Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2012
Periorbital infections after Dermabond closure of traumatic lacerations in three children.
Клинический случайСтатьяМетаанализПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Yeilding Ruth H, O'Day Denis M, Li Chun, Alexander Pauline T, Mawn Louise A
Аннотация
PURPOSE: To report the occurrence of periorbital infections in 3 children treated with the tissue adhesive 2-octyl cyanoacrylate (Dermabond) after traumatic periorbital laceration.
METHODS: We retrospectively reviewed the records of consecutive patients referred to Vanderbilt Children's Hospital for the treatment of periorbital infections to identify cases associated with the use of Dermabond. The clinical features and outcomes of each case were reviewed. We performed a meta-analysis of published cases to identify any association of tissue adhesive with wound infection rate.
RESULTS: The review identified 3 patients, all of whom were younger than 3 years of age and developed cellulitis within 24 hours of wound closure. Broad-spectrum intravenous antibiotic therapy was started in less than 3 hours in all cases. Cultures were obtained in 2 of the 3 cases; both grew Streptococcus pyogenes. Two cases required surgical intervention, including one with necrotizing fasciitis. In the meta-analysis, the wound infection rate was 1.8% in tissue adhesive closure and 0.3% in standard wound closure (odds ratio 6.0; 95% confidence interval 0.7-50.3, P = 0.06).
CONCLUSIONS: The development of periorbital cellulitis after the closure of periorbital lacerations with Dermabond should alert the physician to the possibility of periorbital infection, including necrotizing fasciitis. The literature review suggests a trend toward an increased infection rate with tissue adhesive closure. We propose that ineffective wound sterilization before tissue adhesive wound closure may be a contributing factor.
METHODS: We retrospectively reviewed the records of consecutive patients referred to Vanderbilt Children's Hospital for the treatment of periorbital infections to identify cases associated with the use of Dermabond. The clinical features and outcomes of each case were reviewed. We performed a meta-analysis of published cases to identify any association of tissue adhesive with wound infection rate.
RESULTS: The review identified 3 patients, all of whom were younger than 3 years of age and developed cellulitis within 24 hours of wound closure. Broad-spectrum intravenous antibiotic therapy was started in less than 3 hours in all cases. Cultures were obtained in 2 of the 3 cases; both grew Streptococcus pyogenes. Two cases required surgical intervention, including one with necrotizing fasciitis. In the meta-analysis, the wound infection rate was 1.8% in tissue adhesive closure and 0.3% in standard wound closure (odds ratio 6.0; 95% confidence interval 0.7-50.3, P = 0.06).
CONCLUSIONS: The development of periorbital cellulitis after the closure of periorbital lacerations with Dermabond should alert the physician to the possibility of periorbital infection, including necrotizing fasciitis. The literature review suggests a trend toward an increased infection rate with tissue adhesive closure. We propose that ineffective wound sterilization before tissue adhesive wound closure may be a contributing factor.
Предметные рубрики MeSH
Anti-Bacterial AgentsChild, PreschoolCombined Modality TherapyCyanoacrylatesEye Infections, BacterialEye Injuries, PenetratingEyebrowsFasciitis, NecrotizingFemaleHumansInfantInfusions, IntravenousLacerationsMaleOphthalmologic Surgical ProceduresOrbital CellulitisRetrospective StudiesStreptococcal InfectionsStreptococcus pyogenesTissue AdhesivesWound Infection