Smoldering subcutaneous polymicrobial infection concealed beneath a cast and a skin graft: Delayed wound healing due to recurring soft-tissue infections
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 (I&D) 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 yr. old woman with a chronic would 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 6 more I&Ds and wound debridement over a 5-month period due to a chronic non-healing wound with recurring SSTIs. Wound Healing was tentatively achieved with antibiotic coverage for both Staph Aureus and Pseudomonas Aeruginosa.
Copyright (c) 2021 Jonathan Aldrete, Ashley Sturgeon, Daniel Baird, Deepak Bharadia
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