Chronic Wound Infection: Bacterial Colonization in the Dermal Pericolostomic Region

  • 3/31/2008
  • 0 Comments
  • 6320 reads
Author(s): 
Valdemir Salles, MD;1 Sarhan Saad, MD, PhD;2 Delcio Matos, MD, PhD2

Results

Of the 34 participants, 20 (58.8%) were male and 14 (41.2%) were female. The average age was 51.6 years (range 16–84 years). Using the surgical risk evaluation adopted by the American Society of Anesthesiology, 25 patients (73.5%) were class 1 and 9 (26.5%), class 2.

Among the participants, 16 (47.0%) had a colostomy due to malignant colorectal disease, 13 (81.3%) were classified in stage B2, and 3 (18.7%) in stage B1.

The most frequently cultured bacteria were Escherichia coli (31 of 34 patients, 91.2%). Also noted were Bacteroides spp (13/34, 38.2%), and Peptococcus spp (13/34, 38.2%), Klebsiella spp (11/34, 32.4%), and Bacteroides fragilis (10/34, 29.4% [Table 1]). When bacterial species were compared with consideration to length of time with a colostomy, researchers noted that Escherichia coli was present in all groups, while Bacteroides fragilis and Klebsiella spp were not found. Peptococcus spp increased in the period beyond 20 weeks (Table 2).


According to Fisher’s Exact Test and linear-by-linear association, Bacteroides fragilis (P = 0.021) and Klebsiella spp (P = 0.003) were not found in the > 20-week group, a statistically significant finding. It was observed that Peptococcus spp (P = 0.068) was increasingly present in the > 20-week group; Escherichia coli presence was statistically significant (P < 0.001).

References: 

1. Londono-Schimmer EE, Leong APK, Phillips RKS. Life table analysis of stomal complications following colostomy. Dis Colon Rectum. 1994;37(9):916–920.
2. Park JJ, Del Pino A, Orsay CP, et al. Stoma complications: the Cook County hospital experience. Dis Colon Rectum. 1999;42(12):1575–1580.
3. Leenen LPH, Kuypers JHC. Some factors influencing the outcome of stoma surgery. Dis Colon Rectum. 1989;32(6):500–504.
4. Hoffman MS, Barton DP, Gates J, et al. Complications of colostomy performed on gynecologic cancer patients. Gynecol Oncol. 1992;44(3):231–234.
5. Pearl RK, Prasad ML, Orsay CP, Abcarian H, Tan AB, Melzl MT. Early local complications from intestinal stomas. Arch Surg. 1985;120(10):1145–1147.
6. Bouillot JL, Aouad K. Traitement chirurgical des complications des colostomies. In: Encyclopedie Médical-Chirurgicale. Techniques Chirurgicales—Appareil Digestif. Paris, France: Scientifiques et Médicales Elsevier; 2002.
7. Burton RC. Postoperative wound infection in colonic and rectal surgery. Br J Surg. 1973;60(5):363–365.
8. Bartlett SP, Burton RC. Effects of prophylactic antibiotics on wound infection after elective colon and rectal surgery. Am J Surg. 1983;145(2):300–309.
9. Simon GL, Gorbach SL. The human intestinal microflora. Dig Dis Sci. 1986;31(9 Suppl):147S–162S.
10. Stoutenbeek CP, van Saene HKF, Miranda DR, Zandstra DF. The effect of selective decontamination of the digestive tract on colonisation and infection rate in multiple trauma patients. Intensive Care Med. 1984;10(4):185–192.
11. Robson MC. Disturbances of wound healing. Ann Emerg Med. 1988;17(12):1274–1278.

image description image description 





  


  
Post new comment


  



 
 




 
 




 
 



  • Lines and paragraphs break automatically.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Use  to create page breaks.
More information about formatting options





Image CAPTCHA

 
 
 
Enter the characters shown in the image.