Serratia marcescens surgical wound infection following breast reconstruction
Article Abstract:
It is estimated that 100,000 women had breast surgery with implants in 1988. Breast implants or prostheses are used for breast enlargement, reconstruction following mastectomy, and to correct defects. There are two different types of breast implants, called expandable or nonexpandable depending on whether the implant can be expanded once it is placed inside of the breast. Breast infections have been reported following implant surgery. The rate of infection is the same for both types of implants, and staphylococcal bacteria are the most common cause of infection. Between April and November 1989, four cases of breast infection occurred following breast reconstruction with expandable implants (Becker Expander/Mammary Prosthesis) performed in a private plastic surgery office. All four patients developed infections with the Gram-negative bacteria Serratia marcescens. In two of the cases, the infections were traced to contaminated saline that was injected into the implants. The symptoms of infection developed between 13 and 161 days after the surgery. During the 12-month period between November 1988 and October 1989, 21 operations involving breast implants were performed in the same private practice. Ten of the operations used expandable and 11 used nonexpandable implants (Silastic II). Forty percent of the patients receiving the expandable implants developed breast infections, while none of the patients receiving the nonexpandable implants developed infections. It was discovered that sterile techniques were not used during the expansion procedure and that the same bag of saline was used for more than one injection and on more than one patient. It is concluded that physicians and nurses who perform breast expansion should wear sterile gloves, wash the skin at the site of the injection with antiseptic, and should not reuse opened bags of saline. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Successful treatment of gastroparesis with erythromycin in a patient with progressive systemic sclerosis
Article Abstract:
Studies of erythromycin, a common antibiotic, have indicated that the drug stimulates contractions of the stomach, and that diabetic patients with impaired gastric (stomach) emptying improve after erythromycin treatment. A case is reported of a 40-year-old woman with progressive systemic sclerosis (PSS) in whom stomach emptying improved with erythromycin. Disturbances of gastrointestinal musculature are common in PSS, also known as scleroderma. The woman had lost more than 70 pounds over two years, and had symptoms that included heartburn, early satiety (feeling full shortly after starting to eat), night time vomiting, and difficulty swallowing. Diagnostic studies revealed poor stomach tone, reflux from stomach to esophagus, and no stomach emptying after 90 minutes. Metoclopramide, which improves gastric emptying, was ineffective. The patient had to be hospitalized due to her inability to eat. During further tests of gastric emptying, the patient was given erythromycin intravenously, and emptying began within three to six minutes. Orally administered erythromycin was equally effective. The patient's symptoms diminished within two days, she began to eat a regular diet, and gained five pounds before hospital discharge. No complications were associated with erythromycin therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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