free tissue 20 days and PPM flap 21 days) 51 . Shorter admissions with the PPM flap have been described (9 and 10 days) 30,34,52 and duration varies with procedure (7.5 days primary reconstruction and 20 days salvage reconstruction) 36 .…”

Section: Advantagesmentioning

confidence: 76%

“…Conservative wound care procedures are common (10-50%) 16,33,34,38,60 but major secondary surgery infrequent (2-5%) 4,28,34,35,38,69 . In the Leicester study, a reduction in complications coincided with a reduced incidence of methicillin-resistant Staphylococcus aureus 38,51 and possibly increasing surgical experience 48,60 . Donor site complications are usually minor and occur in 4-6% 28,35,76 .…”

Section: Complicationsmentioning

confidence: 99%

A perspective on the role of the pectoralis major flap in oral and maxillofacial oncology surgery

Avery

2014

Oral Surgery

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In general, the pedicled pectoralis major (PPM) flap has become a secondary choice for reconstruction in the developed world while remaining popular within the developing world. The pectoralis major flap is utilised in varying proportions as either the preferred reconstruction or for salvage reconstruction following free flap failure, further disease or complications. Refinements in surgical technique and an experienced surgeon may yield high total flap success rates with modest levels of wound complications. The pectoralis major flap is particularly useful with serious or multiple comorbidities, advanced disease, and previous surgery and/or chemoradiotherapy. It has primarily been used for reconstruction of extended radical neck dissection, posterolateral mandible, large glossectomy and oropharyngeal defects, and occasionally together with a free flap. A second free flap has increasingly been used after initial failure, particularly in the larger centres, but the PPM flap probably remains the most commonly used salvage option. The needs of the local population vary, survival outcomes are improving and patient choice may become an increasing factor in flap selection.

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Infection of surgical wounds in the maxillofacial region and free flap donor sites with methicillin-resistant Staphylococcus aureus

Cited by 32 publications

References 24 publications

Detecting Nosocomial Intrinsic Infections through Relating Bacterial Pathogens of Incision

Detecting Nosocomial Intrinsic Infections through Relating Bacterial Pathogens of Incision

Outcomes of prophylactic antibiotics following surgery for zygomatic bone fractures

A perspective on the role of the pectoralis major flap in oral and maxillofacial oncology surgery

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