Abstract
Objective To assess the clinical features and the management of
skin flap infection (SFI) following cochlear implantation (CI) and to
characterize the biofilm features by the scanning electron microscopy.
Setting The study was conducted at a tertiary care center.
Participants A total of 1,251 patients receiving CI in the
tertiary Hospital between August 2001 and March 2021 were enrolled.
Scanning electron microscopy was utilized for characterizing the
etiology of infection.
Main outcome measures A proposed stratification system was
applied to optimize treatments for post-operation flap infection.
Results After CI, SFI was reported in 16 patients (1.28%) and
patients under 6-year-old were more prone to flap infection.
Staphylococcus Aureus was found to be the most common bacterial culprit
for flap infection, with 6 cases explored in this group (6/16, 37.5%).
Bacterial biofilm was observed within the jelly-like substance on the
surface of CI equipment of SFI patients. A two-stage stratification was
proposed for optimizing the treatment schemes. Conservative therapy was
recommended for stage I cases while surgical treatment was the preferred
method for stage II patients.
Conclusions Pediatric patients are more susceptible to SFI
after CI. The formation of bacterial biofilm may be the vital cause of
SFI. The proposed stratification can facilitate the
management
of SFI.
Keywords Cochlear implant; biofilm; infection; scanning
electron microscope; management