Abstract
The intact stratum corneum prevents invasion by microbes by acting as a barrier against the many organisms encountered daily. Skin is the first line of defense against infection. In the patient with spinal cord injury, debilitating neurologic disease, and surgical pressure necrosis results in the loss of this barrier. But even the loss of the stratum corneum does not guarantee infection and most patients will be able to defend themselves against the bacteria contaminating the wound; however, this is not true of the elderly patient, the diabetic patient, and patients with other reasons for decreased immunity [1–5].
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References
Bergstrom N, Braden B (1992) A prospective study: pressure sore risk among institutionalized elderly. J Am Geriatric Soc 40:747–758
Jelinek JE (1994) Cutaneous manifestations of diabetes mellitus. Int J Dermatol 33:605–617
Leigh IH, Bennett G (1994) Pressure ulcers: prevalence, etiology, and treatment modalities. A review. Am J Surg 167:25S–30S
Manley M (1978) Incidence, contributory factors and cost of pressure sores. South Afr Med J 53:217–222
Young JB, Dobrzanski S (1992) Pressure sores. Epidemiology and current management concepts. Drugs Aging 2:42–57
Perez ED (1993) Pressure ulcers; updated guidelines for treatment and prevention. Geriatrics 48(l):39–44
Kertesz D, Chow AW (1992) Infected pressure and diabetic ulcers. Clin Geriatr 8:835–852
Laing P (1994) Diabetic foot ulcer. Am J Surg 167[Suppl]:34–36
Rudensky B, Lipschits M, Isaacsohn M, Sonnenblick M (1992) Infected pressure sores: comparison of methods for bacterial identification. South Med J 85(9):901–903
Sapico FL, Witte JL, Canawati HN, Montgomerie JZ, Bessmann AN (1984) The infected foot of the diabetic patient: quantitative microbiology and analysis of clinical features. Rev Infect Dis 6[Suppl]:171–176
Haley RW, Hightower AW, Khabbaz RF et al. (1982) The emergence of methicillin-resistant Staphylococcus aureus infections in United States hospitals: possible role of the house staff-patients transfer circuit. Ann Intern Med 97:297–308
Rhinehart E, Shales DM, Keys TF et al. (1987) Nosocomial clonal dissemination of methicillin-resistant Staphylococcus aureus: elucidation by plasmid analysis. Arch Intern Med 147:521–524
Galpin JE, Chow AW, Bayer AS, Guze LB (1976) Sepsis associated with decubitus ulcers. Am J Med 61:346–350
Rodeheaver G, Ballamy W, Kody M et al. (1982) Bactericidal activity and toxicity of iodine-containing solutions wounds. Arch Surg 117:181–186
Bryan CS, Dew CE, Reynolds KL (1983) Bacteremia associated with decubitus ulcers. Arch Intern Med 143:2093–2095
Darouiche RO, Landon GC, Klima M, Musher DM, Markowski J (1994) Osteomyelitis associated with pressure sores (see comments). Arch Intern Med 154:753–758
Deloach ED, DiBenedetto RJ, Womble L, Gilley JD (1992) The treatment of osteomyelitis underlying pressure ulcers. Decubitus 5(6):32–41
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© 1997 Springer-Verlag Berlin Heidelberg
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Craft, J.C. (1997). Antimicrobial Therapy. In: Parish, L.C., Witkowski, J.A., Crissey, J.T. (eds) The Decubitus Ulcer in Clinical Practice. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60509-3_15
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DOI: https://doi.org/10.1007/978-3-642-60509-3_15
Publisher Name: Springer, Berlin, Heidelberg
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