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PREOPERATIVE MRSA COLONISATION IN TRAUMA PATIENTS: ITS INFLUENCE ON WOUND INFECTION IN IMPLANT SURGERIES.



Abstract

Patients admitted to trauma wards are routinely screened for MRSA pre-operatively. The majority of them have implant surgery before the screening results were available. The aim of our study was to identify the incidence of MRSA wound infection in these patients and their outcome following it.

We randomly reviewed 40 patients who were colonised with MRSA pre-operatively and have had implant surgeries. The case notes, drug charts and the microbiology were reviewed to identify the incidence of MRSA wound infection and its outcome in these patients. The place of residence, site of colonisation and the treatment given were also considered.

70% of the patients were admitted from home and 20% had previous admission within one year. The commonest site colonised is the nose (50%) followed by the perineum in 20%. Multiple sites were colonised in 10% of the patients. Only 50% of them with positive nasal MRSA were given nasal bactroban and chlohexidine wash was given in only 70% of them with MRSA colonisation in other areas. 22.5% (9/40) of the patients developed MRSA infection post operatively and they were treated with vancomycin or teicoplanin. Wound debridement and washout were done in 67.5%. 75% of the MRSA infected wound healed well with no MRSA in the wound site after treatment. 25% of the MRSA infected wounds had persistent MRSA in the wound.

As per our study the incidence of MRSA wound infection in patients colonised pre-operatively is about 22.5%. Most cases seem to heal well without much complication with appropriate antibiotics and wound care.

The abstracts were prepared by Mr Tim Briggs. (Editoral Secretary 2003/4) Correspondence should be addressed to him at Lane Farm, Chapel Lane, Totternhoe, Dunstable, Bedfordshire LU6 2BZ, United Kingdom