Harmon et al reported risk factors for infection following a penetrating brain injury. The authors are from the Eastern Association for the Surgery of Trauma.
Patient selection: penetrating brain injury
Infections were both monomicrobial and polymicrobial. Enterococcus and Staphylococcus werre the most common isolates, but many types of bacteria are implicated.
Risk factors for infection:
(1) surgical intervention (OR 2.6)
(2) intracerebral pressure monitor (OR 2.3)
Factors that did not reduce infections:
(1) prophylactic antibiotics
Factors not predictive of infection:
(1) degree of dural penetration
(2) trajectory through the oropharynx
Removal of deep foreign body fragments tends to cause more harm than good, and antibiotic prophylaxis may not be of benefit.
