Surgery of venous leg ulcers - wound infections with perioperofive antibiotic prophylaxis based on the preoperotive antibiogram

Abstract

Aim: We are presenting the rate of wound infections after surgery of venous leg ulcers in the department of dermatology/University of Goettingen. Moreover, the preoperative contamination with pathogenic microorganisms of the pretreated patients under inpatient conditions is described. Methods: 59 patients with venous leg ulcers were treated with 95 surgical interventions (46 patients one leg, 13 patients both legs; 7 5 epifascial procedures, 20 crural fasciotomies). All patients received a perioperative antibiotic prophylaxis (PAP) based on the preoperative resistance determination. Results: Preoperatively, we found in most cases Staphylococcus aureus on the ulcers, followed by Proteus mirabilis. Three patients (5.1%) were contaminated with methicillin-resistant Staphylococcus aureus (MRSA). Cefazolin and ciprofloxacin were used as PAP in most cases. Five of the 59 patients (8.5%) developed a postoperative wound infection. In three of these cases the preoperative pathological bacteria caused the wound infection. Conclusion: The rate of postoperative wound infections after surgical therapy of venous leg ulcers with the regimen of PAP, based on the preoperative resistance determination, is very acceptable.