Analysis of scalp wound infections among craniocerebral trauma patients following the 2008 wenchuan earthquake

Turk Neurosurg. 2012;22(1):27-31. doi: 10.5137/1019-5149.JTN.4391-11.0.

Abstract

Aim: To explore the causes of scalp wound infection, pathogen distribution, characteristics of antimicrobial susceptibility and therapeutic measures following craniocerebral trauma caused by the 2008 Wenchuan earthquake. MATERIAL and

Methods: We retrospectively analyzed the microbiology records of patients admitted with craniocerebral trauma to the Department of Neurosurgery, West China Hospital, Sichuan University. Scalp wound infections following craniocerebral trauma were caused by the Wenchuan earthquake.

Results: A total of 82 patients suffered from scalp trauma in this study, including 52.4% cases (43/82) with wound infections, mostly accompanied by severe foreign body contamination, for which the time of first debridement was significantly delayed. There were 59 strains of infectious pathogenic bacteria. Gram-positive bacteria were the most common organisms found (64.4%), including strains of Staphylococcus aureus (26/59, 44.1%) and strains of Staphylococcus epidermidis (12/59, 20.3%). Gram-negative bacteria accounted for 35.6% of samples: 22.0% (13/59) were strains of Enterobacter cloacae; 5.1% (3/59) were strains of Klebsiella pneumoniae; and 8.5% (5/59) were strains of Serratia rubidaea.

Conclusion: The rate of scalp wound infections following earthquake-induced craniocerebral trauma, which was dominated by Grampositive Staphylococcus aureus infection, has been markedly elevated in recent years. Early debridement and suturing, nutritional support and application of sensitive antibiotics can augment the therapeutic effect.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Child, Preschool
  • Craniocerebral Trauma / surgery*
  • Debridement
  • Earthquakes*
  • Emergency Medical Services
  • Female
  • Foreign Bodies / microbiology
  • Foreign Bodies / surgery
  • Glasgow Outcome Scale
  • Gram-Negative Bacteria
  • Gram-Positive Bacteria
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Neurosurgical Procedures / methods*
  • Nutritional Support
  • Retrospective Studies
  • Scalp / injuries*
  • Staphylococcal Infections / epidemiology
  • Sutures
  • Tetanus Toxoid / therapeutic use
  • Treatment Outcome
  • Turkey / epidemiology
  • Wound Infection / drug therapy*
  • Wound Infection / epidemiology
  • Wound Infection / microbiology*
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Tetanus Toxoid