Infectious complications in GSWs through the gastrointestinal tract into the spine
Injury, 06/26/2012

Rabinowitz RP et al. – Despite the potential for significant deep infections of the spine, standard antimicrobial prophylaxis is sufficient for the initial management of these patients.

• The authors retrospectively analysed all patients with penetrating trauma through the GI tract into the spine admitted to a level I trauma centre from 1/02 to 12/09.
• Patients were excluded if they died within 24h.
• Patients received 24–48h of peri–operative prophylactic antibiotics, except in damage control where antibiotics were continued until packs were removed.

• 51 patients were included. 94% were male with a mean age of 27years.
• The mean ISS was 28 (9–50).
• The mean length of stay was 19 days (3–53) and mortality was 9.8%.
• The mean follow up period was 277 days (0–1765).
• There were 12 gastric, 25 small bowel, 26 colonic, and 4 esophageal injuries.
• There were 48 exploratory laparotomies, of which 12 were damage control procedures.
• 18 patients had no infections.
• There were 20 abdominal infections and 7 surgical wound infections.
• There were 23 infections not related to the abdomen.
• One patient developed a CNS infection 4 days after discharge despite receiving a two week course of piperacillin/tazobactam for Escherichia coli bacteremia during his initial hospital stay.
• There were no other CNS infections.