Mycotic wound infections. A new challenge of the surgeon
S. D. Codish, I. D. Sheridan and A. P. Monaco
Fungal wound infections have become more common because of the increased
use of immunosuppressive and antineoplastic agents, prosthetic devices and
grafts, broad-spectrum antibiotics, and hyperalimentation. Severe burns,
renal failure, and other debilitating conditions also predispose to
invasive mycoses. An aggressive diagnostic approach is particularly
important, and tissue biopsy specimens are often necessary to establish a
diagnosis. Meticulous surgical technique and minimization of the
predisposing factors are crucial in the prevention of these infections, and
prophylactic antimycotic agents may be of value in selected high-risk
patients. Some mycotic wound infections can be managed effectively without
systemic therapy; but when systemic agents are needed, combination
antifungal therapy may provide improved results without increased drug
toxicity.