Periorbital Necrotizing Fasciitis: Outcomes Using a CT-Guided Surgical Debridement Approach
| Autor: | Mona Khandwala, Deepak Gupta, Bijan Beigi, Manuel Saldana, Robert Weir |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Healthy tissue Ophthalmologic Surgical Procedures Computed tomographic Sepsis 03 medical and health sciences 0302 clinical medicine Orbital Diseases medicine Humans Fasciitis Necrotizing 030223 otorhinolaryngology Fasciitis Aged Retrospective Studies Aged 80 and over Debridement business.industry Surgical debridement General Medicine Middle Aged medicine.disease Surgery Ophthalmology Regimen Treatment Outcome 030220 oncology & carcinogenesis Female Orbital cellulitis Tomography X-Ray Computed business |
| Zdroj: | European Journal of Ophthalmology. 20:209-214 |
| ISSN: | 1724-6016 1120-6721 |
| Popis: | Purpose The surgical management of necrotizing fasciitis usually involves early radical/wide and aggressive debridement of involved areas. We describe 5 cases of periorbital necrotizing fasciitis (NF), managed using a computed tomographic (CT)-guided approach to surgical debridement. Methods Retrospective case series review. Results Five patients (4 female, 1 male; age range 39–81) were treated for periorbital NF. The diagnosis was confirmed in all cases with blood cultures and wound swabs. All patients were managed medically by a surviving sepsis regimen. CT scans confirmed suprafascial infection and excluded orbital cellulitis. Four patients had minimal surgical debridement to the surface muscle. All patients survived. Four out of 5 patients underwent delayed reconstruction. Conclusions Periorbital NF behaves differently from NF of other areas. CT-guided surgical debridement of the superficial muscle maximizes preservation of healthy tissue and facilitates reconstruction. Delayed reconstruction allows fibrosis to settle and good cosmetic and functional results are possible. However, NF remains potentially lethal and close observation and a flexible management plan are required. |
| Databáze: | OpenAIRE |
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