Infection after farm machine-related injuries in children and adolescents
S. R. Brennan, K. H. Rhodes and H. A. Peterson
Department of Pediatrics, Mayo Clinic, Rochester, MN 55905.
Infection played an important role in prolonging hospitalization and
increasing morbidity in 68 children injured in farm settings. Predominantly
gram-negative enteric organisms, group D streptococci, and anaerobic
organisms were isolated in cultures of specimens obtained from wounds.
Infection was more often associated with severe injuries of the large bones
of the extremities than in amputation injuries of the digits and crush or
roll-over injuries when the skin barrier was intact. The occurrence of
infection in farm injuries was associated with prolonged hospitalization
for parenteral antibiotic therapy, multiple surgical debridements with a
need for general anesthesia, and permanent disability (decreased range of
motion and loss of limbs and digits). Early aggressive surgical debridement
and antimicrobial therapy guided by isolation and sensitivity testing of
the major organisms are required because of polymicrobial invasion of
vascularly compromised tissue.
