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World Journal of Clinical Cases 2021年第28期9卷 8537-8544页

作者： Xiao-Chun Tao De-Chang Hu Li-Xin Yin Chen Wang Jin-Gen Lu Department of Anorectal LongHua Hospital Shanghai University of Traditional Chinese MedicineShanghai 200032China

BACKGROUND necrotizing fasciitis is a fulminant necrotizing soft tissue disease with a high fatality *** always starts with impact on the deep fascia rapidly and might result in secondary necrosis of the subcutaneous tissue,fascia,and ***,timely and multiple surgical operations are needed for the ***,the damage of skin and soft tissue caused by multiple surgical operations may require dermatoplasty and other treatments as a *** SUMMARY Here,we report a case of 50-year-old male patient who was admitted to our hospital with symptoms of necrotizing fasciitis caused by cryptoglandular infection in the perianal and perineal *** symptoms of necrotizing fasciitis,also known as the cardinal features,include hyperpyrexia,excruciatingly painful lesions,demonstration gas in the tissue,an obnoxious foul odor and *** results of postoperative pathology met the *** on the premise of complete debridement,multiple incisions combined with thread-dragging therapy(a traditional Chinese medicine therapy)and intensive supportive therapies including comprising antibiotics,nutrition and fluids were *** outcome of the treatment was *** patient recovered quickly and achieved ideal anal function and *** Timely and effective debridement and multiple incisions combined with thread-dragging therapy are an integrated treatment for necrotizing fasciitis.

关键词： necrotizing fasciitis Cryptoglandular infection Traditional Chinese medicine Multiple incisions and thread-dragging therapy Integrated treatment Case report

necrotizing fasciitis secondary to enterocutaneous fistula:Three case reports

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World Journal of Gastroenterology 2014年第24期20卷 7988-7992页

作者： Guo-Li Gu Lin Wang Xue-Ming Wei Ming Li Jie Zhang Department of General Surgery Air Force General HospitalChinese PLA Department of Colorectal Surgery Key laboratory of Carcinogenesis and Translational Research (Ministry of Education)Peking University Cancer Hospital and Institute

necrotizing fasciitis(NF)is an uncommon,rapidly progressive,and potentially fatal infection of the superficial fascia and subcutaneous *** caused by an enterocutaneous fistula has special clinical characters compared with other types of *** caused by enterocutaneous fistula may have more rapid progress and more severe consequences because of multiple germs infection and corrosion by digestive *** treated three cases of NF caused by postoperative enterocutaneous fistula since Jan *** followed empirically the principle of eliminating anaerobic conditions of infection,bypassing or draining digestive juice from the fistula and changing dressings with moist exposed burn therapy impregnated with zinc/silver *** three cases were eventually cured by debridement,antibiotics and wound management.

关键词： necrotizing fasciitis Enterocutaneous fistula Diagnosis Treatment

necrotizing fasciitis following varicella in a child

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Chinese Medical Journal 2012年第5期125卷 951-953页

作者： LI Feng XIA Jie Department of Bums and Plastic Surgery First Affiliated Hospitalof General Hospital of Chinese People's Liberation ArmyBeijing 100048China Intensive Care Unit 302 Hospital of Chinese People's LiberationArmyBeijing 100039China

Varicella is a self-limited disease, but sometimes it may be associated with some serious life-threatening complications. necrotizing fasciitis is a rare complication of varicella. This is a case of a 7-year-old girl with septic shock caused by necrotizing fasciitis as a complication of varicella. Swelling and pain in the left inguinal region and left axillary region were found five days after varicella. Then a high fever occurred followed by hypotension. Fluid infusion, vasopressor and antibiotics were administered, Group A beta-hemolytic Streptococcus was isolated from exudates from the wounds. The clinical symptoms markedly improved after surgical drainage and removal of the necrotic tissue. Both wounds were covered with skin grafts after healthy granulation tissue formed. Although there have been few reports of life-threatening necrotizing fasciitis following varicella in western countries, it is rare in China. Usually patients with varicella were admitted to pediatric or infectious disease department but not surgical departments; so that the clinicians should be aware that varicella may be complicated by life-threatening surgical infections. necrotizing fasciitis should be suspected in patients of varicella who showed an increasing pain and swelling in any body areas associated with increasing fever and local erythema. Early identification, surgical drainage and debridement are essential for successful treatment of necrotizing fasciitis.

关键词： necrotizing fasciitis varicella child

necrotizing fasciitis Secondary to Emphysematous Cholecystitis and Cholecystocutaneous Fistula: A Rare Case Report Presentation

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Surgical Science 2023年第5期14卷 388-397页

作者： Alexandra N. Dominianni Samantha A. Delapena Luis G. Fernandez Mostaffa T. Jabassini Sean F. O’Keefe Rachel L. Villanueva Marc R. Matthews College of Medicine-Phoenix University of Arizona Phoenix AZ USA Creighton University Arizona Health Education Alliance Phoenix AZ USA Department of Surgery Division of Trauma Surgery/Surgical Critical Care The University of Texas Health Science Center Tyler TX USA The University of Texas-Tyler School of Medicine Bill Barrett Endowed Chair in Trauma Surgery Tyler TX USA Trauma Wound Care UT Health East Tyler TX USA Department of Surgery University of Texas Medical Branch Galveston TX USA Adjunct Clinical Professor of Medicine and Nursing University of Texas Arlington TX USA Past Commanding General TXSG Medical Brigade Austin TX USA Surgical Resident Abrazo Health Network General Surgery Residency Glendale AZ USA Area Sales Manager Miach Orthopedics Surgical Acute Account Manager 3M Minneapolis MN USA Clinical Professor of Surgery Banner University of Arizona/University Medical Center Tucson AZ USA

Emphysematous cholecystitis is a rare subtype of acute cholecystitis characterized by the presence of gas in the gallbladder wall secondary to ischemia. Typically, this is a result of cystic artery vascular compromise with a concomitant infection from gas-forming organisms such as Clostridium species, Klebsiella species, or Escherichia coli. The mortality rate of acute emphysematous cholecystitis is 15% - 20% compared with 1.4% in uncomplicated acute cholecystitis. The subsequent development of a cholecystocutaneous fistula, an abnormal connection between the gallbladder and the skin, is also a rare complication of gallbladder disease. We describe a case of a 77-year-old male who presented with right flank necrotizing fasciitis which developed from a cholecystocutaneous fistula secondary to emphysematous cholecystitis. Once the necrotic tissues were adequately debrided, the large open wound was treated with negative pressure wound therapy with instillation (NPWT-i) utilizing hypochlorous acid (HOCL). The wound was closed with a split-thickness skin graft.

关键词： Emphysematous Cholecystitis Gangrenous Cholecystitis Cholecystocutaneous Fistula necrotizing fasciitis Sepsis

necrotizing fasciitis in the Sub-Saharan Zone: Analysis of an Exceptional Case and Review of the Literature

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第4期11卷 211-218页

作者： Kassim Diarra Nfaly Konaté Yaya Dembélé Youssouf Sidibe Kalifa Coulibaly Drissa Kaloga Bagayoko Fatogoma Issa Koné Siaka Soumaoro Boubacary Guindo Doumbia Kadidiatou Singaré Mohamed Amadou Keita Gabriel Toure University Hospital Bamako Mali Army Polyclinic Bamako Mali Luxembourg Mother and Child Hospital Bamako Mali

necrotizing fasciitis (FN) are severe, fulminant infection with necrosis of the skin and superficial fascia. The variability of the clinical picture and the severity of the condition make it a formidable condition. B.A, 16 years old, breeder, was admitted to ENT hospitalization for a large necrotic cervico-thoracic and dorsal ulceration of sudden onset following febrile odynophagia. ENT examination: large necrotic wound extending from the antero-posterior cervical region to the thoraco-abdominal and dorsal region, letting pus weld with trismus at 1.5 cm and a fistula of the anterior pillar of the right tonsil. Cytobacteriological examination of the pus isolated Staphylococcus aureus. We instituted a probabilistic antibiotic therapy readjusted afterward to the association amoxicillin clavulanic acid with the result of the antibiogram. Incision, drainage and surgical debridement of all necrotic tissues were performed, leading to extensive loss of skin substance. A daily local dressing was applied for 11 days, then replaced by honey for 51 days. On the 64th day, he was entrusted to the dermatology department for a skin graft where he stayed for 3 months. Conclusion: current name, necrotizing bacterial dermohypodermatitis. Surgery has a key role in treatment. Antibiotic therapy should be broad-spectrum.

关键词： necrotizing fasciitis Surgery Sequelae

necrotizing fasciitis in Low Income Countries: About 23 Cases of Bujumbura Hospitals

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Open Journal of Orthopedics 2021年第2期11卷 33-39页

作者： Jean Claude Niyondiko Evrard Niyonkuru Gilbert Ndayizeye Stève Nimubona Clovis Paulin Baramburiye Léodégal Bazira Kamenge Teaching Hospital Department of Trauma and Orthopedic Surgery Bujumbura Burundi Kamenge Teaching Hospital Department of General Surgery Bujumbura Burundi

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 predi... 详细信息

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

关键词： necrotizing fasciitis Prognosis Low Income Countries

Effectiveness of negative pressure wound therapy in complex surgical treatment of necrotizing fasciitis of the upper limb

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World Journal of Orthopedics 2024年第11期15卷 1015-1022页

作者： Konstantin V Lipatov Arthur Asatryan George Melkonyan Aleksandr D Kazantcev Ekaterina I Solov’eva Denis V Krivikhin Irina V Gorbacheva Urii E Cherkasov Department of General Surgery Institute of Clinical Medicine named after N.V.SklifosovskySechenov First Moscow State Medical University(Sechenov University)Moscow 119021Russia Department of General Surgery Wound and Wound Infection SurgeryState Budgetary Institution“City Clinical Hospital named after S.S.Yudin of Moscow Healthcare Department”Moscow 115446Russia Department of General Surgery Physician of The Hospital for War Veterans No 3Moscow 129336Russia Department of General Surgery I.M.Sechenov First Moscow State Medical UniversityMoscow 119048Russia

BACKGROUND necrotizing fasciitis(NF)of the upper extremities is a severe surgical pathology,and the incidence of this disease has been steadily increasing in recent *** treatment is accompanied by the formation of extensive wounds,which can be treated with significant *** recent years,negative pressure wound therapy(NPWT)has proven to be highly *** is also promising for the treatment of *** To explore the effectiveness of NPWT in the treatment of NF of the upper *** The results of the treatment of 36 patients with NF of the upper extremities in two groups(NPWT group and control group;2022−2023)were retrospectively *** the NPWT group,the NPWT method(120 mmHg;constant mode)was used after surgical *** number of vacuum-assisted dressings in patients ranged from 1 to 3,depending on the dynamics of the wound *** duration of fixation of one bandage was up to 2−3 *** the control group,conventional methods of local wound treatment were *** following indicators were analyzed:The treatment delay,the prevalence of inflammation,the microbial landscape,the number of debridements,the duration of wound preparation for surgical closure,and the nature of skin plastic *** Most patients experienced a significant treatment delay[4 d,interquartile range(IQR):2–7 d],which led to the spread of the pathological process to the forearm and *** most common pathogens were Staphylococcus aureus(14;38.9%)and Streptococcus pyogenes(22;61.1%).The average number of debridements per patient was 5(IQR:3–7),with no difference between *** average time to prepare wounds for surgical closure was 11±4 d in the NPWT group and 29±10 d(P=0.00001)in the control *** the NPWT group,the wounds were more often closed with local tissues(15;83.3%),and in the control group,split-thickness skin grafts were more often used(4;50%).CONCLUSION The predominant isolation of Staphylococcus aureus and/or Strep

关键词： necrotizing fasciitis Upper limb Negative pressure wound therapy Vacuum-assisted closure Surgical treatment

necrotizing fasciitis as a complication of taxanes: a case report

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Journal of Cancer Metastasis and Treatment 2018年第1期4卷 402-405页

作者： Nasser Mohammed Amer Rabia Niaz Department of General Surgery King Fahad Hospital of the UniversityImam Abdulrahman Bin Faisal UniversityAl Khobar 34445Saudi Arabia

necrotizing fasciitis is a rare complication of chemotherapy,however,few reports were published as a specific complication of *** are reporting this rare complication of a lady who was treated with taxanes as an adjuvant therapy for her breast cancer who was referred to us from the medical department and turned out to be necrotizing fasciitis in her right *** are also presenting the literature review of this type of complication.

关键词： necrotizing fasciitis breast cancer taxanes,docetaxel complication of chemotherapy

necrotizing fasciitis highly suspected as gas gangrene:A case report

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Necrotizing fasciitis highly suspected as gas gangrene:A cas...

Multi-limb necrotizing fasciitis in a patient with rectal cancer

2014年浙江省医学会烧伤外科学分会烧伤外科学学术年会

作者： Xiang-wei Ling Cai Lin Burn Department the First Affiliated HospitalWenzhou Medical College

A 48 year-old male patient who fevered for 8 days,being left limbs feeble for 5 days,being delirious for 2 days,came to our *** was a medical history of skin trauma ten days before he came to our hospital,he handled the wounds with Chinese herbal *** admission,systemic infection was serious,which caused multiple organs including brain,lung,liver,kidney injuring;the wounds had crepitus;and the X-ray showed that gas infringes muscle *** the patient was highly suspected as gas *** a few days,the bacterial and fungal culturing of bubble liquid and tissue showed klebsiella、multidrug-resistant staphylococcus haemolyticus.,multidrug-resistant staphylococcus *** the biopsy,we saw numerous neutrophils,a large number of necrotic fascias,damaged hemal *** to the result of culturing and biopsy,we diagnosed the illness as necrotizing *** had reported this kind of necrotizing fasciitis type I which involves muscle as synergistic necrotizing cellulitis,to which Bacillus cereus infection was the most ***,we did not find Bacillus cereus during *** the treatments of anti-infection,debridement,vaccum sealing drainage and skin grafting,the patient was finally healed.

关键词： necrotizing fasciitis gas gangrene synergistic necrotizing cellulitis

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World Journal of Gastroenterology 2006年第32期12卷 5256-5258页

作者： Shirley Yuk Wah Liu Simon Siu Man Ng Janet Fung Yee Lee Department of Surgery Prince of Wales Hospital 30-32 Ngan Shing StreetShatinN.T.Hong KongChina

necrotizing fasciitis is a devastating soft tissue infection affecting fascias and subcutaneous soft tissues. Literature reviews have identified several related risk factors, including malignancy, alcoholism, malnutrition, diabetes, male gender and old age. There are only scanty case reports in the literature describing its rare association with colorectal malignancy. All published cases are attributed to bowel perforation resulting in necrotizing fasciitis over the perineal region. Isolated upper or lower limb diseases are rarely identified. Simultaneous upper and lower limb infection in colorectal cancer patients has never been described in the literature. We report an unusual case of multi-limb necrotizing fasciitis in a patient with underlying non-perforated rectal carcinoma.

关键词： necrotizing fasciitis Soft tissue infection Colorectal cancer Malignancy Group G streptococcus