Modern Dressing Approach for Surgical Site Infection in Gender-Affirming Surgery Using Stem Cells: A Case Report

Background: Gender-affirming surgery is a serious process where both physical and psychosocial changes in the body of the transgender individual occur, bringing about great changes in the quality of life. However, like all other surgical interventions, gender-affirming surgery involves the risk and complications of SSI, thereby delaying recovery. This case examines a case of surgical site infection in a ۲۷-year-old female patient undergoing gender-affirming surgery with the implantation of male genitalia using stem cells. Materials and Methods: A ۲۷-year-old female with masculine features presented to the physician two weeks post-gender-affirming surgery. Her past medical history was unremarkable. Examination revealed redness, swelling, and purulent discharge from the surgical site. Based on the physical condition and clinical symptoms, a diagnosis of surgical site infection was made. Results: The patient was initially referred to an infectious disease specialist for antibiotic treatment due to the signs of localized wound infection. The medication Levofloxacin ۵۰۰ mg was ordered and started. There was necrotic tissue and slough on the wound bed that was treated with sharp debridement. Additionally, antibacterial dressings impregnated with PHMB and silver such as hydrogel and hydrofiber dressings were also used to reduce microbial load and odor and to provide autolytic debridement. After cleaning the wound bed to enhance granulation tissue growth, dressings like silver alginate and collagen were used, while the final stage of the wound was epithelialized and covered completely with silver atraumatic dressing. Treatment Outcomes: There was marked improvement in the patient after two months of treatment. Infection was brought under control and the wound healed completely. Conclusion: SSI is among the most important postoperative care issues, especially after complicated surgeries such as gender affirming surgeries. The management of SSI is multidisciplinary in nature, including the use of antibiotics and dressings. In their findings, the results indicated that dressings made from hydrogel, hydrofiber, and silver alginate and collagen have reduced costs for treatment and accelerated the process of healing. These dressings promoted optimal conditions for the growth of granulation tissue by reducing microbial load and aiding autolytic debridement. This was the precursor to the complete epithelialization of the wound. Thus, this may be a good strategy in the management of SSI and improvement of clinical outcomes for patients.

Keywords:

Gender-affirming surgery , surgical site infection , modern dressing