Integrated clinical care pathway for managing necrotising soft tissue infections

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Necrotising soft-tissue infection.

DESCRIPTION A 55-year-old woman presented with a 3-day history of progressively worsening pain, swelling and ‘unpleasant crackling feeling’ on her left upper limb. These complaints had begun after she noticed a small reddish lesion on her left elbow. The patient had received a diagnosis of systemic lupus erythematosus 15 years before coming to us and was taking methylprednisolone and acenocouma...

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Severe necrotising soft tissue infections in orthopaedic surgery.

PURPOSE To review all cases of necrotising infection managed in the Department of Orthopaedic Surgery of Dunedin Hospital in New Zealand between 1989 and 1998. METHODS Hospital records were analysed for predisposing factors, clinical features, diagnostic results, treatment strategies, and outcomes. RESULTS 13 cases (9 males and 4 females) of necrotising infection were identified. The mean a...

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Immunoglobulin for necrotising soft tissue infections (INSTINCT): protocol for a randomised trial.

INTRODUCTION Necrotising soft tissue infections (NSTI) are aggressive infections that can result in severe disability or death. Intravenous polyspecific immunoglobulin G (IVIG) is used as supplementary treatment for patients with NSTIs. The level of evidence is very low, but suggests that IVIG may have beneficial effects. However, IVIG may also have adverse effects. With this trial we will esti...

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Necrotising soft tissue infection following mastectomy

Necrotising fasciitis is a rare but rapidly progressive soft tissue disease which can lead to extensive necrosis, systemic sepsis and death. Including this case, only 7 other cases have been reported in the world literature with only 2 others affecting the patient post mastectomy. This 59 year old Caucasian lady presented with severe soft tissue infection soon after mastectomy, which was succes...

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Necrotizing soft-tissue infections: clinical guidelines.

Options 1. Clindamycin should be considered in initial coverage for its effects on exotoxin production in group A beta-hemolytic Streptococcus (GAS) infections. 2. Vacuum-assisted closure devices may be helpful in secondary wound management after debridement of NSTIs. 3. Empiric vancomycin may be warranted during pending culture results to cover for the increasing incidence of community-acquire...

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ژورنال

عنوان ژورنال: Indian Journal of Surgery

سال: 2009

ISSN: 0972-2068,0973-9793

DOI: 10.1007/s12262-009-0076-6