Abstract
Introduction: Necrotizing fasciitis is severe soft tissue that contain with skin-subcutaneous tissue and fascial necrosis, too. Necrotizing fasciitis usuallay occurs post operation and after blunt trauma, even in minör intramusculer injection areas. To correct diagnosis and to make surgical debridement with reconstructive intervention should be very important. İn spite of early diagnosis and treatment is high mortality and morbidity. Such as immun system weakening conditions diabetes mellitus, liver and kidney failure, various malignancy, chronic alcohol use, peripheral vasculer diseases, conditions provoke Necrotizing fasciitis mortality of Necrotizing fasciitis ratio is %20-%50.
Case: Necrotizing fasciitis event is presented that occur after cancer gynecological surgery with phannenstiel cut in this article.
Conclusion: Basic of treatment is early diagnosis and wide spectrum antibiotic treatment, to make debridement recurrent until intact tissue catch up necrosis tissue.
References
- Wong CH, Chang HC, Pasupathy S, et al. Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am 2003; 85-A:1454.
- Holland MJ. Application of the Laboratory Risk Indicator in Necrotising Fasciitis (LRINEC) score to patients in a tropical tertiary referral centre. Anaesth Intensive Care 2009; 37:588.
- Huang KF, Hung MH, Lin YS, et al. Independent predictors of mortality for necrotizing fasciitis: a retrospective analysis in a single institution. J Trauma 2011; 71:467.
- Yildirim Y, Inal M, Tinar S. Necrotizing fasciitis after abdominal hysterectomy: a report on five cases. Arch Gynecol Obstet. 2005;273(2):126-8.
- Das DK, Baker MG, Venugopal K. Increasing incidence of necrotizing fasciitis in New Zealand: a nationwide study over the period 1990 to 2006. J Infect 2011; 63:429.
- Cederna JP, Davies BW, Farkas SA, Sonta JA, Sworniowski T. Necrotizing fasciitis of the total abdominal wall after sterilization by partial salpingectomy. Case report and review of literature. Am J Obstet Gynecol. 1990 Jul;163(1 Pt 1):138-9.
- Eke N. Fournier's gangrene: a review of 1726 cases. Br J Surg 2000; 87:718.
- Hasham S, Matteucci P, Stanley PR, Hart NB. Necrotising fasciitis. BMJ 2005; 330:830.
- Jallali N. Necrotizing fasciitis: its aetiology, diagnosis and management. J Wound Care 2003; 12: 297-300.
- Kaul R, McGeer A, Low DE, et al. Population-based surveillance for group A streptococcal necrotizing fasciitis: Clinical features, prognostic indicators, and microbiologic analysis of seventy-seven cases. Ontario Group A Streptococcal Study. Am J Med 1997; 103:18.
- Elliot DC, Kufera JA, Myers RA. Necrotizing soft tissue infections. Risk factors for mortality and strategies for management. Ann Surg.1996; 224: 672-83.
- Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America. Clin Infect Dis 2014; 59:147.
Abstract
Giriş: Nekrotizan fasiit (NF), cilt-ciltaltı dokusu ile birlikte fasya nekrozunu da içine alan ağır seyirli subkutan yumuşak doku enfeksiyonudur. Genellikle cerrahi girişim ya da künt travmalar sonrası görülmektedir, ancak intramusküler injeksiyon gibi minor girişim bölgelerinde dahi görülebilmektedir. Doğru tanı koyulması ve gerekli cerrahi debridman ile rekonstrüktif cerrahi işlemlerin acilen yapılması çok önemlidir. Ancak, bazen erken tanı ve tedaviye rağmen mortalite ve morbiditesi yüksektir. Diyabetes mellitus, karaciğer ve böbrek yetmezliği, çeşitli malignensiler, kronik alkol kullanımı, periferik vasküler hastalıklar ve ileri yaş gibi immün sistemi zayıflatan haller bu klinik tablo için zemin hazırlayan durumlardır. Genel olarak mortalite oranı %20-50 kadardır.
Olgu: Burada Pfannenstiel insizyon ile yapılan jinekolojik kanser cerrahisi sonrası gelişen bir NF olgusu sunulmaktadır.
Sonuç: NF için tedavinin temelini erken tanı, geniş spektrumlu antibiyotik tedavisi, geride nekrotik doku kalmayacak şekilde sağlam dokulara kadar ve gerektiğinde tekrarlanan debridman oluşturur.
References
- Wong CH, Chang HC, Pasupathy S, et al. Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am 2003; 85-A:1454.
- Holland MJ. Application of the Laboratory Risk Indicator in Necrotising Fasciitis (LRINEC) score to patients in a tropical tertiary referral centre. Anaesth Intensive Care 2009; 37:588.
- Huang KF, Hung MH, Lin YS, et al. Independent predictors of mortality for necrotizing fasciitis: a retrospective analysis in a single institution. J Trauma 2011; 71:467.
- Yildirim Y, Inal M, Tinar S. Necrotizing fasciitis after abdominal hysterectomy: a report on five cases. Arch Gynecol Obstet. 2005;273(2):126-8.
- Das DK, Baker MG, Venugopal K. Increasing incidence of necrotizing fasciitis in New Zealand: a nationwide study over the period 1990 to 2006. J Infect 2011; 63:429.
- Cederna JP, Davies BW, Farkas SA, Sonta JA, Sworniowski T. Necrotizing fasciitis of the total abdominal wall after sterilization by partial salpingectomy. Case report and review of literature. Am J Obstet Gynecol. 1990 Jul;163(1 Pt 1):138-9.
- Eke N. Fournier's gangrene: a review of 1726 cases. Br J Surg 2000; 87:718.
- Hasham S, Matteucci P, Stanley PR, Hart NB. Necrotising fasciitis. BMJ 2005; 330:830.
- Jallali N. Necrotizing fasciitis: its aetiology, diagnosis and management. J Wound Care 2003; 12: 297-300.
- Kaul R, McGeer A, Low DE, et al. Population-based surveillance for group A streptococcal necrotizing fasciitis: Clinical features, prognostic indicators, and microbiologic analysis of seventy-seven cases. Ontario Group A Streptococcal Study. Am J Med 1997; 103:18.
- Elliot DC, Kufera JA, Myers RA. Necrotizing soft tissue infections. Risk factors for mortality and strategies for management. Ann Surg.1996; 224: 672-83.
- Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America. Clin Infect Dis 2014; 59:147.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | OBSTETRICS AND GYNECOLOGY |
| Authors | |
| Publication Date | May 8, 2016 |
| Published in Issue | Year 2016 Volume: 47 Issue: 2 |
