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Delgado C, Erice A, García Navlet M. Necrotizing fasciitis following an arthroscopic shoulder surgery: a case report and literature review. JSES REVIEWS, REPORTS, AND TECHNIQUES 2023; 3:548-552. [PMID: 37928981 PMCID: PMC10624992 DOI: 10.1016/j.xrrt.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Affiliation(s)
- Cristina Delgado
- Shoulder and Elbow Reconstructive Surgery Unit, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Alejo Erice
- Internal Medicine Department, Hospital Asepeyo Coslada, Madrid, Spain
| | - Miguel García Navlet
- Shoulder and Elbow Reconstructive Surgery Unit, Hospital Asepeyo Coslada, Madrid, Spain
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Ditsios K, Chitas K, Christidis P, Charatsis K, Katsimentzas T, Papadopoulos P. Necrotizing Fasciitis of the Upper Extremity – A Review. Orthop Rev (Pavia) 2022; 14:35320. [DOI: 10.52965/001c.35320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/29/2022] [Indexed: 11/06/2022] Open
Abstract
Necrotizing fasciitis is a soft tissue infection that habitually originates from the fascial sheaths, expands at a volant pace, leads to extensive necrosis of the subcutaneous tissues, and eventually ends up in a life-threatening condition with notably elevated amputation and mortality rates. Factors that induce interruption of skin integrity, such as trauma or intravenous drug use, are the most common inciting events. Specific clinical signs heralding its presence are usually absent in the early stages, often resulting in misdiagnosis. Early recognition, prompt and aggressive surgical debridement, antibiotic use, and supportive care constitute the fundamental principles to lean on for a better prognosis. Necrotizing fasciitis of the upper extremity is relatively rare and consequently holds a limited place in the literature. Only a few studies assess it as a separate entity, with most of them being case reports or small case series. We, therefore, performed a review of the current literature, to assemble the dispersed results of different studies and clarify the various aspects of upper limb necrotizing fasciitis. In this systematic review, we present the epidemiological data, the causative events, the most frequent underlying diseases, the risk factors, the amputation and mortality rates, the pathogenic microorganisms, the clinical characteristics, the diagnostic tools, the medical and surgical management concerning necrotizing fasciitis of the upper limb. Finally, the results indicating its differentiation compared to necrotizing fasciitis of other anatomic sites are remarkably highlighted.
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Affiliation(s)
- Konstantinos Ditsios
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital of Thessaloniki “G. Gennimatas”, Greece
| | - Konstantinos Chitas
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital of Thessaloniki “G. Gennimatas”, Greece
| | | | - Konstantinos Charatsis
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital of Thessaloniki “G. Gennimatas”, Greece
| | - Triantafyllos Katsimentzas
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital of Thessaloniki “G. Gennimatas”, Greece
| | - Pericles Papadopoulos
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, General Hospital of Thessaloniki “G. Gennimatas”, Greece
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Ghezala HB, Feriani N. [Postoperative necrotizing fasciitis: a rare and fatal complication]. Pan Afr Med J 2016; 23:123. [PMID: 27279950 PMCID: PMC4885698 DOI: 10.11604/pamj.2016.23.123.8734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 03/18/2016] [Indexed: 11/18/2022] Open
Abstract
Les complications pariétales post opératoire peuvent être exceptionnellement majeures et graves menaçant le pronostic vital. La fasciite nécrosante est une infection rare de la peau et des tissus sous-cutanés profonds, se propageant le long des fascias et du tissu adipeux. Elle est surtout causée par le streptocoque du groupe A Streptococcus pyogènes mais également par d'autres bactéries telles que Vibrio vulnificus, clostridium perfringens ou Bacteroides fragilis. La fasciite nécrosante est une véritable urgence médicochirurgicale. Nous rapportons dans ce travail une observation très rare d'une gangrène pariétale abdominale survenant chez une patiente de 75 ans au cinquième jour post-opératoire d'un kyste de l'ovaire. L’évolution était marquée par l'installation d'un état de choc septique réfractaire rapidement fatal à J3 de la prise en charge.
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Affiliation(s)
- Hassen Ben Ghezala
- Service de Réanimation Médicale, Faculté de Médecine de Tunis, Hôpital de Zaghouan, Zaghouan, Tunisie
| | - Najla Feriani
- Service de Chirurgie Générale à la Faculté de Médecine de Tunis, Hôpital de Zaghouan, Zaghouan, Tunisie
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Abstract
Necrotizing soft tissue infections and necrotizing fasciitis are life-threatening infections affecting the hypodermis, muscular fascia, and dermis secondarily. Mortality is high, with an average of 30%. The early diagnosis of necrotizing soft tissue infection is challenging, but is key to successful management of these patients. The mainstay of therapy includes early and wide surgical debridement, antibiotics and supportive care. Adjunctive therapies may have a role, but their effectiveness remains unproven. A review of the literature allows us to highlight this multidisciplinary management.
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Affiliation(s)
- A Forli
- Service de chirurgie plastique, de la main et des brûlés, hôpital Michalon, CHU de Grenoble, 38043 Grenoble, France.
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Abstract
Skin and soft tissue infections are among the most common reasons for people to seek medical advice. They also represent one of the most common indications for antimicrobial therapy and account for approximately 7-10% of hospitalisations in North America. Although non-limb and non-life threatening infections may be treated on an out-patient basis with oral antibiotics, patients with more serious acute skin and soft tissue infections may require admission to hospital for management; this decision is especially true if the infection is rapidly progressive. We provide a concise overview of the differential diagnosis and approach to management of community-acquired rapidly progressive skin and soft tissue infections.
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Affiliation(s)
- Donald C Vinh
- Section of Infectious Diseases, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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