• Title/Summary/Keyword: Infected wound

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A Case of Subcutaneous Salmonella Abscess Developed on Gunshot Wound Area In Lung Cancer Patient (폐암환자의 총상부위에 발생한 피하조직 살모넬라 농양 1예)

  • Kim, Sun-Hoo;Jeong, Seok;Park, Gi-Soo;Lee, Ki-Hoon;Kwak, Seung-Min;Cho, Chul-Ho;Kim, Jin-Ju
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.777-780
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    • 1995
  • Salmonellosis is one of communicable disease and still occur in sporadic in Korea frequently. They are four main clinical manifestations in salmonellosis. They are gastrocnteritis, typhoidal or septisemia syndrome, focal manifestation and carrier state. Among them, focal manifestation is rarely seen. Saphra, et al. reported that localized salmonella infection is about 5%. Localized salmonella infection frequently occur during salmonella bacteremia, but may also occur with enteric fever or gastroenteritis. Gray, et al reported 3390 cases of minor gunshot wound infection that bacterial isolates from infected wounds consisted of Staphylococcus aureus(90%), Streptococcus sp.(6%), and mixed organisms(4%). Incresed host susceptibility to infection secondary to lowered resistance due to debilitating disease is an important determinant of Salmonella infection. Since salmonella is seldom suspected as a cause of soft tissue infections, there is usually a dangerous delay in the institution of appropriate antimicrobial therapy and isolation procedure. We experienced one case of subcutaneous salmonella abscess developed on gunshot wound area in lung cancer patient, which was confirmed by pus culture.

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Staged reconstruction of a chronically infected large skull defect using free tissue transfer and a patient-specific polyetheretherketone implant

  • Moon, Seung Jin;Jeon, Hong Bae;Kim, Eui Hyun;Lew, Dae Hyun;Kim, Yong Oock;Hong, Jong Won
    • Archives of Craniofacial Surgery
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    • v.21 no.5
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    • pp.309-314
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    • 2020
  • Reconstructions of extensive composite scalp and cranial defects are challenging due to high incidence of postoperative infection and reconstruction failure. In such cases, cranial reconstruction and vascularized soft tissue coverage are required. However, optimal reconstruction timing and material for cranioplasty are not yet determined. Herein, we present a large skull defect with a chronically infected wound that was not improved by repeated debridement and antibiotic treatment for 3 months. It was successfully treated with anterolateral thigh (ALT) free flap transfer for wound salvage and delayed cranioplasty with a patient-specific polyetheretherketone implant. To reduce infection risk, we performed the cranioplasty 1 year after the infection had resolved. In the meantime, depression of ALT flap at the skull defect site was observed, and the midline shift to the contralateral side was reported in a brain computed tomography (CT) scan, but no evidence of neurologic deterioration was found. After the surgery, sufficient cerebral expansion without noticeable dead-space was confirmed in a follow-up CT scan, and there was no complication over the 1-year follow-up period.

THE EFFICACY OF PROPHYLACTIC ANTIBIOTICS FOR MANDIBULAR THIRD MOLAR EXTRACTION (하악 제3대구치 발치를 위한 예방적 항생제의 효용성)

  • Kang, Sang-Hoon;Kim, Jung-In;Park, Won-Se;Yi, Choong-Kook;Lee, Sang-Hwy
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.365-369
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    • 2008
  • This study analyzed the incidence of wound infection after the operation of mandibular third molar extraction in relation with antibiotic prophylaxis with the object of young and healthy patients. The study object was 1,177 mandibular third molars of 850 men of 20 to 25 years old without any specific systemic disease. Three methods of preventive antibiotic medication were selected according to the preventive antibiotic medication previously reported; three experimental groups were selected based on them, and the antibiotic used was amoxicillin($^{(R)}Kymoxin$, Yuhanyanghaeng, Seoul). The group 1 includes the patients that took the antibiotic orally before the operation(one hour earlier, 500mg) and for three days after the operation(250mg per time, three times/day), the group 2 is the ones that took the same antibiotic orally only once about one hour before the operation(500mg), and the group 3 did not take any antibiotics before and after the operation. And to compare the difficulties and the degrees of extraction during operations which can be possibly related to the wound infection after the operations, the mandibular third molars' impacted depths and extraction methods were investigated as well. To check if the wound was infected, observations with an internal of one week were performed twice after the operation, and the meaningfulness of the infection incidence was verified through Chi-square test using SPSS program(SPSS Inc., IL, USA). There was no statistically significant difference between the antibiotic medication methods and the wound infection incidence after the operation among the experimental groups. As examining the relations between the mandibular third molar operation methods and the wound infection incidence after the operation, there existed a statistically meaningful difference in the infection incidence according to the operation methods(p=0.020). And there was no statistically significant difference in the wound infection incidence according to the impacted depth of the mandibular third molar. Therefore, it is thought that there exists little necessity of prophylatic antibiotics medication when extracting the mandibular third molar of young and healthy men without any systemic disease in general; however, in case when it is expected that the possibility of infection will be high or the wound on the tissue will be severe, it is sure that the prophylactic antibiotics medication will be necessary.

Corelation between the Treatment Result and Causative Bacteria in Amputation of Diabetic Foot (당뇨발 절단에 있어 원인 감염균과 치료 결과와의 관계)

  • Lee, Myoung Jin;Lee, Kyu Yeol;Kim, Sung Soo;Kim, Chul Hong;Wang, Lih;Kim, Hyeon Jun;Kim, Ki Woong
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.3
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    • pp.209-214
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    • 2013
  • Purpose: To evaluate correlation between the clinical results and causative bacteria in diabetic foot patients with lower extremity amputation. Materials and Methods: One hundred twenty nine patients(131 feet) of diabetic foot amputations were followed for more than one year. Wound cultures were done by deep tissue or bone debris at first visit to our clinics. Retrospective analysis was performed using chart review and interview with the patients. Depending on the culture result, level of amputation, reinfection, duration of treatment, death rate, patient satisfaction and admission dates were evaluated. Results: Microorganisms were confirmed in 114 cases. In the other 17 cases, there were no cultured microorganisms. In bacterial growth group, Methicillin-sensitive Staphylococcus aureus was the most common pathogen and accounted for 34 cases. As other common pathogens, there were Methicillin-resistant Staphylococcus aureus(24 cases) and mixed infection(14 cases). Mortality is no difference in each infected group. Mixed bacterial infected patients have higher reinfection, longer hospital day and duration of treatment, but there is no difference in patients satisfaction and pain at last follow up. Conclusion: The most common pathogen in diabetic foot patients with lower extremity amputation was Methicillin-sensitive Staphylococcus aureus, and mixed bacterial infected patients have higher reinfection rate, longer admission date and duration of treatment than other bacterial infected patients.

Sustained release of alginate hydrogel containing antimicrobial peptide Chol-37(F34-R) in vitro and its effect on wound healing in murine model of Pseudomonas aeruginosa infection

  • Shuaibing Shi;Hefan Dong;Xiaoyou Chen;Siqi Xu;Yue Song;Meiting Li;Zhiling Yan ;Xiaoli Wang ;Mingfu Niu ;Min Zhang;Chengshui Liao
    • Journal of Veterinary Science
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    • v.24 no.3
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    • pp.44.1-44.17
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    • 2023
  • Background: Antibiotic resistance is a significant public health concern around the globe. Antimicrobial peptides exhibit broad-spectrum and efficient antibacterial activity with an added advantage of low drug resistance. The higher water content and 3D network structure of the hydrogels are beneficial for maintaining antimicrobial peptide activity and help to prevent degradation. The antimicrobial peptide released from hydrogels also hasten the local wound healing by promoting epithelial tissue regeneration and granulation tissue formation. Objective: This study aimed at developing sodium alginate based hydrogel loaded with a novel antimicrobial peptide Chol-37(F34-R) and to investigate the characteristics in vitro and in vivo as an alternative antibacterial wound dressing to treat infectious wounds. Methods: Hydrogels were developed and optimized by varying the concentrations of crosslinkers and subjected to various characterization tests like cross-sectional morphology, swelling index, percent water contents, water retention ratio, drug release and antibacterial activity in vitro, and Pseudomonas aeruginosa infected wound mice model in vivo. Results: The results indicated that the hydrogel C proved superior in terms of cross-sectional morphology having uniformly sized interconnected pores, a good swelling index, with the capacity to retain a higher quantity of water. Furthermore, the optimized hydrogel has been found to exert a significant antimicrobial activity against bacteria and was also found to prevent bacterial infiltration into the wound site due to forming an impermeable barrier between the wound bed and external environment. The optimized hydrogel was found to significantly hasten skin regeneration in animal models when compared to other treatments in addition to strong inhibitory effect on the release of pro-inflammatory cytokines (interleukin-1β and tumor necrosis factor-α). Conclusions: Our results suggest that sodium alginate -based hydrogels loaded with Chol-37(F34-R) hold the potential to be used as an alternative to conventional antibiotics in treating infectious skin wounds.

Measures to Reduce Aeromonas Hydrophila Infection that May Occur after Leech Apllication (거머리 사용후 발생할수 있는 Aeromonas hydrophila 감염을 줄이기 위한 대책)

  • Yun, Hyo-Heon;Jeong, Doo-Seong;Choe, Joon
    • Archives of Reconstructive Microsurgery
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    • v.11 no.1
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    • pp.73-77
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    • 2002
  • Medical application of leeches, by means of leech's blood suction, has advantages in not only directly removing blood congestion, but also preventing hindrance to venous drainage by inhibiting local thrombus formation and inducing continuous bleeding. Nevertheless, Aeromonas hydrophila infection secondary to such suction is most common and may develop into serious conditions from local inflammatory reaction to total necrosis of replanted parts and enterocolitis as well as sepsis. Once infected, it requires infection treatment, removal of necrotic tissues and reconstruction. Hence, duration and cost of treatment increase while functional recovery falls markedly. Accordingly, we present measures to reduce Aeromonas infections as follows: First, do not manipulate as much as possible while the leeches are sucking or moving. Second, the site which suction plates of the leeches are attached, should be selected away from the surgical wound site or open wound as much as possible. Third, contaminated or blood-wet gauze should be replaced often so that the skin of surgical areas would not swell. Furthermore, bleeding or oozing should be well-drained. Fourth, the areas other than the sites of leech attachment should be covered with sterilized gauzes in order to limit leech movement.

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Linezolid Treatment for Osteomyelitis due to Staphylococcus Epidermidis with Reduced Vancomycin Susceptibility

  • Nam, Joon-Rok;Kim, Myoung-Soo;Lee, Chae-Heuck;Whang, Dong-Hee
    • Journal of Korean Neurosurgical Society
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    • v.43 no.6
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    • pp.307-310
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    • 2008
  • Limited therapeutic options are available for vancomycin intermediate-resistant Staphylococcus epidermidis (VISE) infections and no optimum therapy has been established. We report a case of VISE skull osteomyelitis that was successfully treated with linezolid. The patient was a 53-year-old man who presented with headache, nausea and dysphasia. Brain computerized tomography (CT) demonstrated a subdural hematoma in the left hemisphere. Craniotomy and hematoma evacuation was performed and he showed good recovery despite a scalp wound infection caused by methicillin-resistant Staphylococcus aureus (MRSA). The organism isolated from the scalp wound was sensitive to vancomycin. The patient was treated with intravenous vancomycin for 44 days. However, he showed a high fever, persistent positive methicillin-resistant Staphylococcus epidermidis (MRSE) blood cultures, and a deteriorating clinical status. He underwent infected skull bone flap removal and linezolid treatment for 35 days. During one year of follow up, he has not had any further episodes of osteomyelitis or fever. Linezolid has shown to be effective agent to eradiate osteomyelitis caused by VISE.

Histological and Cytological Changes Associated with Susceptible and Resistant Responses of Chili Pepper Root and Stem to Phytophthora capsici Infection

  • Kim, Sang-Gyu;Kim, Young-Ho
    • The Plant Pathology Journal
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    • v.25 no.2
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    • pp.113-120
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    • 2009
  • Microscopic study of chili pepper (Capsicum annuum L.) infected with Phytophthora capsici, causing Phytophthora blight of chili pepper, was conducted to compare histological and cytological characteristics in the root and stem of susceptible (C. annuum cv. Bugang) and resistant (C. annuum cv. CM334) pepper cultivars. The susceptible pepper roots and stems were extensively penetrated and invaded by the pathogen initially into epidermal cells and later cortical and vascular cells. Host cell walls adjacent to and invaded by the infecting hyphae were partially dissolved and structurally loosened with fine fibrillar materials probably by cell wall-degrading enzymes of the pathogen. In the resistant pepper, the pathogen remained on root epidermal surface at one day after inoculation, embedded and captured in root exudation materials composed of proteins and polysaccharides. Also the pathogen appeared to be blocked in its progression at the early infection stages by thickened middle lamellae. At 3 days after inoculation, the oomycete hyphae were still confined to epidermal cells of the root and at most outer peripheral cortical cells of the stem, resulting from their invasion blocked by wound periderms formed underneath the infection sites and/or cell wall appositions bounding the hyphal protrusions. All of these aspects suggest that limitation of disease development in the resistant pepper may be due to the inhibition of the pathogen penetration, infection, invasion, and colonization by the defense structures such as root exudation materials, thickened middle lamellae, wound peridems and cell wall appositions.

Inhibition of Bacterial Growth with Silver Wire Iontophoresis (은 이온도입이 세균성장에 미치는 영향)

  • Lee Jae-Hyoung;Kim Joo-Young;Jekal Seung-Joo
    • The Journal of Korean Physical Therapy
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    • v.7 no.1
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    • pp.61-67
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    • 1995
  • The silver cation has broad-spectrum antibiotic activity toward Gram-positive, Gram-negative, fungal. aerobic and anerobic micro-organisms. Silver has been used to care of infected wound. pyogenic arthritis, and chronic osteomyelitis. The purpose of this study was to determine whether pure silver wire iontophoresis using milliamperage direct current has an inhibitory effect on growth in vitro of 3 different species of bacteria-Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Using agarose based media, silver iontophoresis performed at 0, 1, 2, 4, 8 mA for 15 minutes. All experiments were performed in triplicate. Following iontophoresis, inhibition zone width of bacterial growth was measured with calliper. The inhibition of bacterial growth occured at the anodal silver electrode. Inhibition zone width of bacterial growth was significantly increased in all three bacterial species (p<0.05). Between bacterial species, inhibition zone width was not significantly different. Inhibition gone and amperage showed a highly significant positive linear relationship (p<0.001). The result of this study showed that pure silver wire iontophoresis with milliamperage direct current, as well as microamperage direct current, can inhibit bacterial growth in vivo.

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Scalp Reconstruction and Cranioplasty using the Latissimus Dorsi Musculocutaneous Flap in a Patient with Recurrent Wound Dehiscence Accompanied by MRSA Infection (광배근 근피판을 통한 두피 재건 및 두개골성형)

  • Yoon, Taekeun;Kim, Sang Wha
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.1
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    • pp.59-63
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    • 2022
  • The latissimus dorsi flap has high vascularity and is helpful for the reconstruction of infected areas. Herein, we present a patient with recurrent infections and soft-tissue defects who underwent cranial reconstruction using a free latissimus dorsi flap. The patient had undergone craniectomy and reconstruction using alloplastic bone 18 years previously. A scalp defect accompanied by infection occurred five years ago, and patient underwent reconstruction using a free flap at another hospital; however, the problem persisted. After debridement and bone flap removal, the right latissimus dorsi musculocutaneous flap was elevated, and the thoracodorsal artery and vein were anastomosed end-to-end to the right superficial temporal artery and vein. Methicillin-resistant Staphylococcus aureus was eradicated, and the flap survived. Cranioplasty was performed eight months later, and one year follow-up proceeded without complications. Effective reconstruction and cranioplasty are possible using the free latissimus dorsi musculocutaneous flap, even on scalp with persistent infections and soft-tissue defects.