Asunto(s)
Cuerpos Extraños/etiología , Gastrostomía/efectos adversos , Hernia Inguinal/cirugía , Obstrucción Intestinal/etiología , Anciano de 80 o más Años , Servicio de Urgencia en Hospital , Femenino , Estudios de Seguimiento , Cuerpos Extraños/diagnóstico , Cuerpos Extraños/cirugía , Gastrostomía/instrumentación , Hernia Inguinal/complicaciones , Hernia Inguinal/diagnóstico , Humanos , Obstrucción Intestinal/cirugía , Intestino Delgado/cirugía , Laparotomía/métodos , Medición de Riesgo , Resultado del TratamientoAsunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Arteriopatías Oclusivas/cirugía , Implantación de Prótesis Vascular/efectos adversos , Procedimientos Endovasculares/efectos adversos , Migración de Cuerpo Extraño/cirugía , Stents/efectos adversos , Anciano , Angiografía/métodos , Arteriopatías Oclusivas/diagnóstico , Implantación de Prótesis Vascular/métodos , Procedimientos Quirúrgicos Electivos/efectos adversos , Procedimientos Quirúrgicos Electivos/métodos , Procedimientos Endovasculares/métodos , Femenino , Estudios de Seguimiento , Humanos , Arteria Ilíaca/fisiopatología , Arteria Ilíaca/cirugía , Laparotomía/métodos , Reoperación/métodos , Medición de Riesgo , Tomografía Computarizada por Rayos X/métodos , Resultado del TratamientoRESUMEN
The treatment of complex wounds is commonplace for plastic surgeons. Standard management is debridement of infected and devitalized tissue and systemic antibiotic therapy. In cases where vital structures are exposed within the wound, coverage is obtained with the use of vascularized tissue using both muscle and fasciocutaneous flaps. The use of nondissolving polymethylmethacrylate and absorbable antibiotic-impregnated beads has been shown to deliver high concentrations of antibiotics with low systemic levels of the same antibiotic. We present a multicenter retrospective review of all cases that used absorbable antibiotic-impregnated beads for complex wound management from 2003 to 2013. A total of 104 cases were investigated, flap coverage was used in 97 cases (93.3%). Overall, 15 patients (14.4%) required reoperation with the highest groups involving orthopedic wounds and sternal wounds. The advantages of using absorbable antibiotic-impregnated beads in complex infected wounds have been demonstrated with minimal disadvantages. The utilization of these beads is expanding to a variety of complex infectious wounds requiring high concentrations of local antibiotics.