From the Guidelines
If you suspect a wound site infection with surgical staples, seek medical attention promptly, as the most effective treatment involves removing the staples and performing incision and drainage, with possible adjunctive systemic antimicrobial therapy, as recommended by the Infectious Diseases Society of America in 2014 1. When dealing with a wound site infection with surgical staples, it is crucial to recognize the signs of infection, which include increasing redness, warmth, swelling, pus, increasing pain, or fever.
- Key considerations for managing such infections include:
- Removing the staples to allow for proper drainage and cleaning of the wound
- Possibly prescribing systemic antimicrobial therapy, especially if there are significant systemic signs of infection, such as erythema and induration extending >5 cm from the wound edge, temperature >38.5°C, heart rate >110 beats/minute, or white blood cell (WBC) count >12 000/µL, as suggested by the guidelines 1
- Choosing the appropriate antimicrobial agent based on the suspected causative pathogens, with options including first-generation cephalosporins or antistaphylococcal penicillins for methicillin-susceptible Staphylococcus aureus (MSSA), or vancomycin, linezolid, daptomycin, telavancin, or ceftaroline for cases with risk factors for MRSA 1
- It is essential to note that while waiting to see a healthcare provider, keeping the wound clean by gently washing with mild soap and water, then pat dry with a clean towel, and applying an over-the-counter antibiotic ointment like Neosporin and covering with a sterile bandage can be beneficial, but these measures should not delay seeking medical attention.
- The healthcare provider will likely examine the wound, possibly take a culture, and may prescribe oral antibiotics, with the specific choice and duration of therapy depending on the severity of the infection and the presence of any underlying conditions or allergies, as outlined in the guidelines 1.
From the Research
Treatment Options for Wound Site Infection with Surgical Staples
- Negative pressure wound therapy is a common treatment for infected wounds, including those with surgical staples, and has been shown to increase wound healing rate and reduce hospital stay 2.
- Antibiotic therapy, such as linezolid, may be effective in treating methicillin-resistant Staphylococcus aureus (MRSA) infections in surgical wounds, including those with staples 3.
- The use of wound dressings, such as film dressings, hydrocolloid dressings, or silver-containing dressings, may not significantly reduce the risk of surgical site infection, and the choice of dressing may depend on dressing costs and patient preference 4.
Wound Closure Methods and Surgical Site Infection
- A comparative study found that wound closure using 2-octyl-cyanoacrylate was associated with a lower rate of surgical site infection than wound closure with staples in spinal surgery 5.
- Another study found that the use of skin staples for wound closure was associated with a lower incidence of surgical site infection compared to absorbable sutures in obese patients undergoing lumbar fusion surgery 6.
Management of Surgical Site Infection
- The management of surgical site infection may involve a combination of treatments, including negative pressure wound therapy, antibiotic therapy, and wound dressings.
- The choice of treatment may depend on the severity of the infection, the type of bacteria present, and the patient's overall health status.
- Further research is needed to determine the most effective treatments for surgical site infection and to develop evidence-based guidelines for management.