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Methicillin-Resistant Superinfection of the Wound After Body-Contouring Abdominal Surgery

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Abstract

Background

This report presents the case of a patient who underwent abdominal body-contouring surgery, then later experienced a severe deep infection and a methicillin-resistant (MRSA) superinfection.

Case Report

A 56-year-old female ex-smoker presented, after massive weight loss, with skin excesses on the abdomen and flanks. She underwent an abdominoplasty with muscle plication and flank liposuction. On postoperative day 14, the woman presented with a deep wound infection, then 1 week later with MRSA superinfection. Since then, two surgical debridements and specific intravenous antibiotics have been necessary for a cure and to avoid septicemic complications. Complete wound closure was achieved only after 3 months of therapy, but a massive retractile and painful scar remained.

Conclusion

Concomitant risk factors for wound infections (obesity, smoking, flap undermining) determined a rare but potentially fatal wound complication after body-contouring abdominoplasty. This complication was presented to alert plastic and general surgeons to such postoperative infections and to the possibility of a nonconservative approach.

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References

  1. Chambers HF (1997) Methicillin resistance in staphylococci: molecular and biochemical basis and clinical implications. Clin Microbiol Rev 10:781–791

    PubMed  CAS  Google Scholar 

  2. Gemmell CG, Edwards DI, Fraise AP et al (2006) Guidelines for the prophylaxis and treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections in the UK. J Antimicrob Chemother 57:589–608

    Article  PubMed  CAS  Google Scholar 

  3. Aly R (1990) The pathogenic staphylococci. Semin Dermatol 9:292–299

    PubMed  CAS  Google Scholar 

  4. Hardy KJ, Hawkey PM, Gao F (2004) Methicillin-resistant Staphylococcus aureus in critically ill. Br J Anaesth 92:121–130

    Article  PubMed  CAS  Google Scholar 

  5. Stewart KD, Stewart DA. Coghlan B (2006) Complications of 278 consecutive abdominoplasties. J Plast Reconst Aesth Surg 59:1152–1155

    Article  CAS  Google Scholar 

  6. Vastine VL, Morgan RF, Williams GS et al (1999) Wound complications of abdominoplasty in obese patients. Ann Plast Surg 42:34–39

    Article  PubMed  CAS  Google Scholar 

  7. Shermak A, Chang D, Magnuson TH (2006) An outcome analysis of patient undergoing body contouring surgery after massive weight loss. Plast Reconstr Surg 118:1026–1031

    Article  PubMed  CAS  Google Scholar 

  8. Mosely LH, Finseth F (1977) Cigarette smoking: impairment of digital blood flow and wound healing in the hand. Hand 9:97–101

    Article  PubMed  CAS  Google Scholar 

  9. Mosely LH, Finseth F, Goody M (1978) Nicotine and its effect on wound healing. Plast Reconstr Surg 61:570–575

    Article  PubMed  CAS  Google Scholar 

  10. Rees TD, Liverett DM, Guy CL (1984) The effect of cigarette smoking on skin-flap survival in the face-lift patient. Plast Reconstr Surg 73:911–915

    Article  PubMed  CAS  Google Scholar 

  11. Chan LK, Withey S, Butler PE (2006) Smoking and wound healing problems in reduction mammaplasty: is the introduction of urine nicotine testing justified? Ann Plast Surg 56:111–115

    Article  PubMed  CAS  Google Scholar 

  12. Rogliani M, Labardi L, Silvi E et al (2006) Smokers: risks and complications in abdominal dermolipectomy. Aesth Plast Surg 30:422–424

    Article  CAS  Google Scholar 

  13. Manassa EH, Hertl CH, Olbrisch RR (2003) Wound healing problems in smokers and nonsmokers after 132 abdominoplasties. Plast Reconstr Surg 111:2082–2087

    Article  PubMed  Google Scholar 

  14. Black CE, Huang N, Neligan PC et al (2001) Effect of nicotine on vasoconstrictor and vasodilator responses in human skin vasculature. Am J Physiol Regul Integr Comp Physiol 281:R1097–R1104

    PubMed  CAS  Google Scholar 

  15. Birnstingl MA, Brinson K, Chakrabarti BK (1971) The effect of short-term exposure to carbon monoxide on platelet stickiness. Br J Surg 58:837–839

    Article  PubMed  CAS  Google Scholar 

  16. Dintenfass L (1975) Elevation of blood viscosity, aggregation of red cells, haematocrit values, and fibrinogen levels with cigarette smokers. Med J Aust 1:617–620

    PubMed  CAS  Google Scholar 

  17. Vastine VL, Morgan RF, Williams GS et al (1999) Wound complications of abdominoplasty in obese patients. Ann Plast Surg 42:34–39

    Article  PubMed  CAS  Google Scholar 

  18. Lahiri A, Duff CG, Brown TL et al (2006) Anthropometric measurements and their value in predicting complications following reduction mammaplasty and abdominoplasty. Ann Plast Surg 56:248–250

    Article  PubMed  CAS  Google Scholar 

  19. Sanger C, David LR (2006) Impact of significant weight loss on outcome of body contouring surgery. Ann Plast Surg 56:9–13

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Dolan Park Hospital, Bromsgrove, United Kingdom

    A. Araco, R. Zaccheddu & F. Araco

  2. Department of General Surgery, Whipps Cross University Hospital, Leytonstone, London, E11 1NR, United Kingdom

    G. Gravante

Authors
  1. A. Araco
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  2. R. Zaccheddu
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  3. F. Araco
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  4. G. Gravante
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Correspondence to G. Gravante.

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Araco, A., Zaccheddu, R., Araco, F. et al. Methicillin-Resistant Superinfection of the Wound After Body-Contouring Abdominal Surgery. Aesth Plast Surg 32, 681–683 (2008). https://doi.org/10.1007/s00266-008-9177-z

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  • DOI: https://doi.org/10.1007/s00266-008-9177-z

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