Necrotizing Fasciitis in Low Income Countries: About 23 Cases of Bujumbura Hospitals

作     者：Jean Claude Niyondiko Evrard Niyonkuru Gilbert Ndayizeye Stève Nimubona Clovis Paulin Baramburiye Léodégal Bazira Jean Claude Niyondiko;Evrard Niyonkuru;Gilbert Ndayizeye;Stève Nimubona;Clovis Paulin Baramburiye;Léodégal Bazira

作者机构：Kamenge Teaching Hospital Department of Trauma and Orthopedic Surgery Bujumbura Burundi Kamenge Teaching Hospital Department of General Surgery Bujumbura Burundi 

出 版 物：《Open Journal of Orthopedics》 (矫形学期刊（英文）)

年 卷 期：2021年第11卷第2期

页      面：33-39页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Necrotizing Fasciitis Prognosis Low Income Countries 

摘      要：Background: Necrotizing fasciitis is a rapidly spreading soft tissue infection involving the deep facial layers. It can cause secondary necrosis leading to significant morbidity and mortality. The most important predictor of mortality is a delay in diagnosis. In low income countries, that delay must be high and other predictors of morbidity and mortality must be pointed out. Objective: To determine necrotizing fasciitis (NF) prognostic factors in a low income country. Patients and Methods: It is a prospective and descriptive study conducted over a one-year period from November 1, 2017 to November 1, 2018 about 23 cases of necrotizing fasciitis in two hospitals of Bujumbura. Results: The incidence of necrotizing fasciitis in these 2 hospitals (Kamenge Teaching Hospital and Prince Regent Charles Hospital) was 1%. The average age of patients was 41.76 years. Males were predominant with a sex ratio of 1.55. The risk factors for NF were: NSAIDs in 39%;HIV infection in 13%, diabetes mellitus in 4% and high blood pressure in 4%. The average time from symptoms onset to admission was 17.13 days. The mean time from admission to surgical treatment was 4 days with extremes of 1 to 22 days. The most affected site was the lower limb in 82% of cases. All patients (96%) were treated with necrotic tissue debridement. It was associated with skin grafting in 48% of cases. One patient (4%) with diabetes mellitus and HIV infection was amputated. The mortality rate was 22%(n = 5). Among those 5 patients, there was a combination of risk factors (diabetes mellitus, NSAID use and HIV infection) in 80% (n = 4), 60% (n = 3) were over 60 years of age and 60% (n = 3) were operated 10 days after the onset of symptoms. The average time of hospital stay was 101 days with extremes of 14 to 400 days. Conclusion: Necro