Necrotizing fasciitis: an alternative approach.
نویسندگان
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.
منابع مشابه
Cervicofacial Necrotizing Fasciitis in Patients with No Underlying Medical Conditions: A Review of Four Cases Seen in Twelve Months at a Nigerian Tertiary Hospital
Necrotizing fasciitis of the head and neck is a rare but rapidly progressive infection involving the skin, subcutaneous tissue, and fascia. We report 4 cases of cervicofacial necrotizing fasciitis with similar patterns of presentation. All the 4 cases presented with an odontogenic source and no underlying medical condition. All the patients had tooth extraction and serial wound debridement. Thr...
متن کاملUnsuspected early necrotizing fasciitis identified by 18F-FDG PET imaging in a patient with acute myeloid leukemia
Necrotizing fasciitis is a part of a spectrum of necrotizing soft tissue infections that usually follow a surgical intervention or a chronic / acute medical illness. Diagnosis is often based on symptoms which classically start within hours after an injury. There are no reports on the use of PET/CT in this condition. Sparing reports of its association in patients with malignancy (Ca of colon and...
متن کاملLife –threatening Necrotizing Fasciitis: a case report
Necrotizing fasciitis is characterized by a rapidly progressing necrosis of subcutaneous fat and fascia that rarely occurs in head and neck. It can be life threatening in the case of late diagnosis and antibiotic therapy and without surgical intervention. It is caused by group A streptococci or by a synergistic combination of aerobe and anaerobe microorganisms and bacterial synergy is an import...
متن کاملThe Perils of Complementary Alternative Medicine
More than 11,000 articles lauding alternative medicine appear in the PubMed database, but there are only a few articles describing the complications of such care. Two patients suffering from complications of alternative medicine were treated in our hospital: one patient developed necrotizing fasciitis after acupuncture, and the second developed an epidural hematoma after chiropractic manipulati...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Postgraduate medical journal
دوره 58 686 شماره
صفحات -
تاریخ انتشار 1982