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Antimicrobial Characterization of Advanced Materials for Bioengineering Applications
Published on: August 4, 2018
Microbiological Profiles of Surgical Pad Cultures in Damage Control Surgery: Clinical Implications and Predictive
Hyunseok Jang1, Younggoun Jo1, Yunchul Park1
1Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
Purpose:
This study aimed to investigate the microbiological profiles of surgical pad cultures in patients undergoing damage control surgery (DCS) for abdominal trauma and to assess their association with clinical outcomes.
Patients And Methods:
A retrospective observational study was conducted on 122 patients who underwent DCS at a regional trauma center between January 2012 and December 2021. Patients were grouped according to the presence or absence of positive pad culture results. Microbiological data from surgical pad, abdominal, and wound cultures were analyzed. Clinical characteristics and postoperative infectious complications were compared between groups. Multi-variable logistic regression was performed to identify factors associated with infectious complications.
Results:
Pad cultures were positive in 71 patients (58.2%). The microbial distribution differed between sites: Staphylococcus epidermidis (20.3%) predominated in wound cultures, while Enterococcus faecalis was significantly more prevalent in abdominal cultures (20.0% vs. 4.3%, p = 0.006). Culture-positive patients had significantly higher rates of surgical site infection (42.1% vs. 20.2%, p = 0.018), intra-abdominal abscess (18.4% vs. 8.9%, p = 0.042), and pneumonia (15.2% vs. 7.8%, p = 0.038). In multi-variable analysis, positive pad culture (odds ratio [OR]: 3.49, 95% confidence interval [CI]: 1.52-8.01, p = 0.003) and red blood cell (RBC) transfusion ≥10 units (OR: 4.29, 95% CI: 1.89-9.74, p < 0.001) were independently associated with infectious complications. Culture positivity was not associated with mortality (p = 0.982).
Conclusion:
Surgical pad cultures obtained during DCS provide independent infection risk stratification beyond clinical and injury parameters. Positive cultures predict infectious complications but not mortality, suggesting specific utility for infection surveillance. Microbiological profiles differ by anatomical site, supporting site-specific antimicrobial approaches. These findings suggest potential utility of routine pad culture collection in DCS patients.
Insights
Surgical pad cultures in damage control surgery (DCS) predict infectious complications but not mortality. Positive pad cultures identify patients at higher risk for surgical site infections and abscesses, aiding infection surveillance.
Area of Science:
- Trauma Surgery
- Infectious Diseases
- Microbiology
Background:
- Damage control surgery (DCS) is critical for managing abdominal trauma.
- Identifying infection risk in DCS patients is essential for improving outcomes.
- Microbiological surveillance aids in targeted treatment and infection prevention.
Purpose of the Study:
- To investigate the microbiological profiles of surgical pad cultures in patients undergoing DCS.
- To assess the association between positive pad cultures and clinical outcomes, including infectious complications and mortality.
- To determine the utility of pad cultures for infection risk stratification in this patient population.
Main Methods:
- A retrospective observational study of 122 patients undergoing DCS for abdominal trauma.
- Analysis of microbiological data from surgical pad, abdominal, and wound cultures.
- Comparison of clinical characteristics and postoperative infectious complications between culture-positive and culture-negative groups.
- Multivariable logistic regression to identify independent predictors of infectious complications.
Main Results:
- Pad cultures were positive in 58.2% of patients.
- Positive pad cultures were significantly associated with higher rates of surgical site infection, intra-abdominal abscess, and pneumonia.
- Positive pad culture (OR: 3.49) and high RBC transfusion volume (OR: 4.29) were independent predictors of infectious complications.
- Culture positivity was not associated with mortality (p = 0.982).
Conclusions:
- Surgical pad cultures obtained during DCS offer independent infection risk stratification.
- Positive pad cultures predict infectious complications, supporting their use in infection surveillance.
- Microbiological profiles vary by anatomical site, suggesting the need for site-specific antimicrobial strategies.
- Routine pad culture collection may be beneficial for patients undergoing DCS.
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