Patterns of microbiology in intra-abdominal packing for trauma

Introduction. This study tracks the microbiology of packs and infections in damage-control trauma patients to determine whether the packs cause infections. Methods. The peritoneum and abdominal packs were cultured in patients who survived to re-operation. The study recorded all positive cultures, pack count, packing duration, number of operations, and infections. Results. Thirty-five patients were studied. Twenty-eight patients survived; seven died. Packs were cultured in 29 patients. Data for 291 cultures collected. Pack cultures were positive in 20 patients and negative in nine. Positive pack cultures grew skin and gut flora. Twenty-one patients had infections, 14 did not. Organisms from positive pack cultures did not contribute to subsequent infections or mortality. Microbes and sites of infections were consistent with SICU patients. Conclusions. Intra-abdominal packs are contaminated with skin and gut flora. These contaminants, however, do not contribute to subsequent infections. Pathogens from subsequent infections were typical for ICU infections.