Emergency hip disarticulations for severe necrotising fasciitis of the lower limb: a series of rare cases from a rural district general hospital
| Autor: | D J Williams, S Iyer, S M Korambayil |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Disarticulation medicine.medical_treatment Necrotising fasciitis Hospitals General Severity of Illness Index Sepsis 03 medical and health sciences 0302 clinical medicine Streptococcal Infections medicine Humans Femur Fasciitis Necrotizing Hospital Mortality 030212 general & internal medicine Emergency Treatment Retrospective Studies Aged 80 and over 0303 health sciences 030306 microbiology business.industry Streptococcus General Medicine Hospitals District medicine.disease Acetabulum Lower limb pain Surgery Hemipelvectomy Treatment Outcome Lower Extremity Amputation Female Hip Joint business |
| Zdroj: | The Annals of The Royal College of Surgeons of England. 103:e223-e226 |
| ISSN: | 1478-7083 0035-8843 |
| DOI: | 10.1308/rcsann.2021.0079 |
| Popis: | Hip disarticulation is the removal of the entire lower limb through the hip joint by detaching the femur from the acetabulum. This major ablative procedure is rarely performed for infection but may be required in severe necrotising fasciitis. We present a single centre retrospective review of all cases of emergency hip disarticulations in patients with necrotising fasciitis between 2010 and 2020. All five patients included in the review presented with acute lower limb pain and sepsis. Three patients had comorbidities predisposing them to necrotising fasciitis. Three were deemed to be high risk and two were at intermediate risk of developing necrotising fasciitis. There were two deaths in the postoperative period. Of the three survivors, two required revision surgery for a completion hindquarter amputation and one for flap closure. All three survivors had good functional outcomes after discharge from hospital. Despite its associated morbidity, emergency amputation of the entire lower limb is a life-saving treatment in cases of rapidly progressing necrotising fasciitis and should be considered as a first-line option in managing this condition. |
| Databáze: | OpenAIRE |
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