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[Leech-borne infection on a TRAM flap: a case report]
L Bourdais1, J-L Heusse, S Aillet
1Service de Chirurgie Plastique, CHU de Rennes, Hôpital Sud, 16 Boulevard Bulgarie, 35203 Rennes Cedex 2, France. bourdaisludovic@aol.com
Summary
Leeches can cause delayed Aeromonas hydrophila infections after flap surgery, potentially leading to flap loss. Prophylactic antibiotics are recommended until wound closure to prevent these serious leech-borne infections.
Area of Science:
- Medical Microbiology
- Plastic and Reconstructive Surgery
- Infectious Diseases
Background:
- Leeches are utilized globally for managing venous congestion in reconstructive surgery, particularly with tissue flaps.
- Aeromonas hydrophila infections represent a known complication associated with the use of medicinal leeches.
Observation:
- A case of delayed infection by Aeromonas hydrophila occurred in a patient undergoing mammary reconstruction using a Transverse Rectus Abdominis Myocutaneous (TRAM) flap.
- This infection, stemming from leech use, resulted in the complete loss of the TRAM flap.
Findings:
- The study highlights a case of delayed leech-borne Aeromonas hydrophila infection following TRAM flap surgery.
- The infection led to the critical complication of flap loss, underscoring the potential severity of these infections.
Implications:
- Prophylactic antibiotic administration, such as third-generation cephalosporins or ciprofloxacin, is crucial for preventing Aeromonas hydrophila infections.
- Antibiotic prophylaxis should be continued until the venous congested tissue achieves complete wound closure to mitigate infection risk.
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