Treatment of Necrotizing fasciitis

doi:10.3877/cma.j.issn.2095-9133.2017.05.005

Abstract

Abstract:

Objective

To study the clinical features and the treatment methods of Fournier’s Gangrene (FG).

Methods

Twenty-six patients who were admitted to surgical unit of Shanghai Public Clinical Center presenting with FG between January 2010 and April 2017 were reviewed, including 21 men and 5 women. The average age was 47.3±11.2 years old. Patients were divided into conventional surgery debridement dressing group and surgical debridement plus VSD negative pressure suction group. Preoperative leukocytes, hemoglobin and postoperative hospital stay were compared between the two groups.

Results

11 cases had sites of gangrene at leg. 12 cases had sites around anal. 3 cases were at abdomen. 8 patients occurred septic shock, among which 4 patients died. 12 patients received normal incision while 24 received VSD. Average hospitalization time of normal incision with drainage was 26±8 days while that of vacuum sealing drainage was 19±6 days. VSD reduce average hospitalization time significantly (P<0.05).

Conclusions

Necrotizing fasciitis (NF) is an acute, rapidly progressive and severe surgical disease and had a high mortality rate caused by septic shock. Debridement and drain age is a main treatment for it. Additional VSD can reduce average hospitalization time with same effort.

Key words: Necrotizing fasciitis, Debridement, Vacuum sealing drainage, Sepsis, Septic shock

Lei Li, Baochi Liu, Xiaofeng Yu, Yanhui Si, Weiwei Zhang, Xin Liu, Qiling Liu, Tienan Feng. Treatment of Necrotizing fasciitis[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2017, 03(05): 272-276.

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References 20

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组别	例数(例)	年龄(岁，±s)	白细胞(±s)	血红蛋白(±s)	血小板(±s)	糖尿病(例)	创伤(例)	肛周脓肿(例)	HIV感染(例)	感染性休克(例)	住院天数(d，±s)	病死率(%)
常规引流组	12	46±12	15.6±12	11.6±7.2	95±32	4	2	4	1	4	26±8	16.67
VSD引流组	14	47±14	14.8±11	10.4±6.8	97±42	6	3	7	2	4	19±6	14.29
t/χ²值	?	0.053	0.049	0.12	0.036	0.248	0.094	0.735	0.224	0.069	2.54	0.028
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	<0.05	>0.05

组别	例数(例)	年龄(岁，±s)	白细胞(±s)	血红蛋白(±s)	血小板(±s)	糖尿病(例)	创伤(例)	肛周脓肿(例)	HIV感染(例)	感染性休克(例)	住院天数(d，±s)	病死率(%)
常规引流组	12	46±12	15.6±12	11.6±7.2	95±32	4	2	4	1	4	26±8	16.67
VSD引流组	14	47±14	14.8±11	10.4±6.8	97±42	6	3	7	2	4	19±6	14.29
t/χ²值	?	0.053	0.049	0.12	0.036	0.248	0.094	0.735	0.224	0.069	2.54	0.028
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	<0.05	>0.05

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