open access

Vol 62, No 3 (2011)
MARITIME MEDICINE Original articles
Published online: 2011-12-15
Submitted: 2013-02-18
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Wound infections on board ship — prevention, pathogens, and treatment

Eilif Dahl
International Maritime Health 2011;62(3):186-190.

open access

Vol 62, No 3 (2011)
MARITIME MEDICINE Original articles
Published online: 2011-12-15
Submitted: 2013-02-18

Abstract

Wounds are common in seafarers and they can easily become infected in the marine environment. Pre-sea tetanus immunization is essential. Without diagnostic facilities and only a limited range of antibiotics onboard, injury prevention and early treatment to reduce the likelihood of infection are important measures. Suturing clean cuts reduces healing time and risk of infection. Fresh, clean cuts, especially on the face or head, can be closed by adhesive tape or sutures, but if infection arises, then one or more sutures should be removed to enable drainage. Most wounds must be considered contaminated and should not be closed, just covered with sterile dressing after cleaning. Antibiotic treatment should be started immediately in seafarers with hand and puncture wounds. The primary treatment for a simple abscess is incision and drainage. Antibiotic treatment is recommended for abscesses if the infection spreads to the surrounding tissue (associated cellulitis), if there is lack of response to incision and drainage alone, or if the abscess is in an area difficult or dangerous to drain (e.g. face, palm, genitalia). Recommended therapy for cellulitis is 5–10 days of dicloxacillin, cephalexin, clindamycin, or erythromycin, but if there is no improvement after 2–3 days, methicillin-resistant Staphylococcus aureus (MRSA) should be suspected. Bites and burn wounds require special attention. Since wound infections can deteriorate rapidly, a telemedicine advice service (TMAS) should be consulted during the early stages, and serial digital photographs of the affected area, transmitted by e-mail to TMAS, are often useful during treatment at sea.
(Int Marit Health 2011; 62, 3: 186–190)

Abstract

Wounds are common in seafarers and they can easily become infected in the marine environment. Pre-sea tetanus immunization is essential. Without diagnostic facilities and only a limited range of antibiotics onboard, injury prevention and early treatment to reduce the likelihood of infection are important measures. Suturing clean cuts reduces healing time and risk of infection. Fresh, clean cuts, especially on the face or head, can be closed by adhesive tape or sutures, but if infection arises, then one or more sutures should be removed to enable drainage. Most wounds must be considered contaminated and should not be closed, just covered with sterile dressing after cleaning. Antibiotic treatment should be started immediately in seafarers with hand and puncture wounds. The primary treatment for a simple abscess is incision and drainage. Antibiotic treatment is recommended for abscesses if the infection spreads to the surrounding tissue (associated cellulitis), if there is lack of response to incision and drainage alone, or if the abscess is in an area difficult or dangerous to drain (e.g. face, palm, genitalia). Recommended therapy for cellulitis is 5–10 days of dicloxacillin, cephalexin, clindamycin, or erythromycin, but if there is no improvement after 2–3 days, methicillin-resistant Staphylococcus aureus (MRSA) should be suspected. Bites and burn wounds require special attention. Since wound infections can deteriorate rapidly, a telemedicine advice service (TMAS) should be consulted during the early stages, and serial digital photographs of the affected area, transmitted by e-mail to TMAS, are often useful during treatment at sea.
(Int Marit Health 2011; 62, 3: 186–190)
Get Citation

Keywords

injury prevention; bites; burns; abscesses; maritime medicine

About this article
Title

Wound infections on board ship — prevention, pathogens, and treatment

Journal

International Maritime Health

Issue

Vol 62, No 3 (2011)

Pages

186-190

Published online

2011-12-15

Bibliographic record

International Maritime Health 2011;62(3):186-190.

Keywords

injury prevention
bites
burns
abscesses
maritime medicine

Authors

Eilif Dahl

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