대한두개안면성형외과학회지 (Archives of Craniofacial Surgery)

  • 제21권2호
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  • Pages.127-131
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  • 2020
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  • 2287-1152(pISSN)
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  • 2287-5603(eISSN)
대한두개안면성형외과학회 (Korean Cleft Palate-Craniofacial Association)
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Klebsiella pneumoniae necrotizing fasciitis on the upper lip in a patient with uncontrolled diabetes

  • Kim, Hyeong Seop (Department of Plastic and Reconstructive Surgery, Kangdong Sacred Heart Hospital) ;
  • Chang, Yong Joon (Department of Plastic and Reconstructive Surgery, Kangdong Sacred Heart Hospital) ;
  • Chung, Chul Hoon (Department of Plastic and Reconstructive Surgery, Kangdong Sacred Heart Hospital)
  • 투고 : 2019.11.19
  • 심사 : 2020.03.31
  • 발행 : 2020.04.20
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초록

A 60-year-old woman with a history of diabetes mellitus and chronic renal failure was admitted to the hospital with severe pain in the upper lip, which began 4 days prior to admission, accompanied by a bullous lesion and suspected cellulitis in the upper lip. Immediately after admission, as the patient's general condition worsened, tests revealed a non-ST elevated myocardial infarction, septic embolism of the lung, as well as septic shock. Her upper lip suddenly presented a gangrenous and necrotic change, which the tissue and blood culture confirmed to be a Klebsiella pneumoniae infection. After a quick response, the patient's general condition improved. Subsequently, serial debridement was performed to effectively clear away the purulent discharge. While under general anesthesia, the process confirmed full-layer necrosis of the upper lip including the orbicularis oris muscle. Almost half of the entire upper lip sustained a full-layer skin and soft tissue defect, with scar contracture. Six months later, to correct the drooling and lip sealing following the defects, a scar release and an Abbe flap coverage were performed considering both functional and aesthetic aspects. The follow-up revealed a favorable corrective result of the upper lip drooling, and the patient was satisfied from a functional perspective.

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참고문헌

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