• Forest R Sheppard, Paul Keiser, David W Craft, Fred Gage, Martin Robson, Trevor S Brown, Kyle Petersen, Stephanie Sincock, Matt Kasper, Jason Hawksworth, Doug Tadaki, Thomas A Davis, Alexander Stojadinovic, and Eric Elster.
• Department of Surgery, National Naval Medical Center, Bethesda, MD, USA. Forest.Sheppard@med.navy.mil
• Am. J. Surg. 2010 Oct 1; 200 (4): 489-95.

BackgroundThe microbiology of war wounds has changed as medicine and warfare have evolved. This study was designed to determine the microbial flora and bacterial quantification of present-day war wounds in US troops from Iraq and Afghanistan upon arrival at the National Naval Medical Center (NNMC).MethodsPatients with extremity combat wounds treated with a vacuum-assisted wound closure device were enrolled in study. Wounds were biopsied every 48 to 72 hours with quantitative microbiology performed on all biopsies.ResultsTwo hundred forty-two wound biopsies from 34 patients; 167 (69%) showed no growth, and 75 (31%) showed positive growth. The incidence of any bacterial isolation from biopsies weekly from the time of injury was 28% (first), 31% (second), and 37% (≥third). Acinetobacter baumannii was the most prevalent isolate.ConclusionsMost soft-tissue wounds from Iraq and Afghanistan do not have significant bacterial burden upon arrival to and during initial treatment at NNMC. Improved evaluation of combat wound microbiology at all levels of care is warranted to determine shifts in microbiology and to impact care practices.Published by Elsevier Inc.

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