Wound cultures as predictors of complications in reconstructive flap procedures

Cultures were acquired from 125 cases of flap reconstruction. Specimens were collected from the wound beds at the time of wound closure. Fifty-one cases (41%) had negative cultures and 74 (59%) had positive cultures. The positive culture patients had a higher complication rate than the negative culture patients (49% vs. 7.8%, p <.004). Patients with positive cultures coincidentally receiving effective antibiotics relative to their wound cultures had a complication rate statistically comparable to negative culture patients. These findings suggest that wound bed cultures could be incorporated into operative sequence strategies, wound management outcome assessments, and surveillance analyses that could provide guidelines for perioperative antibiotics administration.