A Novel Approach to Treating Coccygectomy Infections

Introduction: Anyone having a surgical procedure has a 1-3% chance of developing a surgical site infection (SSI) ¹.  In the case of coccygectomy, post-operative infections are common because the site is so close to the anus and colon, which contain a greater variety of bacteria that can lead to contamination and infection with a rate as high as 30%².

Aim: To demonstrate the effectiveness of treating a coccygectomy surgical site infection with hypochlorous acid and a woven acetate mesh that is coated with a fatty acid ester called DACC (dialkylcarbamoylchloride).

Method: Hypochlorous acid solution was used to cleanse the coccygectomy site and DACC was used as a contact layer of the dressing used. The infection initially created a large amount of purulent drainage. Dressing changes were performed up to four times daily for the first 3 days and then twice daily until healed. The solution remained in and on the wound for 5 minutes each time. Infection apparent 3 ½ weeks postoperatively and treatment was started on 3^rd day.

Outcome: Dramatic decrease in size of wound and amount of drainage noted after 3 days with complete healing occurring in 7 days. Patient has type 2 DM and usually has extended length of time required for healing even without infection present.

Conclusion: Hypochlorous acid penetrates and disrupts biofilm, kills 99.9% of pathogens in 60 secs, neutralizes inflammatory toxins, is non-cytotoxic, non-sensitizing and non-irritating, has broad-spectrum antimicrobial activity, has proven pH stability, has no known pathogenic resistance, has no known contraindications, reduces odor associated with wounds, and is environmentally safe.

DACC is a synthetically produced derivative of a naturally occurring hydrophobic fatty acid and is effective in binding microbes in contaminated to highly colonized wounds. DACC relies on a physical rather than a chemical property to decrease the bio-burden.