• Title/Summary/Keyword: Necrotizing fasciitis

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Clinical Analysis of Cervical Necrotizing Fasciitis (경부 괴사성 근막염의 임상적 고찰)

  • Park, Byung Kuhn;Lee, Do-Joon;Lee, Sang Joon
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.46-49
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    • 2011
  • Background and Objectives Cervical necrotizing fasciitis is a fulminant disease associated with necrosis of connective tissue, spread along the fascial plane, and high mortality. We analyzed the clinical characteristics and treatment outcome of this rare fatal disease. Materials and Methods We retrospectively reviewed the medical records of 19 patients treated for cervical necrotizing fasciitis from January 1999 to January 2009. Mean age was 53.7 years. Results The most common predisposing illness was tonsillitis (36.8%), followed by odontogenic infection (15.7%). Diabetes mellitus was most common underlying disease. Liver cirrhosis and chronic renal failure were found in 2 patients each. All patients were treated with combination of parenteral antibiotics and wide surgical debridement by transcervical and/or thoracotomy approach. Multiple surgical debridements were performed in 7 patients. Tracheotomy was performed in most of the patients (88.8%). Period of total hospitalization and Intensive care unit was 23 days and 10.1 days. Two patients died of disease and overall survival rate was 89.4%. Conclusion Early surgical management and care in intensive care unit are essential for cervical necrotizing fasciitis. Possible complications such as respiratory failure, mediastinitis or sepsis should be carefully evaluated.

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A Case of Necrotizing Fasciitis of Lower Leg Following Mandible Angle Ostectomy (턱벼각 절골술 후 발생한 괴사근막염의 치험례)

  • Lee, Won;Kang, Sang Yoon;Hong, Sung Kwan;Lee, Seung Ryong;Cho, Sang Hun;Han, Byung Kee
    • Archives of Plastic Surgery
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    • v.32 no.5
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    • pp.663-666
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    • 2005
  • Mandible angle ostectomy is the most widely-operated facial contour surgery. We experienced a rare case of necrotizing fasciitis of the lower leg following mandible angle ostectomy. A 20 years old female visited our department 5 days after mandible angle ostectomy. At the time, she was diagnosed as sepsis and on her 2nd admission day, she was diagnosed as necrotizing fasciitis on her left leg. She was treated by fasciotomy and necrotized tissue removal. Necrotizing fasciitis is a rare complication of any kinds of operation but once it develops, it causes fatal results, especially to cosmetic surgeries. Early diagnosis and aggressive operation is known as only treatment for the disease.

Necrotizing Fasciitis of Nose Skin Following Herpes Zoster (대상포진 후 발생한 비부의 괴사성 근막염 치험례)

  • Pae, Woo-Sik;Bae, Chung-Sang;Roh, Si-Gyun;Lee, Nae-Ho;Yang, Kyung-Moo
    • Archives of Craniofacial Surgery
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    • v.13 no.2
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    • pp.147-150
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    • 2012
  • Purpose: Varicella-zoster virus (VZV) infection is a common childhood disease. However, old and immune compromised patients are also at risk. Necrotizing fasciitis is a life threatening infection of the subcutaneous tissues, rapidly extending along the fascial planes. It is associated with a significant mortality rate, reported between 20% and 50%, and is therefore regarded as a surgical emergency. The authors treated a patient, who developed skin necrosis of her nose and left hemifacial area, following VZV infection. There are few literatures concerning this case; therefore, we present a rare case with review of literature. Methods: A 39-year-old woman had shown a localized, painful, multiple bullae and eschar formation in her nose and left hemifacial area for several days. Her skin lesion had rapidly worsened in size and morphology. Results: We diagnosed her as a necrotizing fasciitis, following herpes zoster, and then we performed a debridement of necrotic tissue and took a full thickness skin graft on her nose and left hemifacial area. Now, she was followed up with acceptable aesthetic result after 6 months. Conclusion: Secondary bacterial skin infection following VZV, can cause a result in a higher risk of complications. Among the complication, a necrotizing fasciitis of the head and neck is uncommon, and involvement of the nose is even more rare. Through this uncommon case report, we intend to emphasize the fact that early diagnosis of necrotizing fasciitis is very important, since it frequently necessitates surgical treatment which improves morbidity and leads to good recovery.

Atypical Type of Descending Necrotizing Fasciitis Spreading into the Lateral Chest Wall: Case Report (흉벽 외측을 타고 내려온 비전형성 하행 경부 괴사성 근막염 1예)

  • Lee, Yong Jik;Lee, Jong Cheol;Lee, Ho Min;Kim, Jung Won;Jung, Jong Phil;Park, Chang Ryul
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.61-64
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    • 2011
  • Cervical necrotizing fasciitis is a rare but well known life-threatening soft tissue infection primarily affecting the superficial and deep cervial fascial planes. It may rapidly spread into the mediastinum along fascial planes. So, if proper diagnosis and prompt surgical debridement is delayed, the infection may cause descending necrotizing mediastinitis with extensive necrosis of overlying skin, destroying fascia and muscle. Therefore, the key to the successful outcome is early recognition and rapid initiation of definitive radical debridement. The authors report, along with a literature review, a case of cervical necrotizing fasciitis with atypical spreading into the lateral chest wall.

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Pseudoaneurysm Leading to Necrotizing Fasciitis at the Femoral Arterial Puncture Site

  • Hong, Soo Chung;Choi, Hwan Jun;Kim, Yong Bae
    • Archives of Plastic Surgery
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    • v.41 no.1
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    • pp.81-84
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    • 2014
  • In this article, we present two cases of femoral pseudoaneurysm (PA) at the femoral arterial puncture site followed by necrotizing fasciitis, which is rare but can be fatal when not managed appropriately. PA was revealed by lower-extremity angiography and color-flow Doppler ultrasonography. Hematoma removal, thrombolysis, and bleeder ligation with Gelfoam were repeatedly performed by a vascular surgeon. When necrotizing fasciitis developed, aggressive surgical drainage and creation of a viable wound bed for reconstruction were mandatory. We adopted a vacuum-assisted closure device (Kinetics Concepts International) as the standard treatment for complicated, serious, infected PA of the puncture site. Excellent clinical outcomes were obtained.

Necrotizing Fasciitis in a 7-day-old Term Healthy Neonate

  • Koo, Soo-Hyun;Chung, Mi-Lim;Park, Kun-Bo
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.148-152
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    • 2011
  • Necrotizing fasciitis is a rare, but life-threatening infection. Prompt diagnosis and early aggressive intervention is required for survival. However, there has been frequently occurred in delays of diagnosis and treatment due to its non-specific nature. Therefore, a high index of suspicion is needed to ensure timely intervention. We report a case of necrotizing fasciitis in a 7-day-old term healthy neonate.

Korean Medical Treatment after Surgical Treatment of Necrotizing Fasciitis on Thigh : A Case Report (대퇴부 괴사성 근막염의 외과적 수술 후 한방치료에 대한 증례 보고)

  • Geum, Ji-Hye;Ha, Won-Bae;Lee, Jung-Han
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.13 no.2
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    • pp.85-95
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    • 2018
  • Objectives : The aim of the present study was to report the clinical progress of a patient who underwent surgical treatment of necrotizing fasciitis. Methods : During the admission period, The patient was treated with acupuncture, cupping, Korean Medicine, Chuna therapy every day and observed by Numeric Rating Scale(NRS), Pain Disability Index(PDI), Beck Depression Inventory(BDI), and assessment about range of motion(ROM) and manual muscle test(MMT) for hip & knee joint. Results : After treated by using above treatment, NRS, PDI, BDI and ROM, MMT were improved. Conclusions : Korean Medical treatment are estimated to be good for patients after surgical treatment of necrotizing fasciitis. But more cases are required to prove the effectiveness of the treatment.

CERVICOFACIAL NECROTIZING FASCIITIS;CASE REPORT (경안면 괴사성 근막염;증례보고)

  • Park, Kwan-Soo;Jeong, Ki-Hoon;Kim, Hyo-Eon;Jeong, Jeong-Kwon;Yoon, Kyu-Ho;Jeon, In-Seong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.1
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    • pp.77-81
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    • 2001
  • Necrotizing fasciitis is defined as infectious disease showing extensive necrosis of the superficial fascia with widespread involvement of the surrounding tissues and concurrent systemic toxicity. It is found commonly in the extremities, the trunk and the perineum, but shows extremely rare occurrence in the well vascularized area such as head and neck area. Occurred in the head and neck area, it is called "cervicofacial necrotizing fasciitis" (CFNF). It is a fatal disease which carries a mortality rate up to 60%. Early diagnosis, aggressive surgical debridement of necrotic tissues and massive antibiotics therapy are essential for achieving a favorable outcome. We present a case of cervicofacial necrotizing fasciitis in 35-year-old male patient with literature review.

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A Case of Descending Necrotizing Mediastinitis (하행 괴사성 종격동염의 치험례)

  • Lee, In Soo;Choi, Hwan Jun;Lee, Han Jung;Lee, Jae Wook;Lee, Dong Gi
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.351-355
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    • 2009
  • Purpose: Cervical necrotizing fasciitis tends to involve the deep soft tissues and spread caudally to the anterior chest and mediastinum, often resulting in major complications and death. It may rapidly spread into the thorax along fascial planes, and the associated diagnostic delay results in this descending necrotizing mediastinitis. So, aggressive multidisciplinary therapy with surgical drainage is mandatory. We present a very rare case of descending necrotizing mediastinitis with literature review. Methods: A 53 years old male visited our department 7 days after trauma in neck. His premorbid conditions and risk factors of necrotizing fasciitis were concealed hepatoma, trauma history, chronic liver disease, and nutrition deficit. Computed tomographic scans of the head and neck region were performed in this patient : signs of necrotizing fasciitis, were seen in the platysma, sternocleidomastoid, trapezius muscle and strap muscles of the neck. Fluid accumulations involved multiple neck spaces and mediastinum. At the time, he diagnosed as necrotizing fasciitis on his neck and anterior chest. Necrotic wound was excised serially and we treated this with the Vacuum - assisted closure(VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge and achieving additional 3 pieces drainage tubes in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was utilized for a period of 12 days. Results: We obtained satisfactory results from wide excision, abscess drainage with the VAC system, and then split thickness skin graft. The postoperative course was uneventful. Conclusion: The refined technique using the VAC system can provide a means of simple and effective management for the descending necrotizing mediastinitis, with better cosmetic and functional results. Finally, the VAC system has been adopted as the standard treatment for deep cervical and mediastinal wound infections as a result of the excellent clinical outcome.

Necrotizing fasciitis of the head and neck: a case report

  • Choi, Moon-Gi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.2
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    • pp.90-96
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    • 2015
  • Necrotizing fasciitis (NF) is an infection that spreads along the fascial planes, causing subcutaneous tissue death characterized by rapid progression, systemic toxicity, and even death. NF often appears as a red, hot, painful, and swollen wound with an ill-defined border. As the infective process continues, local pain is replaced by numbness or analgesia. As the disease process continues, the skin initially becomes pale, then mottled and purple, and finally, gangrenous. The ability of NF to move rapidly along fascial planes and cause tissue necrosis is secondary to its polymicrobial composition and the synergistic effect of the enzymes produced by the bacteria. Treatment involves securing the airway, broad-spectrum antimicrobial therapy, intensive care support, and prompt surgical debridement, repeated as needed. Reducing mortality rests on early diagnosis and prompt aggressive treatment.