J Wound Manag Res.  2019 Mar;15(1):11-16. 10.22467/jwmr.2018.00430.

Skin and Soft Tissue Infections in Plastic Surgery Over 10 Years

• Han SE
• Hwang SO
• Lee SH
• Cho PD

• KMID: 2469755
• DOI: http://doi.org/10.22467/jwmr.2018.00430

Abstract

BACKGROUND
Skin and soft tissue infections (SSTIs) are frequently managed by plastic surgeons. Nowadays, antibiotics resistant organisms are increasing due to inappropriate use of antibiotics, and their treatment is becoming more complex. Regional data of microbiology, resistance patterns, and risk factors associated with resistance in specific types of infections are important in planning the management of SSTIs.
METHODS
A 13-year (2004 to 2016) retrospective chart review of 229 patients with SSTI was performed to elucidate the trend of SSTI with respect to the pathogenic organisms, their antibiotic resistance, and treatment results.
RESULTS
Staphylococcus aureus was a single, most dominant organism (40%), and methicillin-resistant S. aureus (MRSA) was cultured in 80% of the cases. MRSA bacteria was detected significantly higher in patients who were admitted to a hospital within the past 12 months. Patients whose initial treatment failed received intravenous antibiotic therapy for a mean duration of 6.65 additional days; patients with successful initial treatment received no intravenous antibiotic therapy. Moreover, delayed use of vancomycin in patients with complicated SSTI showed a correlation with extended hospital stays and higher total costs.
CONCLUSION
The incidence of MRSA-related SSTI is increasing at a considerable rate, according to the retrospective examination of our data. When MRSA infection is suspected, empirical therapy should not be delayed, if culture report is obtained. This study may be helpful to plastic surgeons for treating SSTI.

Keyword

Skin and soft tissue infections; Methicillin-resistant Staphylococcus aureus; Antibiotics

MeSH Terms

Anti-Bacterial Agents
Bacteria
Drug Resistance, Microbial
Humans
Incidence
Length of Stay
Methicillin Resistance
Methicillin-Resistant Staphylococcus aureus
Plastics*
Retrospective Studies
Risk Factors
Skin*
Soft Tissue Infections*
Staphylococcus aureus
Surgeons
Surgery, Plastic*
Vancomycin
Anti-Bacterial Agents
Plastics
Vancomycin