Dursun Özgür KARAKAŞ, İbrahim YILMAZ, Mutlu ÇAYIRLI, ÖZGÜR DANDİN

Pilonidal Sinüs Cerrahisi Sonrası Nitrofurazone Komplikasyonu: Kontakt Dermatit

Topikal antibiyotikler cerrahi alan enfeksiyonunun profilaksisinde kullanılabilmektedir. Birçok avantajına rağmen topikal antibiyotiklerin kontakt dermatit gibi dezavantajları da vardır. Yirmi yaşında erkek hastada pilonidal sinüs ameliyatını takiben uygulanan uzun süreli nitrofurazone pansumanı sonrası ameliyat yerinde yanma hissi, kaşıntı ve akıntı şikayeti ile lokal egzematöz lezyon saptandı. Hastanın serum fizyolojik pansumanı ile kontakt dermatiti geriledi. Topikal antibiyotikler pilonidal sinüs cerrahisinde; apse varlığında tercih edilmelidir. Povidon iyot tek başına kullanılabilir. Gerektiğinde ise nitrofurazone dikkatli ve kısa süreli veya mupirosin veya rifamisin gibi daha az duyarlılaştırıcı antibiyotikler tercih edilebilir.

Postoperative Complication of Nitrofurazone after Pilonidal Sinus Surgery: Contact Dermatitis

Topical antibiotics can be used for prophylaxis of surgical site infections. Despite advantage, topical antibiotics have disadvantages as contact dermatitis. A twenty-year old man with anamnesis of long time using of topical nitrofurazone dressing after operation presented with burning, itching, secretion and local eczematous lesion on surgical site of pilonidal sinus surgery. His contact dermatitis has healed after saline dressing. Topical antibiotics can be preferred in the presence of abscess at pilonidal sinus surgery. Povidone iodine can be used alone but if it is necessary, nitrofurazone can be used carefully within short period or less sensitizer topical antibiotics such as mupirocin and rifamycin can be preferred.

PDF

___

1. Gagliardi AR, Fenech D, Eskicioglu C, Nathens AB, McLeod R. Factors influencing antibiotic prophylaxis for surgical site infection prevention in general surgery: a review of the literature. Can J Surg 2009;52(6):481-9.
2. Spann CT, Tutrone WD, Weinberg JM, Scheinfeld N, Ross B. Topical antibacterial agents for wound care: a primer. Dermatol Surg 2003;29(6):620-6. 3. Messingham MJ, Arpey CJ. Update on the use of antibiotics in cutaneous surgery. Dermatol Surg 2005;31(8 Pt 2):1068-78.
4. McHugh SM, Collins CJ, Corrigan MA, Hill AD, Humphreys H. The role of topical antibiotics used as prophylaxis in surgical site infection prevention.
J Antimicrob Chemother 2011;66(4):693-701. 5. Gelmetti C. Local antibiotics in dermatology. Dermatol Ther 2008;21(3):187-95.
6. Sasseville D. Contact dermatitis from topical antibiotics. Eur J Dermatol 2011;21(3):311-22.
7. Zappi EG, Brancaccio RR. Allergic contact dermatitis from mupirocin ointment. J Am Acad Dermatol 1997;36(2 Pt 1):266.
8. Bajaj AK, Saraswat A, Mukhija G, Rastogi S, Yadav S. Patch testing experience with 1000 patients. Indian J Dermatol Venereol Leprol 2007;73(5):313-8.
9. Moreno Escobosa MC, Moya Quesada MC, Cruz Granados S, Amat López J. Contact dermatitis to antibiotic ointments. J Investig Allergol Clin Immunol 2009;19(6):510-1.
10. Gillis JC, Brogden RN. Rifaximin. A review of its antibacterial activity, pharmacokinetic properties and therapeutic potential in conditions mediated by gastrointestinal bacteria. Drugs 1995; 49(3):467-84.
11. Hoover WW, Gerlach EH, Hoban DJ, Eliopoulos GM, Pfaller MA, Jones RN. Antimicrobial activity and spectrum of rifaximin, a new topical rifamycin derivative. Diagn Microbiol Infect Dis 1993; 16(2):111-8.
12. Sensi P. History of the development of rifampin. Rev Infect Dis 1983;5 Suppl 3:S402-6.
13. Cardot E, Tillie-Leblond I, Jeannin P, Facon A, Breuil K, Patte F, Tonnel AB. Anaphylactic reaction to local administration of rifamycin SV. J Allergy Clin Immunol 1995;95(1 Pt 1):1-7.
14. Lipsky BA, Hoey C. Topical antimicrobial therapy for treating chronic wounds. Clin Infect Dis 2009;15;49(10):1541-9.
15. Brune WH, Christopher wn, Pulaski EJ, Scavone E. The factor of infection in pilonidal (Sacrococcygeal) disease. Ann Surg 1956;144(2):170-5.
16. O'Meara SM, Cullum NA, Majid M, Sheldon TA. Systematic review of antimicrobial agents used for chronic wounds. Br J Surg 2001;88(1):4-21.