{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:14:20Z","timestamp":1783509260710,"version":"3.55.0"},"reference-count":11,"publisher":"MDPI AG","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,1]]},"abstract":"\n Natural disasters, such as hurricanes and severe flooding, pose a threat of increased skin and soft-tissue infections, especially in the event of open fractures and wading through the waters. The purpose of this case study is to present a complex patient sustaining trauma resulting in an open bimalleolar fracture, multiple wounds, and exposure to a variety of water-borne pathogens during Hurricane Harvey in Houston, Texas, in 2017. He underwent multiple incision and drainage procedures, tissue cultures, and placement of antibiotic beads, with an application of external fixation to the left ankle. Several unique multidrug-resistant water-borne pathogens were identified, including\n Aeromonas hydrophila<\/jats:italic>\n ,\n Pseudomonas fluorescens\/putida<\/jats:italic>\n , and\n Serratia marcescens<\/jats:italic>\n . Once the soft-tissue envelope was restored and infection cleared, a full-thickness rotational flap with tissue expansion was performed. Ultimate reconstruction was delayed several weeks and final left ankle open reduction and internal fixation was performed following antimicrobial treatment with split-thickness skin autograft and wound vacuum-assisted closure application. The patient was discharged after 28 days with no further complications. In instances such as these, all caretakers coming into contact with the patient should be aware of the potential risks of the possible infectious diseases and management to optimize the recovery following hydrologic disasters.\n <\/jats:p>","DOI":"10.7547\/19-068","type":"journal-article","created":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T01:49:18Z","timestamp":1591321758000},"source":"Crossref","is-referenced-by-count":3,"title":["Hurricane Harvey Aftermath"],"prefix":"10.3390","volume":"110","author":[{"given":"Rosemary","family":"Buckle","sequence":"first","affiliation":[{"name":"St. Joseph Medical Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anum","family":"Dhukani","sequence":"additional","affiliation":[{"name":"St. Joseph Medical Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayven L.","family":"Bridges","sequence":"additional","affiliation":[{"name":"St. Joseph Medical Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barton C.","family":"Garcia","sequence":"additional","affiliation":[{"name":"St. Joseph Medical Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"i8750-7315-110-2-Article_10-b01","series-title":"Am J Clin Dermatol","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1007\/s40257-015-0138-4","article-title":"The infectious and noninfectious dermatological consequences of flooding: a field manual for the responding provider","volume":"16","author":"Bandino","year":"2015","unstructured":"Bandino\n JP.\n \n \n Hang\n A.\n \n \n Norton\n SA.\n \n \n The infectious and noninfectious dermatological consequences of flooding: a field manual for the responding provider.\n\t\t\t\t\tAm J Clin Dermatol16: \n\t\t\t\t\t399,\n\t\t\t\t\t2015.\n\t\t\t\thttp:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000361640600005&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1007\/s40257-015-0138-426159354"},{"key":"i8750-7315-110-2-Article_10-b02","series-title":"Major Hurricane Harvey: August 25-29, 2017.","year":"2019","unstructured":"National Weather Service:\n\t\t\t\t\tMajor Hurricane Harvey: August 25-29, 2017.Available at: http:\/\/www.weather.gov\/crp\/hurricane_harvey. Accessed March 8,2019."},{"key":"i8750-7315-110-2-Article_10-b03","series-title":"Houston Press. August 29, 2017. Flooding from Harvey leads to Houston-area hospital closure.","author":"Malisow","year":"2019","unstructured":"Malisow\n C.\n \n \n Houston Press. August 29, 2017. Flooding from Harvey leads to Houston-area hospital closure.\n Available at: http:\/\/www.houstonpress.com\/news\/harvey-prompts-hospital-closures-9743958. Accessed March 8,\n 2019."},{"key":"i8750-7315-110-2-Article_10-b04","series-title":"CNN Website","article-title":"Thousands rescued as Harvey's water rise","author":"McLaughlin","year":"2019","unstructured":"McLaughlin\n EC.\n \n \n Thousands rescued as Harvey's water rise.\n\t\t\t\t\tCNN Website.\n\t\t\t\t\tAvailable at: http:\/\/www.cnn.com\/2017\/08\/28\/us\/harvey-houston-texas-louisiana\/index.html. Accessed March 11,2019."},{"key":"i8750-7315-110-2-Article_10-b05","series-title":"CBS News Website","article-title":"Death toll bumps up to at least 63 amid Hurricane Harvey recovery. September 4, 2017","year":"2019","unstructured":"CBS News:\n\t\t\t\t\tDeath toll bumps up to at least 63 amid Hurricane Harvey recovery. September 4, 2017.\n\t\t\t\t\tCBS News Website.\n\t\t\t\t\tAvailable at: https:\/\/www.cbsnews.com\/news\/hurricane-harvey-death-toll-flood-houston-recovery-harris-county. Accessed March 11,2019."},{"key":"i8750-7315-110-2-Article_10-b06","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1001\/jama.2017.14618","article-title":"Mitigating the mental and physical health consequences of Hurricane Harvey","volume":"318","author":"Shultz","year":"2017","unstructured":"Shultz\n JM.\n \n \n Galea\n S.\n \n \n Mitigating the mental and physical health consequences of Hurricane Harvey.\n\t\t\t\t\tJAMA318: \n\t\t\t\t\t1437,\n\t\t\t\t\t2017.\n\t\t\t\t2889281410.1001\/jama.2017.14618http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000413187300011&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3"},{"key":"i8750-7315-110-2-Article_10-b07","series-title":"World J Surg","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1007\/s00268-014-2663-3","article-title":"Wound management in disaster settings","volume":"39","author":"Wuthisuthimethawee","year":"2015","unstructured":"Wuthisuthimethawee\n P.\n \n \n Lindquis\n SJ.\n \n \n Sandler\n N.\n \n :\n\t\t\t\t\t\n Wound management in disaster settings.\n\t\t\t\t\tWorld J Surg39: \n\t\t\t\t\t842,\n\t\t\t\t\t2015.\n\t\t\t\t10.1007\/s00268-014-2663-325085100http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000351231100005&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3"},{"key":"i8750-7315-110-2-Article_10-b08","series-title":"Am J Bone Joint Surg","doi-asserted-by":"publisher","first-page":"453","DOI":"10.2106\/00004623-197658040-00004","article-title":"Prevention of infection in treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses","volume":"58","author":"Gustilo","year":"1976","unstructured":"Gustilo\n RB.\n \n \n Anderson\n JT.\n \n \n Prevention of infection in treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses.\n\t\t\t\t\tAm J Bone Joint Surg58: \n\t\t\t\t\t453,\n\t\t\t\t\t1976.\n\t\t\t\t77394110.2106\/00004623-197658040-00004"},{"key":"i8750-7315-110-2-Article_10-b09","series-title":"Orthopedics","first-page":"1025","article-title":"Acute management of open fractures: an evidence based review","volume":"38","author":"Halawi","year":"2015","unstructured":"Halawi\n MJ.\n \n \n Moorword\n MP.\n \n \n Acute management of open fractures: an evidence based review.\n\t\t\t\t\tOrthopedics38: \n\t\t\t\t\t1025,\n\t\t\t\t\t2015,\n\t\t\t\thttp:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000367840100012&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3"},{"key":"i8750-7315-110-2-Article_10-b10","series-title":"J Trauma Acute Care Surg","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1097\/TA.0000000000000398","article-title":"Evidence-based protocol for prophylactic antibiotics in open fractures: improved antibiotic stewardship with no increase in infection rates","volume":"77","author":"Rodriguez","year":"2014","unstructured":"Rodriguez\n L.\n \n \n Jung\n HS.\n \n \n Goulet\n JA.\n \n :\n\t\t\t\t\t\n Evidence-based protocol for prophylactic antibiotics in open fractures: improved antibiotic stewardship with no increase in infection rates.\n\t\t\t\t\tJ Trauma Acute Care Surg77: \n\t\t\t\t\t400,\n\t\t\t\t\t2014.\n\t\t\t\thttp:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000341120200003&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1097\/TA.000000000000039825159242"},{"key":"i8750-7315-110-2-Article_10-b11","series-title":"J Trauma Acute Care 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Interdisciplinary Case Report on the Management of an Open Bimalleolar Fracture"],"short-title":[],"issued":{"date-parts":[[2020,3,1]]},"references-count":11,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.7547\/19-068","relation":{},"ISSN":["8750-7315"],"issn-type":[{"value":"8750-7315","type":"print"}],"subject":[],"published":{"date-parts":[[2020,3,1]]}}}