Gauzit R
Unité de réanimation chirurgicale, département d'anesthésie-réanimation, CHU Hôtel-Dieu, université Paris-V, place du Parvis-Notre-Dame, 75004 Paris, France.
Ann Fr Anesth Reanim. 2006 Sep;25(9):967-70. doi: 10.1016/j.annfar.2006.03.018. Epub 2006 May 3.
Among the three types of soft tissue and skins infections (cellulitis, necrotising cellulitis and necrotising fasciitis) only the necrotising injuries are commonly managed in intensive care unit. Location, depth and severity of these potentially life threatening infections may vary and cannot be predicted on clinical grounds No microbiological deduction can be made from clinical signs. A mixed aerobic-anaerobic flora is cultured in 40 to 80% of the cases. Magnetic resonance imaging and CT-scan are the best techniques to assess the diagnosis and determine the extension of infection. However, these exams should not delay surgical treatment. Fifteen to 30% of the patients die. Three parameters play a key role in the prognosis: ability of the physician to recognise the disease and to evaluate the severity of infection, early onset of antimicrobial therapy, and most of all early surgical debridement.
在三种软组织和皮肤感染（蜂窝织炎、坏死性蜂窝织炎和坏死性筋膜炎）中，只有坏死性损伤通常在重症监护病房进行处理。这些潜在威胁生命的感染的部位、深度和严重程度可能各不相同，无法根据临床情况进行预测。无法从临床体征做出微生物学推断。40%至80%的病例培养出需氧菌和厌氧菌混合菌群。磁共振成像和CT扫描是评估诊断和确定感染范围的最佳技术。然而，这些检查不应延误手术治疗。15%至30%的患者死亡。三个参数在预后中起关键作用：医生识别疾病和评估感染严重程度的能力、抗菌治疗的早期开始，以及最重要的早期手术清创。
