Necrotizing fasciitis surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
Surgery
Surgery is the mainstay of treatment for necrotizing fasciitis.
- Immediate surgical referral remains the only method of reducing mortality and morbidity in necrotizing fasciitis patients.[1][2]
- As the patient's are cardiovascularly unstable, immediate resuscitation with intravenous fluids, colloids and inotropic agents are usually necessary.[3]
- Effects of analgesia can be measured by documenting pain score regularly.
- Stop the NSAID's on admission of patients.
Procedure
- Debridement of the tissue is the main surgical procedure.[1][4]
- Wide resection is performed with boundaries at least as wide as the rim of cellulitis including surrounding healthy bleeding tissue.
- Re-exploration and serial debridements, spaced 12 to 36 hours, are needed to control the infection.
References
- ↑ 1.0 1.1 Roje Z, Roje Z, Matić D, Librenjak D, Dokuzović S, Varvodić J (2011). "Necrotizing fasciitis: literature review of contemporary strategies for diagnosing and management with three case reports: torso, abdominal wall, upper and lower limbs". World J Emerg Surg. 6 (1): 46. doi:10.1186/1749-7922-6-46. PMC 3310784. PMID 22196774.
- ↑ Mok MY, Wong SY, Chan TM, Tang WM, Wong WS, Lau CS (2006). "Necrotizing fasciitis in rheumatic diseases". Lupus. 15 (6): 380–3. PMID 16830885.
- ↑ Baxter F, McChesney J (2000). "Severe group A streptococcal infection and streptococcal toxic shock syndrome". Can J Anaesth. 47 (11): 1129–40. doi:10.1007/BF03027968. PMID 11097546.
- ↑ Elliott DC, Kufera JA, Myers RA (1996). "Necrotizing soft tissue infections. Risk factors for mortality and strategies for management". Ann Surg. 224 (5): 672–83. PMC 1235444. PMID 8916882.