Prophylactic Treatment of a Surgical Site Infection in an At-Risk Patient
Michael Schurr, MD, Sarah Waterman-Manning, MD
Mountain Area Health Education Center, Asheville, NC
Patient Presentation
A 33-year old diabetic woman presented with a left arm MRSA-positive abscess in December 2017.
- Patient also had medical history of ongoing tobacco abuse and recurrent necrotizing soft-tissue infections.
- The abscess was drained and required multiple debridement procedures.
- As a result, patient was left with chronic wound with exposed bicep tendon.
- Attempted split-thickness skin-graft placement in January 2018 failed.
Failed Therapy
- Negative pressure wound therapy
- Intravenous antibiotics
- Surgery
Treatment
- Exposed biceps tendon was covered with transparent Microlyte® Surgical.
- Microlyte® Surgical was used to manage the surgical wound, which was closed via Z-plasty.
- No oral or topical antibiotics were administered.
- Oral or topical antibiotics were not administered.
Clinical Outcome
- By post-operative day 4, there was no sign of infection.
- By day 14, the wound was well-healed, and sutures were taken out.
- The wound remained healed and patient regained range of motion in her left elbow.
Conclusion
- Faster and more complete closure of a chronically infected wound was achieved by surgical wound management using Microlyte® Surgical compared to other failed therapie
- This patient had multiple risk factors for postoperative surgical site infection including poor glycemic control, poly-microbial infection, and ongoing tobacco abuse.
- At the time of surgery Microlyte® Surgical was well tolerated and associated with a positive outcome.
- Microlyte® Surgical shows promise in the management of surgical wounds in at-risk patient populations.
Figure 1: A. Microlyte® Surgical is applied to surgical wound. B. Surgical wound is closed via Z-plasty. C. Surgical wound is healing and free of infection. D. Healing has progressed over 14 days and sutures have been removed.