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Patterns of microbiology in intra-abdominal packing for trauma

Thomas S Granchi1, John A Abikhaled, Asher Hirshberg

  • 1Michael E DeBakey Department of Surgery, Baylor College of Medicine and Ben Taub General Hospital, Houston, TX 77030, USA.

The Journal of Trauma
|January 30, 2004
PubMed
Abstract

Insights

Intra-abdominal packs in trauma patients are often contaminated with skin and gut bacteria, but these contaminants do not lead to subsequent infections or increased mortality. Infection causes in trauma intensive care units are typical.

Area of Science:

  • Trauma Surgery
  • Infectious Disease Microbiology

Background:

  • Damage-control surgery frequently involves the use of intra-abdominal packing.
  • The role of microbial contamination of these packs in post-operative infections remains unclear.

Purpose of the Study:

  • To investigate the microbiology of abdominal packs used in damage-control trauma surgery.
  • To determine if pack contamination correlates with the development of intra-abdominal infections.

Main Methods:

  • Culturing of abdominal packs and peritoneal fluid from trauma patients who survived to re-operation.
  • Recording of positive cultures, pack counts, duration of packing, number of operations, and infection status.

Main Results:

  • Of 35 patients studied, 28 survived. Pack cultures were positive in 20 of 29 patients, growing common skin and gut flora.
  • Twenty-one patients developed infections; however, organisms from positive pack cultures did not contribute to these infections or mortality.
  • Infection sites and microbial profiles were consistent with those typically seen in surgical intensive care unit (SICU) patients.

Conclusions:

  • Intra-abdominal packs are frequently contaminated with commensal flora from the skin and gut.
  • This contamination does not appear to be a significant factor in the development of subsequent infections or patient mortality.
  • Infections observed in these trauma patients are caused by pathogens typical for the intensive care unit (ICU) environment.

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