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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

Annales De Chirurgie Plastique Et Esthetique
|August 14, 2009
PubMed

Insights

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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