Toxic shock syndrome surgery: Difference between revisions
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==Overview:== | ==Overview:== | ||
Surgery is not the first-line treatment option for patients with toxic shock syndrome(TSS). Surgical debridement is usually reserved for patients with either necrotizing fasciitis(NF), and patients with deep-seeded pyogenic infection. | [[Surgery]] is not the first-line treatment option for patients with [[toxic shock syndrome]](TSS). Surgical [[debridement]] is usually reserved for patients with either [[necrotizing fasciitis]](NF), and patients with deep-seeded [[pyogenic]] infection. [[Urgent care|Urgent]] surgical [[debridement]] was recommended for all patients who develop [[Necrotizing fasciitis|NF]] earlier, but is under questioning nowadays. | ||
Urgent surgical debridement was recommended for all patients who develop NF earlier, but is under questioning nowadays. | |||
==Surgery== | ==Surgery== | ||
Prompt, aggressive, immediate exploration and debridement of patients thought to have deep tissue localized infection was believed to be a surgical emergency <ref name="pmid9560122">{{cite journal |vauthors=Schurr M, Engelhardt S, Helgerson R |title=Limb salvage for streptococcal gangrene of the extremity |journal=Am. J. Surg. |volume=175 |issue=3 |pages=213–7 |year=1998 |pmid=9560122 |doi= |url=}}</ref>. Surgical exploration of the susceptible infected tissue may help with the early and definitive diagnosis of NF. In NF related TSS patients, infection usually is more extensive than is apparent from external examination. Although the necessity of surgical debridement, the recommendation of immediate radical excision of necrotic tissue in patients with streptococcal TSS NF is not supported by clinical studies and should be reconsidered as an emergency treatment in TSS management<ref name="pmid7553574">{{cite journal |vauthors=Kotb M |title=Bacterial pyrogenic exotoxins as superantigens |journal=Clin. Microbiol. Rev. |volume=8 |issue=3 |pages=411–26 |year=1995 |pmid=7553574 |pmc=174633 |doi= |url=}}</ref>. | Prompt, aggressive, immediate exploration and [[debridement]] of patients thought to have deep tissue localized [[infection]] was believed to be a [[surgical emergency]] <ref name="pmid9560122">{{cite journal |vauthors=Schurr M, Engelhardt S, Helgerson R |title=Limb salvage for streptococcal gangrene of the extremity |journal=Am. J. Surg. |volume=175 |issue=3 |pages=213–7 |year=1998 |pmid=9560122 |doi= |url=}}</ref>. Surgical [[exploration]] of the susceptible infected tissue may help with the early and definitive diagnosis of NF. In NF related [[Toxic shock syndrome|TSS]] patients, infection usually is more extensive than is apparent from external examination. Although the necessity of surgical [[debridement]], the recommendation of immediate radical excision of [[necrotic tissue]] in patients with [[Streptococcus|streptococcal]] TSS NF is not supported by clinical studies and should be reconsidered as an emergency treatment in TSS management<ref name="pmid7553574">{{cite journal |vauthors=Kotb M |title=Bacterial pyrogenic exotoxins as superantigens |journal=Clin. Microbiol. Rev. |volume=8 |issue=3 |pages=411–26 |year=1995 |pmid=7553574 |pmc=174633 |doi= |url=}}</ref>. | ||
==Indications== | ==Indications== | ||
Surgical debridement of body tissues should be considered in these patients: | Surgical [[debridement]] of body tissues should be considered in these patients: | ||
* Localized source of infection is diagnosed | * [[Localized disease|Localized]] source of [[infection]] is diagnosed | ||
* Streptococcal NF-related TSS patients<ref name="urlChapter 125. Infections of the Skin, Muscles, and Soft Tissues | Harrisons Principles of Internal Medicine, 18e | AccessMedicine | McGraw-Hill Medical">{{cite web |url=http://accessmedicine.mhmedical.com/content.aspx?bookid=331§ionid=40726869 |title=Chapter 125. Infections of the Skin, Muscles, and Soft Tissues | Harrison's Principles of Internal Medicine, 18e | AccessMedicine | McGraw-Hill Medical |format= |work= |accessdate=}}</ref> | * [[Streptococcus|Streptococcal]] [[Necrotizing fasciitis|NF]]-related [[Toxic shock syndrome|TSS]] patients<ref name="urlChapter 125. Infections of the Skin, Muscles, and Soft Tissues | Harrisons Principles of Internal Medicine, 18e | AccessMedicine | McGraw-Hill Medical">{{cite web |url=http://accessmedicine.mhmedical.com/content.aspx?bookid=331§ionid=40726869 |title=Chapter 125. Infections of the Skin, Muscles, and Soft Tissues | Harrison's Principles of Internal Medicine, 18e | AccessMedicine | McGraw-Hill Medical |format= |work= |accessdate=}}</ref> | ||
==References== | ==References== | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Syndromes]] | [[Category:Syndromes]] | ||
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[[Category:Emergency mdicine]] | |||
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[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
Latest revision as of 00:27, 30 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]
Overview:
Surgery is not the first-line treatment option for patients with toxic shock syndrome(TSS). Surgical debridement is usually reserved for patients with either necrotizing fasciitis(NF), and patients with deep-seeded pyogenic infection. Urgent surgical debridement was recommended for all patients who develop NF earlier, but is under questioning nowadays.
Surgery
Prompt, aggressive, immediate exploration and debridement of patients thought to have deep tissue localized infection was believed to be a surgical emergency [1]. Surgical exploration of the susceptible infected tissue may help with the early and definitive diagnosis of NF. In NF related TSS patients, infection usually is more extensive than is apparent from external examination. Although the necessity of surgical debridement, the recommendation of immediate radical excision of necrotic tissue in patients with streptococcal TSS NF is not supported by clinical studies and should be reconsidered as an emergency treatment in TSS management[2].
Indications
Surgical debridement of body tissues should be considered in these patients:
References
- ↑ Schurr M, Engelhardt S, Helgerson R (1998). "Limb salvage for streptococcal gangrene of the extremity". Am. J. Surg. 175 (3): 213–7. PMID 9560122.
- ↑ Kotb M (1995). "Bacterial pyrogenic exotoxins as superantigens". Clin. Microbiol. Rev. 8 (3): 411–26. PMC 174633. PMID 7553574.
- ↑ "Chapter 125. Infections of the Skin, Muscles, and Soft Tissues | Harrison's Principles of Internal Medicine, 18e | AccessMedicine | McGraw-Hill Medical".