Abscess

Research from Kitasato University provides new data on sepsis

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"Soft tissue infection was defined as abscess formation in subcutaneous tissue or muscle diagnosed by computed tomography or an operation. Mean injury severity score was 48, and mean systolic blood pressure on arrival was 66 mm Hg. All patients had multiple concomitant injuries and prolonged hemorrhagic shock. Open pelvic fracture was present in five patients. Mean blood transfusion volume within 24 hours was 12,611 mL. Intra-aortic balloon occlusion was performed in three patients and transcatheter angiographic embolization in nine patients. Embolic sites of transcatheter angiographic embolization were bilateral internal iliac arteries (n = 9), lumbar artery (n = 5), median sacral artery (n = 2), and circumflex femoral artery (n = 2). Infection sites included the gluteal (n = 11), femoral (n = 6), sacral (n = 4), lumbar (n = 4), anterior iliac (n = 2), inguinal (n = 1), and perineal (n = 1) regions. Necrotic changes of infected soft tissue were found in all patients. They underwent open drainage and daily debridement with pulsatile irrigation followed by intravenous antibiotics. All patients developed severe sepsis, five of whom subsequently died of multiple organ failure. In critically injured patients with multiple injuries and unstable pelvic fracture, peripelvic soft tissue infections occasionally cause sepsis. Peripelvic infections are often accompanied by necrotic changes and easily develop into severe sepsis or multiple organ failure," wrote Y. Kataoka and colleagues, Kitasato University.

The researchers concluded: "Identifying high-risk patients and early diagnosis with prompt surgical treatment are indispensable for the patients' survival."

Kataoka and colleagues published their study in the Journal of Trauma - Injury Infection and Critical Care (Sepsis Caused by Peripelvic Soft Tissue Infections in Critically Injured Patients With Multiple Injuries and Unstable Pelvic Fracture. Journal of Trauma - Injury Infection and Critical Care, 2009;66(6):1548-1555).

For additional information, contact Y. Kataoka, Kitasato University, School Medical, Sagamihara, Kanagawa 228, Japan.

Publisher contact information for the Journal of Trauma - Injury Infection and Critical Care is: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA.

Keywords: Japan, Sagamihara, Abscess, Angiology, Blood Pressure, Blood Transfusion, Bloodstream Infection, Critical Care, Embolization, Hemorrhagic Shock, Medical Device, Sepsis, Septicemia, Soft Tissue Infections, Transfusion Medicine, Kitasato University.

This article was prepared by Hematology Week editors from staff and other reports. Copyright 2009, Hematology Week via NewsRx.com.