The majority of US combat casualty soft-tissue wounds are not infected or colonized upon arrival or during treatment at a continental US military medical facility

Forest R. Sheppard, Paul Keiser, David Craft, Fred Gage, Martin Robson, Trevor S. Brown, Kyle Petersen, Stephanie Sincock, Matt Kasper, Jason Hawksworth, Doug Tadaki, Thomas A. Davis, Alexander Stojadinovic, Eric Elster

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43 Scopus citations

Abstract

Background: The microbiology of war wounds has changed as medicine and warfare have evolved. This study was designed to determine the microbial flora and bacterial quantification of present-day war wounds in US troops from Iraq and Afghanistan upon arrival at the National Naval Medical Center (NNMC). Methods: Patients with extremity combat wounds treated with a vacuum-assisted wound closure device were enrolled in study. Wounds were biopsied every 48 to 72 hours with quantitative microbiology performed on all biopsies. Results: Two hundred forty-two wound biopsies from 34 patients; 167 (69%) showed no growth, and 75 (31%) showed positive growth. The incidence of any bacterial isolation from biopsies weekly from the time of injury was 28% (first), 31% (second), and 37% (<third). Acinetobacter baumannii was the most prevalent isolate. Conclusions: Most soft-tissue wounds from Iraq and Afghanistan do not have significant bacterial burden upon arrival to and during initial treatment at NNMC. Improved evaluation of combat wound microbiology at all levels of care is warranted to determine shifts in microbiology and to impact care practices.

Original languageEnglish (US)
Pages (from-to)489-495
Number of pages7
JournalAmerican Journal of Surgery
Volume200
Issue number4
DOIs
StatePublished - Oct 2010

All Science Journal Classification (ASJC) codes

  • Surgery

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    Sheppard, F. R., Keiser, P., Craft, D., Gage, F., Robson, M., Brown, T. S., Petersen, K., Sincock, S., Kasper, M., Hawksworth, J., Tadaki, D., Davis, T. A., Stojadinovic, A., & Elster, E. (2010). The majority of US combat casualty soft-tissue wounds are not infected or colonized upon arrival or during treatment at a continental US military medical facility. American Journal of Surgery, 200(4), 489-495. https://doi.org/10.1016/j.amjsurg.2010.03.001