Wang K C, Shih C H
Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Taiwan, R.O.C.
J Trauma. 1992 Feb;32(2):179-82. doi: 10.1097/00005373-199202000-00011.
Necrotizing fasciitis is a limb- and life-threatening soft-tissue infection. Eighteen patients with necrotizing fasciitis of the extremities were reviewed. These infections occurred most commonly after minor trauma. Associated chronic debilitating diseases were present in 13 patients. All but two infections were polymicrobial. The overall mortality rate was 33%. Death was caused by persistent wound sepsis in three and systemic septic complications in spite of apparent local infection control in three. At the admission physical examination the condition may resemble a benign, low-grade cellulitis. Three of four patients died because of a delay in surgical debridement for more than 24 hours after admission. Multiple radial debridements of the involved skin, fat, and fascia are essential to control progressive necrosis. Our results suggest that early diagnosis and prompt surgical debridement of necrotizing fasciitis are essential for survival.
坏死性筋膜炎是一种危及肢体和生命的软组织感染。回顾了18例四肢坏死性筋膜炎患者。这些感染最常见于轻微创伤后。13例患者伴有慢性衰弱性疾病。除两例外，所有感染均为多微生物感染。总死亡率为33%。3例死于持续性伤口败血症，3例尽管局部感染明显得到控制，但仍死于全身性脓毒症并发症。入院体格检查时，病情可能类似于良性、轻度蜂窝织炎。4例患者中有3例因入院后手术清创延迟超过24小时而死亡。对受累皮肤、脂肪和筋膜进行多次广泛清创对于控制进行性坏死至关重要。我们的结果表明，早期诊断和及时手术清创对于坏死性筋膜炎的存活至关重要。
