amoxicillin-potassium-clavulanate-combination and Wounds--Penetrating

Cactus plants are commonly seen in arid southwestern regions of the United States. Due to their ready availability, they have become a popular houseplant. The spines or glochidia can easily puncture the skin with only minor pressure (ie, bumping or touching the cactus). Removal of the offending spine is difficult, even with tweezers.. An 18-year-old woman initially self-removed the spines, and marked discomfort and intense erythematous reaction developed within 8 to 10 hours. Patient presented to the emergency room at Mercy Hospital and Trauma Center (Janesville, Wisconsin), where spine removal was unsuccessful.. Following emergency room discharge, she had difficulty walking from pain and swelling and was advised to use heat packs, take amoxicillin/clavulanic acid, and rest with her leg elevated for another 7 days along with using eye drops for eye irritation. The lesions slowly improved over the next several months.. The case of multiple barrel cactus spine injuries with severe pain and swelling is presented herein as well as a review of the treatment options and complications of cactus spine injuries.

Topics: Adolescent; Amoxicillin-Potassium Clavulanate Combination; beta-Lactamase Inhibitors; Cactaceae; Female; Foreign Bodies; Humans; Knee Injuries; Ophthalmic Solutions; Pain; Treatment Outcome; Wisconsin; Wounds, Penetrating

Residual posttraumatic hemothoraces occur in 1% to 20% of patients managed with tube thoracostomy. Video-assisted thoracoscopic surgery (VATS) has emerged as an alternative to thoracotomy to evacuate these retained collections. This report reviews a recent trauma unit experience with thoracoscopic evacuation of hemothoraces.. The records of all trauma patients undergoing surgical intervention for retained hemothoraces over the 30-month period January 2001 to June 2003 were reviewed.. The study included 46 patients. All sustained penetrating injuries, 40 with stab and 6 with gunshot wounds. Twenty-two, 17, and 7 patients each had one, two and three attempts at drainage with tube thoracostomy, respectively. In 37 patients (80%), retained infected/uninfected pleural fluid was successfully evacuated thoracoscopically. VATS failed in 9 (20%) patients and the procedure was converted to open thoracotomy. Dense adhesions were present in all 9 of these patients. The mean time interval between injury and thoracoscopy and thoracotomy, was 13.3 days (range 3-46 days) and 14.5 days (range 11-24 days), respectively. The mean volume of pleural fluid evacuated thoracoscopically was 650 mL. The failure of VATS evacuation correlated with the empyema rate. The median postoperative stay was 5 days for both groups.. Video-assisted thoracoscopic surgery is an accurate, safe, and reliable operative therapy for retained posttraumatic pleural collections, even in patients presenting later than the conventionally accepted 3- to 5-day window from the time of injury.

Topics: Adolescent; Adult; Amoxicillin-Potassium Clavulanate Combination; Drug Therapy, Combination; Empyema, Pleural; Female; Fever; Hemothorax; Humans; Male; Middle Aged; Suction; Thoracic Injuries; Thoracic Surgery, Video-Assisted; Treatment Outcome; Wounds, Gunshot; Wounds, Penetrating; Wounds, Stab

Previous research has shown that antibiotic usage in patients with superficial sharp lacerations has no influence over infection rate. This study is a prospective controlled trial, using systematic allocation, of 250 patients of which 113 received co-amoxiclav (Augmentin) and 137 did not. Special emphasis was placed on wound debridement and irrigation. All sharp soft tissue lacerations including those with nerve, tendon and muscle damage were entered into the trial. The results show a low overall infection rate of 4%. The infection rate in the group treated with antibiotics was 5% and 3.2% in the group who received no antibiotics. Lacerations operated on up to 48 h from the injury were included and there was no correlation between the length of time waited and the infection rate. We conclude that antibiotics are an unnecessary adjunct in the treatment of sharp lacerations of the hand and upper limb, provided meticulous surgical debridement is performed.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Child; Child, Preschool; Debridement; Drug Therapy, Combination; Forearm Injuries; Humans; Male; Middle Aged; Prospective Studies; Risk Factors; Therapeutic Irrigation; Wound Infection; Wounds, Penetrating

In the pediatric literature, only 1 case of cervical spondylodiscitis from an ingested foreign body is reported and this was caused by a blunt radiolucent foreign body. The authors now describe a unique case of a 13-year-old teenaged boy who presented with neck pain 6 days after accidental ingestion of a sewing pin. Uncomplicated removal of this pin was followed in 36 days by the development of cervical spondylodiscitis that failed conservative management and required surgical debridement and arthrodesis. Physicians should be aware of the possibility of this complication in any patient that presents with neck pain after foreign body ingestion.

Topics: Accidents; Adolescent; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Bone Plates; Ceftriaxone; Cervical Vertebrae; Clindamycin; Combined Modality Therapy; Deglutition Disorders; Discitis; Diskectomy; Emergencies; Equipment Contamination; Follow-Up Studies; Foreign Bodies; Humans; Laryngoscopy; Larynx; Male; Neck Pain; Oxacillin; Paresthesia; Penicillanic Acid; Pharynx; Piperacillin; Piperacillin, Tazobactam Drug Combination; Radiography; Recurrence; Retropharyngeal Abscess; Spinal Fusion; Vancomycin; Wounds, Penetrating

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Animals; Antifungal Agents; Brain Injuries; Cats; Ciprofloxacin; Combined Modality Therapy; Drug Therapy, Combination; Female; Food; Humans; Magnetic Resonance Imaging; Metronidazole; Microsurgery; Neurosurgical Procedures; Orbit; Postoperative Care; Risk-Taking; Severity of Illness Index; Tomography, X-Ray Computed; Wounds, Penetrating; Wounds, Stab