Gürlek Ali, Firat Cemal, Oztürk Ayşe Ersöz, Alaybeyoğlu Nezih, Fariz Alpay, Aslan Serkan
Department of Plastic and Reconstructive Surgery, Inonu University, Medical Faculty, Malatya, Turkey.
J Diabetes Complications. 2007 Jul-Aug;21(4):265-71. doi: 10.1016/j.jdiacomp.2006.08.006.
Necrotizing fasciitis is a life-threatening condition in diabetic patients; its management and salvage of the patient is a formidable challenge. Diabetes mellitus is one of the serious conditions associated with necrotizing fasciitis. It is a disorder that primarily affects the microvascular circulation. We review our experience and present our approach to necrotizing fasciitis in patients with diabetes mellitus. All cases of necrotizing fasciitis treated at Inonu University, Turgut Ozal Medical Center, from January 1997 to December 2003 were reviewed. A review of 59 charts identified 11 cases that met the study criteria. Cases with necrosis due to other obvious causes were excluded. Three patients had spread of infection with no fatality. An average of 42 hospital days (22-64 days), 17 intensive care unit days (7-28 days), and three surgical procedures (2-7) per patient was required. Necrotizing fasciitis is an extremely serious exceptional infectious process affecting subcutaneous soft tissue with skin gangrene and vascular thromboses. Clearly, the mortality and morbidity associated with necrotizing fasciitis even in diabetes can be decreased with clinical awareness, early diagnosis, effective surgical debridement, and intensive supportive care.
坏死性筋膜炎是糖尿病患者的一种危及生命的病症；对患者的治疗和挽救是一项艰巨的挑战。糖尿病是与坏死性筋膜炎相关的严重病症之一。它是一种主要影响微血管循环的疾病。我们回顾了我们的经验，并介绍了我们对糖尿病患者坏死性筋膜炎的治疗方法。对1997年1月至2003年12月在图尔古特·奥扎尔医学中心伊诺努大学治疗的所有坏死性筋膜炎病例进行了回顾。对59份病历的审查确定了11例符合研究标准的病例。排除了因其他明显原因导致坏死的病例。3例患者感染扩散但无死亡。每位患者平均需要住院42天（22 - 64天），在重症监护病房17天（7 - 28天），并接受三次外科手术（2 - 7次）。坏死性筋膜炎是一种极其严重的特殊感染过程，会影响皮下软组织，伴有皮肤坏疽和血管血栓形成。显然，通过临床意识、早期诊断、有效的手术清创和强化支持治疗，即使在糖尿病患者中，与坏死性筋膜炎相关的死亡率和发病率也可以降低。
