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Treating post-renal transplant surgical site infection with combination therapy: a case study

22 April 2021
7 min read
Volume 30 · Issue 8

Abstract

Surgical site infection (SSI) is one of the most common and debilitating complications of surgery. The risk of SSI rises if the patient has underlying health-related risk factors. This article reports on the complicated case of 61-year-old female with a history of obesity and diabetes. She was diagnosed with end-stage renal disease (ESRD) and had been receiving haemodialysis since 2012. She underwent a kidney transplant and developed a multidrug-resistant Pseudomonas aeruginosa SSI following surgery. She experienced delayed wound healing with a partially dehisced incision. Despite conventional wound care, there was no progress in wound healing. The authors combined sharp debridement, irrigation and antibiotic therapy with a silver-containing antimicrobial dressing for 1 month. Her SSI improved significantly and she returned to theatre for wound closure. The patient recovered well and was discharged from the hospital after suture removal. Wound care professionals can use combination therapies to manage SSIs effectively and reduce patient and healthcare costs.

Surgical site infection (SSI) is a common post-surgical complication. An SSI will prolong wound healing, and this may affect a patient's mobility and normal activities, leading to a reduced quality of life. There may be an increased length of hospital stay, with a higher risk of readmission and increased costs for the hospital and patient (Pujol et al, 2012; Abboud et al, 2014).

Approximately 20–25% of Gram-negative bacteria, such as Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae, account for the formation of SSIs (Inui and Bandyk, 2015). Along with diabetes, obesity, sex hormones and some medications, infection is reported as a risk factor that contributes to impaired wound healing (Guo and DiPietro, 2010). Owing to the increasing number of patients with risk factors the prevalence and costs of chronic non-healing wounds are growing (Järbrink et al, 2017; Farokhi et al, 2018). Thus, a combination of treatment strategies (such as debridement, antibiotic therapy, and using appropriate topical antimicrobial agents) would seem necessary for rapid and effective recovery (Schultz et al, 2017).

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