The results of monitoring the dynamics and antibiotic resistance of microflora when performing split-skin grafting in a general surgical hospital

Abstract

Relevance. One of the effective ways to close chronic wounds according to many authors is split-skin grafting. To obtain good results of plastic operations, a constant monitoring of the structure of microbiological associations of chronic wounds and their sensitivity to antimicrobial agents is necessary.
 Aim. Analysis of the structure and properties of pathogens of wound infections when performing split-skin grafting and optimizing the choice of drugs for starting empirical antibacterial therapy.
 Materials and methods. A retrospective analysis of the results of microbiological studies was conducted in 86 patients who underwent split-skin grafting. For statistical processing of the data obtained, the computer program Statistica 6.0 was used.
 Results. Microbial contamination in patients on admission to hospital was (Me [Q1; Q3]) 106 [102; 108] CFU/ml. Unsatisfactory results of split-skin grafting were noted in 15 patients (17%). In this group of patients, strains of non-fermenting gram-negative bacteria - Pseudomonas aeruginosa (in 6 cases) and Acinetobacter baumannii (in 4 cases), which retained sensitivity to carbapenems in 65% of cases, were most often detected.
 Conclusions. Non-fermenting gram-negative microorganisms sharply reduce the likelihood of good results of plastic operations. If found in the recipient wound after split-skin grafting signs of an infectious process, it is advisable to use carbapenems.