Infectious complications in GSWs through the gastrointestinal tract into the spine
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.Methods
- 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.