Yıl: 2005 Cilt: 11 Sayı: 3 Sayfa Aralığı: 230 - 237 Metin Dili: Türkçe

The effect of delayed admission in burn centers on wound contamination and infection rates

Öz:
AMAÇ Uludağ Üniversitesi Tıp fakültesi yanık ünitemize yanık olayından sonra belli bir zaman geçtikten sonra geç dönemde başvuran hastalarda görülen yara enfeksiyonu oranlan belirgin bir şeklide yüksek olduğu için beş yıllık bir sürede, üç yüz yirmi yanık hastası üzerinde, yanık merkezine gecikmiş erişimin yara enfeksiyonu ve kontaminasyonuna etkisinin retrospektif olarak incelenmesini amaçladık. GEREÇ VE YÖNTEM Yanık hastaları, orta ve ağır derecede yanıklar olmak üzere iki gruba ayrıldı. Yara enfeksiyonlarının ve yara kontaminasyonlarımn sıklığı her iki grup için de hospitalizasyon süreleri ve yanık merkezine erişimdeki gecikme zamanı bakımından analiz edildi. BULGULAR Yanık merkezine erişimdeki gecikmenin, yara enfeksiyon ve kontaminasyon sıklığım artıran önemli bir faktör olduğu görüldü. Bu fark özellikle orta derecede yamklı hasta grubunda daha çok belirginleşmişti.. Ağır yamklı hasta grubunda yara enfeksiyon ve kontaminasyon sıklığının tüm başvuru zamanları için yüksek düzeyde olduğu saptanmıştır. SONUÇ Orta derecede yamklı hastalarda, yanık olayından en az yetmiş sekiz saat geçtikten sonra yanık merkezine erişmiş olanlara, sistemik antibiyotik profilaksisi başlanması tartışmaya açılmalıdır. Ağır yamklı tüm hastalarda başvuru zamanından bağımsız olarak yara kontaminasyon ve enfeksiyon sıklığı yüksek bulunmuştur. Bu nedenle, bu gurup hastalarda da antibiyotik profilaksisi, her ne kadar normal deri florası için zararlı olsa da, tartışmaya açılmalıdır.
Anahtar Kelime: Antibiyotik proflaksisi Yara enfeksiyonu Yanıklar

Yanık merkezlerine gecikmiş erişiminin yara kontaminasyon ve enfeksiyonuna etkisi

Öz:
BACKGROUND Since wound infection rates in patients with delayed admission seemed to be significantly higher, a retrospective study of bacteriology in 320 burn patients, over a 5-year period was carried out in order to analyze the relation between delayed admission and wound infection rates in our Burn unit of Uludağ University, Faculty of Medicine.. METHODS The patients were separated into moderate or major burn groups according to burn severity. Wound infection and contamination frequencies were analyzed according to time-delay between burn injury and hospitalization time. RESULTS Delayed admission was found to be an important factor that causes an increase in wound infection and contamination frequency. This increase was significant especially among patients with moderate burn wounds. In patients with severe burns, wound infection and contamination frequencies were found to be higher for all admission time points. CONCLUSION Systemic antibiotic prophylaxis should be discussed in patients with moderate burns whose admission-delay is more than 78 hours. Wound infection and contamination rates were high in patients with major burns independent of the admission time. Therefore, systemic antibiotic prophylaxis should also be discussed in this group of patients, although it results in elimination of the normal skin flora.
Anahtar Kelime: Wound Infection Antibiotic Prophylaxis Burns

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Donati L, Scammazo F, Gervasoni M, et al. Infection and antibiotic therapy in 4000 burned patients treated in Milan, Italy between 1976 and 1988. Burns. 1993; 19:345.
  • 2. McManus AT, Mason AD Jr., McManus WF, et al. A de- cade of reduced gram-negative infections and mortality associated with improved isolation of burned patients. Arch Surg. 1994; 129:1306.
  • 3. Moylan JA. Burn Injury. In: Georgiade GS, Georgiade NG, Riefkohl R, et al. Textbook of Plastic, Maxillofaci- al and Reconstructive Surgery. Williams and Wilkins. Baltimore; 1992: 243-252.
  • 4. Mandell GL, Bennett JE, Dolin R. Principles and prac- tice of infectious diseases. In: Yurt RW. Burns. Phila- delphia: Churchill Livingstone; 2000: 3198-3202.
  • 5. Winkelstein AU. What are the immunological alterati- ons induced by burn injury? J Trauma. 1984; 24:72.
  • 6. Luterman A, Dasco CC, Curreri PW. Infections in burn patients. AmJ Med. 1986; 28:45.
  • 7. Wong MK, Ngim RCK. Burns mortality and hospitali- zation time - a prospective statistical study of 352 pati- ents in an Asian National Burn Centre. Burns. 1995; 21:39.
  • 8. Muller MJ, Nicolai M, Wiggins R, et al. Modern treatment of a burn wound. In: Herndon DN. Total burn care. WB Saunders Company LTD. London; 1996: 136-147.
  • 9. Lund CC, Browder NC. The estimation of areas of burns. Surg Gynecol Obstet. 1944; 79:352.
  • 10. Pruitt BA, McManus AT. The changing epidemiology of infection in burn patients. World J Surg. 1992; 16:57.
  • 11. El Danaf A. Burn variables influencing survival: a study of 144 patients. Burns. 1995; 21:517.
  • 12. Marichy J, Vaudelin T, Marin-Lafleche I, et al. Trans- portation of burn patients. Ann. Medit. Burns Club. 1989; 2:66.
  • 13. Sheridan R, Weber J, Prelack K, et al. Early burn enter transfer shortens the length of hospitalization and re- duces complications in children with serious burn in- juries. J Burn Care Rehabil. 1999; 20:347.
  • 14. Atoyebi OA, Sowemimo GOA, Odugbemi T. Bacterial flora of burn wounds in Lagos, Nigeria: a prospective study. Burns. 1992; 18:448.
  • 15. Estahbanati HK, Kashani PP, Ghanaatpisheh F Frequ- ency of pseudomonas aeruginosa serotypes in burn wo- und infections and their resistance to antibiotics. Burns. 2002; 28:340.
  • 16. Kaushik R, Kumar S, Sharma R, et al. Bacteriology of burn wounds-the first years in a new burn unit at the Medical College Chandigarh. Burns. 2001; 27:595.
  • 17. Nakhla LS, Sanders R. Microbiologic aspect of burns at Mount Vernon Hospital, UK. Burns. 1991; 17:309.
  • 18. Ozumba UC, Jibirum BC. Bacteriology of burn wounds in Enugu, Nigeria. Burns. 2000; 26:178.
  • 19. Revathi G, PuriJ, Jain BK. Bacteriology of burns. Burns. 1998; 24:347.
  • 20. Song W, Lee KM, Kang HJ, et al. Microbiologic aspects of predominant bacteria isolated from the burn patients in Korea. Burns. 2001; 27:136.
  • 21. Dasco DC, Luterman A, Curreri PW. Systemic antibi- otic treatment in burned patients. Surg Clin North Am. 1987; 67:57.
  • 22. Appelgren P, Björnhagen V, Bragderyd K, et al. A pros- pective study of infections in burn patients. Burns. 2002; 28:39.
  • 23. Bang RL, Gang RK, Sanyal SC, et al. Burn septicaemia: an analysis of 79 patients. Burns. 1998; 24: 354.
APA ÖZBEK S, ÖZGENEL Y, ETÖZ A, AKIN S, KAHVECİ R, HEPER Y, ERCAN İ, ÖZCAN M (2005). The effect of delayed admission in burn centers on wound contamination and infection rates. Ulusal Travma Dergisi, 11(3), 230 - 237.
Chicago ÖZBEK SERHAT,ÖZGENEL Yeşim,ETÖZ Abdullah,AKIN Selçuk,KAHVECİ RAMAZAN,HEPER Yasemin,ERCAN İLKER,ÖZCAN Mesut The effect of delayed admission in burn centers on wound contamination and infection rates. Ulusal Travma Dergisi 11, no.3 (2005): 230 - 237.
MLA ÖZBEK SERHAT,ÖZGENEL Yeşim,ETÖZ Abdullah,AKIN Selçuk,KAHVECİ RAMAZAN,HEPER Yasemin,ERCAN İLKER,ÖZCAN Mesut The effect of delayed admission in burn centers on wound contamination and infection rates. Ulusal Travma Dergisi, vol.11, no.3, 2005, ss.230 - 237.
AMA ÖZBEK S,ÖZGENEL Y,ETÖZ A,AKIN S,KAHVECİ R,HEPER Y,ERCAN İ,ÖZCAN M The effect of delayed admission in burn centers on wound contamination and infection rates. Ulusal Travma Dergisi. 2005; 11(3): 230 - 237.
Vancouver ÖZBEK S,ÖZGENEL Y,ETÖZ A,AKIN S,KAHVECİ R,HEPER Y,ERCAN İ,ÖZCAN M The effect of delayed admission in burn centers on wound contamination and infection rates. Ulusal Travma Dergisi. 2005; 11(3): 230 - 237.
IEEE ÖZBEK S,ÖZGENEL Y,ETÖZ A,AKIN S,KAHVECİ R,HEPER Y,ERCAN İ,ÖZCAN M "The effect of delayed admission in burn centers on wound contamination and infection rates." Ulusal Travma Dergisi, 11, ss.230 - 237, 2005.