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Int. Rev. Allergol. Clin. Immunol. Family Med., 2020, XXVI/2: 094-099 Maximize

Int. Rev. Allergol. Clin. Immunol. Family Med., 2020, XXVI/2: 094-099

Title: Pulmonary embolism and surgical site infection after multi-site trauma treated with surgery – a case report 

Authors: Konieczny R, Baranowska A, Baranowski P, Białowąs W, Rybarczyk M. 

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07-02-2020

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SUMMARY IN POLISH & ENGLISH. FULL ARTICLE ONLY IN POLISH.

Pulmonary embolism and surgical site infection after multi-site trauma treated with surgery – a case report

Konieczny R, Baranowska A, Baranowski B, Białowąs W, Rybarczyk M.

Department of Neuroorthopedics, Mazovian Rehabilitation Center STOCER, Konstancin-Jeziorna, Poland

International Review of Medical Practice, 2020; Vol. 26, No. 2, 094

The incidence of surgical site infection in spinal surgery is 4.4% and pulmonary embolism is 2-4%. Comorbidity of both complications is relatively rare.
A case report
. Obese patient, aged 34, suffered a multiple trauma as a result of a fall from a height resulting in a multi-fracture of the radial head and a fracture of the distal base of the right humerus and fracture of the L1 vertebral body with spinal stenosis and kyphosis of the spine, fracture of the upper endplate of Th 9 vertebral body and fracture of the upper and lower right pubic bone. He was treated surgically for fractures of the upper limb, and then transferred to our center for the treatment of L1 vertebral fracture. Patient underwent transpedicular stabilization of the Th11, Th12, L2, L3 vertebrae and decompression of the spinal canal. During rehabilitation at another center, the patient developed symptoms of severe pulmonary embolism, which was treated with unfractionated heparin under the control of the APTT index. Patient improvement and regression of pulmonary vascular changes were obtained. However, the patient re-feverish and blood leakage was found from the post-operative wound after spinal surgery. Revision of the surgical site and administration of antibiotics made it possible to reduce the infection. After the treatment, the patient was discharged home.
Conclusions
. Multiple fractures of the limbs and vertebrae of the spine pose an increased risk of thromboembolism and infection of the surgical site. Physical mobilization after multiple injuries should be emphasized early after surgery, but with full anticoagulation protection individually selected under the control of coagulation indicators.

Key words: pulmonary embolism, postoperative wound infection, multiple fractures