Necrotizing Fasciitis: Improved Survival With Early Recognition by Tissue Biopsy and Aggressive Surgical Treatment

Autor:	Elizabeth I. Majeski, James Majeski
Rok vydání:	1997
Předmět:	Adult Male medicine.medical_specialty Necrosis Biopsy medicine.medical_treatment Diagnosis Differential Gangrene Patients' Rooms Frozen Sections Humans Medicine Combined Modality Therapy Fasciitis Necrotizing Fasciitis Survival rate Escherichia coli Infections Aged Aged 80 and over Debridement medicine.diagnostic_test Nutritional Support business.industry Reproducibility of Results Soft tissue Cellulitis General Medicine Middle Aged Staphylococcal Infections medicine.disease Connective tissue disease Abscess Anti-Bacterial Agents Surgery Survival Rate Treatment Outcome Female medicine.symptom Proteus Infections business Anesthesia Local
Zdroj:	Southern Medical Journal. 90:1065-1068
ISSN:	0038-4348
DOI:	10.1097/00007611-199711000-00001
Popis:	Necrotizing fasciitis is a soft tissue gangrenous infection that is optimally treated by early diagnosis, radical surgical debridement of all involved necrotic tissue, broad spectrum antibiotics, and aggressive nutritional support. The early clinical diagnosis of an area of necrotizing fasciitis is difficult and frequently unreliable. We are reporting a series of cases in which an early, accurate diagnosis of necrotizing fasciitis was established by a frozen section tissue biopsy obtained at the bedside.Over a 15-year period, a consecutive series of 43 patients had a bedside biopsy under local anesthesia with immediate frozen section evaluation. All patients were seen in the hospital or emergency room for treatment of an inflammatory process.These 43 patients had bedside biopsy and frozen section evaluation of an inflammatory process. Twelve patients were found to have necrotizing fasciitis. These patients were treated with immediate surgical debridement of all gross necrotic tissue, broad spectrum antibiotics, and adequate nutritional support. All of them survived. No cases of infectious gangrene occurred in the group of patients whose biopsy did not reveal necrotizing fasciitis.Frozen section tissue biopsy is a useful adjunct in establishing an early, accurate diagnosis of infectious gangrene.
Databáze:	OpenAIRE
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