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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 |
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| Authors: | Sheppard Forest R Keiser Paul Craft David W Gage Fred Robson Martin Brown Trevor S Petersen Kyle Sincock Stephanie Kasper Matt Hawksworth Jason Tadaki Doug Davis Thomas A Stojadinovic Alexander Elster Eric |
| Affiliation: | a Department of Surgery, National Naval Medical Center, Bethesda, MD, USA b Regenerative Medicine Department, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD, 20910 USA c Department of Surgery, Uniformed Services University of Health Sciences, Bethesda, MD, USA d Walter Reed Army Institute of Research, Silver Spring, MD, USA e Department of Surgery, University of South Florida, Tampa, FL, USA f Diving Medicine, Naval Medical Research Center, Silver Spring, MD, USA g Department of Microbiology, National Naval Medical Center, Bethesda, MD, USA h Department of Surgery, Walter Reed Army Medical Center, Washington, District of Columbia, USA |
| Abstract: | BackgroundThe 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).MethodsPatients 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.ResultsTwo 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.ConclusionsMost 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. |
| Keywords: | Combat extremity wounds Combat soft-tissue wounds Vacuum-assisted wound closure Device Microorganisms |
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