Ledingham I M, Tehrani M A
Br J Surg. 1975 May;62(5):364-72. doi: 10.1002/bjs.1800620510.
Twenty patients with acute dermal gangrene following surgery, trauma or sepsis are described. In 12 the skin became gangrenous secondary to a necrotizing process affecting the subdermal fascia, and in 8 the condition arose primarily in the skin. In the first group mortality was high unless radical excision of the necrotic fascia was performed at an early stage; in 3 of the recent patients the overlying skin was removed, defatted and stored for later grafting. In the second group, incision and adequate drainage combined with antibiotics seemed to suffice. Hyperbaric oxygen was of dubious value in the first group but appeared to contribute to arrest of the lesion in the second group.
本文描述了20例因手术、创伤或败血症后发生急性皮肤坏疽的患者。其中12例患者的皮肤坏疽是由于影响皮下筋膜的坏死过程继发所致，8例患者的病情主要发生在皮肤。在第一组中，除非早期对坏死筋膜进行根治性切除，否则死亡率很高；在最近的3例患者中，切除了坏死筋膜上方的皮肤，进行去脂处理并储存以备后期移植。在第二组中，切开并充分引流结合使用抗生素似乎就足够了。高压氧在第一组中的价值存疑，但在第二组中似乎有助于阻止病变发展。
