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Toxic Shock Syndrome After Skin Grafting

Arch Surg. 1985;120(2):243. doi:10.1001/archsurg.1985.01390260101016.
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To the Editor.—Toxic shock syndrome (TSS) predominantly affects women during their menstrual periods. However, TSS can also occur in a variety of other situations where surgery, trauma, or infection allow certain exotoxin-producing strains of Staphylococcus aureus to be sequestered.1

Report of a Case.—A 19-year-old man sustained a compound fracture of the right tibia and fibula along with severe, lower leg soft-tissue injury in a motorcycle accident. Initially the wound was debrided, the fractures were reduced, a Hoffman device was applied, and the skin flap was partially closed. The patient seemed to do well, and 12 days later the eschar was excised. On the 23rd day the wound was granulating well but felt somewhat soft and a thin mucoid film covered the wound; a swab culture was taken. On that day, a split-thickness skin graft from the right thigh was applied to the wound and covered with a


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