Necrotizing fasciitis: an alternative approach.

نویسندگان

  • R Percival
  • A W Hargreaves
چکیده

In 1933, Meleney clearly distinguished 'streptococcal' gangrene from postoperative synergistic gangrene in a classical description. In modern surgical practice (Ledingham and Tehrani, 1975), necrotizing fasciitis is considered a more applicable term for 'streptococcal' gangrene in both descriptive and aetiological terms. There are a number of reports indicating that postoperative synergistic gangrene is successfully treated with antibiotics (Grimshaw and Stent, 1945; Meleney, Friedman and Harvey, 1945; Meleney, Shambaugh and Millen, 1950; Hutchinson, Summerley and Lawson, 1976). In contrast, antibiotics and hyperbaric oxygen are ineffective with necrotizing fasciitis. Conventional treatment dictates that the only effective management is radical debridement of the area involved (Meleney, 1933; Wilson, 1952; Stone and Martin, 1972). Following debridement, skin grafts are applied as a second stage procedure only after the development of a clean, granulating recipient bed. In this paper, three cases of necrotizing fasciitis are presented. Following a uniformly fatal outcome, an alternative approach is suggested.

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عنوان ژورنال:
  • Postgraduate medical journal

دوره 58 686  شماره 

صفحات  -

تاریخ انتشار 1982