INFECTIVE COMPLICATIONS OF PENETRATING GUNSOT CRANIOCEREBRAL WOUNDS

A.A. Potapov, G.G. Shaginyan, I.A. Aleksandrova, V.F. Imshenetskaya, A.D. Kravchuk, L.B. Likhterman

Burdenko Research Institute of Neurosurgery

Tactics of surgical and conservative treatment as well as types of species, their structure and resistance of infecting agents responsible for pyo-inflammatory complications to antibiotics are analyzed in 193 cases with penetrating gunshot craniocerebral wounds who were admitted to Burdenko Research Institute of Neurosurgery in October 1993-December 1998.

All the wounded underwent complex examination including CT of the brain on admission and during treatment. Bacteriologic study of lumbar and ventricular liquor, fluid accumulating under a skin graft, abscess content, bone fragments, discharge from wounds and fistulas was carried out. Resistance to antibiotics was determined on the basis of one out of three programs and a set of disks with 15 antibacterial drugs for Gram-positive, Gram-negative and non-fermenting bacteria.

Data on the structure and resistance of infecting agents causing posttraumatic pyo-inflammatory complications to antibiotics and results of treatment were used for determination of the most effective scheme of antibiotic treatment.