Analysis of the bacteria spectrum and clinical treatment of topical skin infection during soft tissue expander implantation

Abstract

To analyze the identification and antibiotics susceptibility of infectious bacteria obtained from the topic skin infection during soft tissue expander implantation. A retrospective analysis of 121 cases with local infections during soft tissue expander implantation between 2003 to 2012 in Department of Plastic and Reconstructive Surgery, Xijing Hospital was performed. The efficacy of clinical management of local infection was evaluated. Laboratory examination on exudates bacterial pathogen and antibiotic susceptibility were performed. . Based on the severity of wound infection, change of dressings, wound debridement, exudates drainage and intravenous antibiotics administration were applied. All infections were successfully controlled although the expanders were removed in 16 cases with severe infections. Total success rate of expansion in this cohort was 89.33％.Twenty-nine exudates samples collected from either skin rupture wounds or skin outlets of connector tubes of externally placed infusion ports in 29 patients underwent bacterial culture and antibiotic susceptibility test. The 23 samples showed positive while the rest 6 samples showed negative on bacterial identification in the bacterial culture test.Staphylococcus aureus strain was found in 20 samples (86.96％),Staphylococcus epidermidis in 1 sample, Klinefelter Citrobacter in 1 sample, and Aeromonas hydrophila in 1 sample. More than 80％ of the pathogens were susceptive to cefazolin, oxacillin, and levofloxacin. Staphylococcus aureus is the main pathogen of infection at expander implantation site. The local dressing change,surgical debridement, continuous infusion drainage, and the use intravenous antibiotics are the effective managements