Ahmad Humaid, Siddiqui Sheeraz Shakoor
Dow Medical College & Civil Hospital Karachi Dow University of Health Sciences Baba-e-Urdu Road, Karachi, Sindh, Pakistan.
Wounds. 2017 Apr;29(4):92-95.
Skin carbuncles are debilitating skin infections commonly seen in elderly patients with diabetes. These infections develop when a cluster of adjacent furuncles coalesce to form one inflammatory mass. While they commonly occur on the nape of the neck and back, rarer sites involving the face and head have been noted. Management of these rare sites is urgent because of the potential intracranial complications and the surgical outcome is often unsatisfactory due to associated facial scarring. Intraoral drainage is advocated to avoid this; however, when the carbuncle involves a larger area, debridement from the exterior is necessary. The resultant soft-tissue defect requires a skin graft or a flap for coverage, but this may still lead to an unsatisfactory cosmetic outcome. The authors report a case of a carbuncle involving an extensive area over the right temporofacial region, including its management and the remarkable post-debridement cosmetic outcome despite avoidance of plastic surgery techniques due to the patient's high risk associated with anesthesia.
皮肤痈是糖尿病老年患者常见的使人虚弱的皮肤感染。当一簇相邻的疖融合形成一个炎性肿块时,就会发生这些感染。虽然它们通常发生在颈部和背部的项部,但也有涉及面部和头部的罕见部位的报道。由于潜在的颅内并发症,对这些罕见部位的处理非常紧急,而且由于相关的面部瘢痕形成,手术结果往往不尽人意。提倡口腔内引流以避免这种情况;然而,当痈累及较大面积时,需要从外部进行清创。由此产生的软组织缺损需要用皮肤移植或皮瓣覆盖,但这仍可能导致不理想的美容效果。作者报告了一例痈累及右侧颞面部广泛区域的病例,包括其处理方法,以及尽管由于患者麻醉风险高而未采用整形手术技术,但清创后的美容效果显著。