Suppurative Thrombophlebitis: A Lethal Iatrogenic Disease

In 521 patients hospitalized for burns, and treated by venous cannulation, suppurative thrombophlebitis developed in 24 (4.6 per cent). The suppurative process was clinically suspected during life in only 11 of the 24 patients. In these, a latent period of two to 10 days between removal of the cannula and onset of thrombophlebitis was typical. If examination of the site of cannula introduction fails to yield purulent material, exploratory proximal venotomy is recommended. The diagnosis is made by the finding of gross or microscopic suppuration within the lumen of the vein. Nonsurgical treatment with specific antibiotics, anticoagulants, elevation and local care fails to eradicate the disease. Curative treatment is surgical and requires excision of the entire length of the involved vein, followed, preferably, by delayed wound closure.