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Mustansiriya Medical Journal Volume 12 Issue 2 December 2013 | 34

Author: Haqqi I. Razzouki
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2013 Volume: 12 Issue: 2 Pages: 34-39
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Despite the improvement in health care in general and antiseptic techniques in particular, cases of gluteal abscess following intra-muscular injections are still encountered. Although this condition is not considered a serious illness, still it causes complications and exerts a pressure on health resources. Objectives: To determine the factors responsible for the development of gluteal abscesses and to suggest measures to avoid this problem and to study the methods used in management. Methods: This is a prospective analytic study in which all patients admitted to the surgical ward with gluteal abscess over a six months period were included. Detailed demographic, clinical and investigative data were recorded. Predisposing factors and co-morbid conditions were documented, also, the persons who did the injection, the types of drugs used and other factors related to the process of injection were studied. The contribution of the human, technical and pharmacological elements were analysed. The methods used in management, early post-operative complications and the final outcome were recorded. Results: Forty-two patients were included in the study; of those, 30 were females (75%) and the mean age was 35 years. Eighteen were diabetic (42.8%) and 16 (38.04%) were over-weight. Thirty-eight patients (90.47%) had history of preceding intra-muscular injections. Most of the drugs used were antibiotics, mainly Cefotaxime used in 14 patients (33.33%). There was also 8 instances related to Diclofenac injection (19.04%) and 4 related to iron preparation (9.5%). There were 8 instances of mixed injections using more than one drug (19.04%). Twenty-eight episodes were related to under-trained personnel (66.67%); 20 female nurses (47.62%) and 8 male nurses (19%). Forty patients presented mainly as local pain(97%) and 36 patient as visible swelling(90%). The main method of diagnosis was clinical. All patients were treated surgically mostly using general anaesthesia (95%) and frank pus obtained in 34 patients(80.95%). The most common organisms obtained on culture were coagulase-positive staph.aureus and proteus. Conclusions: Gluteal abscess disease is still common despite advances in anti-septic techniques. Most of the cases are due to the lack of experience and improper training of para-medical personnel. This condition is seen more with certain types of drugs and in immune-compromised patients like diabetics.

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