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, and patients with deep-seeded pyogenic infection. | |||
:Urgent/rapid/elective surgical debridement was recommended for all patients who develop NF earlier, but is under questioning. | |||
:Surgery is not the first-line treatment option for patients with | |||
:Urgent/rapid/elective | |||
ne of the symptoms of streptococcal toxic shock syndrome is extreme infection of the skin and deeper parts is called [[fasciitis necroticans|necrotizing fasciitis]]. This often requires prompt surgical treatment. | |||
* Although every medical reference continously announce that early surgical debridement in STSS patients can lead to better management of the disease, there are no enough studies to suggest this idea. | * Although every medical reference continously announce that early surgical debridement in STSS patients can lead to better management of the disease, there are no enough studies to suggest this idea. | ||
* 9560122 | * 9560122 | ||
Revision as of 13:49, 15 May 2017
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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, and patients with deep-seeded pyogenic infection.
- Urgent/rapid/elective surgical debridement was recommended for all patients who develop NF earlier, but is under questioning.
ne of the symptoms of streptococcal toxic shock syndrome is extreme infection of the skin and deeper parts is called necrotizing fasciitis. This often requires prompt surgical treatment.
- Although every medical reference continously announce that early surgical debridement in STSS patients can lead to better management of the disease, there are no enough studies to suggest this idea.
- 9560122
- Prompt, aggressive exploration and debridement of patients thought to have deep-seeded pyogenic infection constitutes a surgical emergency. Surgical exploration through a small incision with visualization of the muscle and fascia may provide an early and definitive diagnosis of necrotizing fasciitis. Infection often is more extensive than is apparent from external examination. Surgical debridement of infected tissue is extremely important and often requires re-exploration to ensure adequacy of resection.
The recommendation of immediate radical excision of necrotic tissue in patients with STSS NF is not supported by clinical studies and should be reconsidered.M. Kotb. Bacterial pyrogenic exotoxins as superantigens. Clin Microbiol Rev, 8 (1995), pp. 411–426
Early and immediate surgical debridement should be considered in most patients with suspected streptococcal toxic shock syndrome (i.e., those who present with fever, pain, soft-tissue swelling, and/or vesicle and bullae formation).
Aggressive surgical debridement of infected tissue including fascia is imperative and mandatory if a site of potential infection is identified. Repeated and sequential operative and bedside debridements of infected tissue are often needed, particularly if necrotizing fasciitis is present in streptococcal disease. [null [19]] [1] In addition to surgical debridements, fasciotomy or amputation may be needed to halt the progression of the disease.Stevens DL, Tanner MH, Winship J, et al. Severe group A streptococcal infections associated with a shock-like syndrome. N Engl J Med. 1989;321:1-7 [2]
Surgery
- Describe the key surgical therapies used the treat the disease, and how they work to cure the disease.
- You may want to include sub-sections for each surgical therapy used.
- For an example of the surgery segment in a surgery page, click here.
- To search for guidelines, go to the National Guideline Clearinghouse (http://www.guidelines.gov/).
Indications
- Here you can outline the indications for sugery.
- A template sentence is: "Indications for surgery for (disease name) include: ___"
Contraindications
- Here you can outline the contraindications for surgery.
- A template sentence is: "Contraindications for surgery for (disease name) include: ___"
References
- ↑ Polna I, Aleksandrowicz J (1975). "Effect of adsorbents on IgM and IgG measles antibodies". Acta Virol. 19 (6): 449–56. PMID 1989.
- ↑ "Chapter 125. Infections of the Skin, Muscles, and Soft Tissues | Harrison's Principles of Internal Medicine, 18e | AccessMedicine | McGraw-Hill Medical".