Bladder Pressure Measurements and Urinary Tract Infection in Trauma Patients

Abstract

Although patients undergoing BPM have more UTIs than patients without BPM, the measurements are not an independent predictor of UTI when done by the closed technique. These findings emphasize the judicious use of BPM with a closed system and, more importantly, the need for early removal of catheters.

Early prevention of trauma-related infection/sepsis

“…Traumatic laceration wounds (≤5 cm) without signs of infection can be closed immediately, and disinfected wounds may be closed up to 24 h afterwards (based on the Friedrich dogma); wounds with active signs of infection should undergo secondary closure after 3–5 days [22]. There is no powerful evidence to demonstrate that traumatic wounds should not be sutured after 6 hours.…”

“…High-dose intravenous 3rd-generation cephalosporins, rather than oral 1st-generation drugs, may be effective in patients with open fractures [25]. The incidence of wound infection in patients with fresh traumatic wounds or lacerations is low after the administration of co-amoxiclav [22, 26]. Cefazolin, or vancomycin if the patient is allergic to penicillin, cefoxitin/clindamycin and gentamicin, or clindamycin and gentamicin are commonly administered to patients in the trauma intensive care unit (TICU) [27].…”

“…It is crucial for all trauma patients with deep wounds to receive appropriate immunization against tetanus. The present tetanus vaccination requirement, as a booster or revaccination, should also be considered by clinicians according to local protocols [22]. Because emergency clinicians are frequently faced with patients who are sensitive to tetanus infection in the emergency department, the attitude toward tetanus prophylaxis should be changed among emergency physicians [35].…”