Deepak Bharadia MD, Ashley Sturgeon MD, Daniel Baird MD, Jonathan Aldrete BA
Injury to soft tissues secondary to trauma is common and may require surgical intervention depending on the extent of the injury and the structures involved. Motor vehicle accidents are a leading cause of traumatic injury and often require surgical irrigation and debridement to remove damaged and necrotic tissue while preserving tissue integrity and function. Surgical intervention carries its own risks, however, with the introduction of pathogens to the surgical site being a potential complication. This case of an 18-year-old woman with a chronic wound due to recurring skin and soft tissue infections (SSTIs) highlights the complications of surgical intervention and the difficulty of dealing with recurring SSTIs. The patient suffered a left knee injury with patellar tendon laceration secondary to trauma from a motor vehicle accident. She initially underwent surgical irrigation and debridement, followed by patellar tendon repair with a rotational flap to close the open wound. Following the initial closure in December 2019, the patient underwent six incision and drainage procedures over a 9-month period due to a chronic non-healing wound with recurring SSTIs. Despite these interventions, the patient ultimately underwent a total patellectomy due to recurring wound infections with penicillin resistant, methicillin-susceptible Staphylococcus aureus for which she was successfully treated with IV nafcillin over a period of 42 days.
Keywords: Chronic wound, skin and soft tissue infections, polymicrobial wounds
Article citation: Bharadia D, Sturgeon A, Baird D, Aldrete J. Smoldering subcutaneous polymicrobial infection concealed beneath a cast and a skin graft: delayed wound healing due to recurring soft-tissue infections. The Southwest Respiratory and Critical Care Chronicles 2021;9(37):78–81
From: Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas
Submitted: 8/10/2020
Accepted: 1/18/2021
Reviewer: Jacob Nichols MD
Conflicts of interest: none
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