RESUMO
Surgical site infections (SSIs) remain a significant cause of morbidity and mortality in patients undergoing traumatic exploratory laparotomy. The goal of this study was to compare antibiotic usage and subsequent outcomes in patients undergoing traumatic exploratory laparotomy. A retrospective chart analysis and a chi-square test of independence were performed to examine the relation between preoperative cefoxitin versus ceftriaxone and metronidazole and the rate of SSI development. 323 patients were analyzed, 111 patients receiving cefoxitin and 212 patients receiving ceftriaxone and metronidazole. The proportion of patients who developed SSI was 16.2% for the cefoxitin group and 9.9% for the ceftriaxone and metronidazole group, X2 (1, N = 323) = 2.7, P = .098, thus displaying no statistical difference in the development of SSIs between patients in the cefoxitin group when compared to the ceftriaxone and metronidazole group.
Assuntos
Antibacterianos , Cefoxitina , Ceftriaxona , Laparotomia , Metronidazol , Infecção da Ferida Cirúrgica , Humanos , Metronidazol/uso terapêutico , Metronidazol/administração & dosagem , Infecção da Ferida Cirúrgica/prevenção & controle , Estudos Retrospectivos , Cefoxitina/uso terapêutico , Cefoxitina/administração & dosagem , Ceftriaxona/uso terapêutico , Masculino , Feminino , Adulto , Antibacterianos/uso terapêutico , Laparotomia/efeitos adversos , Laparotomia/métodos , Pessoa de Meia-Idade , Antibioticoprofilaxia/métodos , Cuidados Pré-Operatórios/métodos , Resultado do Tratamento , Traumatismos Abdominais/cirurgia , Traumatismos Abdominais/complicaçõesRESUMO
Gunshot wounds account for significant morbidity and mortality in the United States. A rare and potentially fatal complication of a gunshot wound is bullet embolus. Potential complications include distal limb ischemia, coronary infarct, renal infarction, stroke, pulmonary embolization, cardiac valvular injury, thrombophlebitis, and dysrhythmias. Overall, surgical embolectomy and endovascular retrieval are the preferred treatments for bullet emboli. We report one case of venous bullet embolus and one case of arterial bullet embolus, both of which were successfully treated with endovascular retrieval. A thorough physical exam and appropriate imaging are vital to prompt identification and treatment of bullet emboli, as the repercussions of missed injuries can be devastating.