Shang Shuai, Zhang Ruipeng, Hou Zhiyong
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Medicine (Baltimore). 2017 Jun;96(23):e6908. doi: 10.1097/MD.0000000000006908.
Necrotizing fasciitis (NF) is defined as a rare, life-threatening, rapidly spreading soft tissue infection resulting from a polymicrobial origin, with a predominance of anaerobic organisms that presents with necrosis of the muscle, fascia, and surrounding soft tissue.
A 64-year-old male who sustained tibia fracture caused by falling from a height underwent a tibia surgery with minimally invasive plate osteosynthesis technique in another institution. Postoperatively, the patient had development of a very uncommon NF at the site of the tibia procedure. When the patient was transferred to our unit, he rapidly processed to toxic shock and coagulopathy.
Although the patient underwent antibiotics treatment in the emergency room and was transferred to the operating room for surgery promptly, the patient's condition deteriorated rapidly and he died of septic shock and multiple organ failure unfortunately.
Our study aims to highlight the risk of NF in the elderly with diabetes during the perioperative period even if the injury is a simple closed fracture. Physicians must be vigilant to early inflammatory signs and pain in immunosuppressed patients.
坏死性筋膜炎（NF）被定义为一种罕见的、危及生命的、迅速蔓延的软组织感染，由多种微生物引起，以厌氧菌为主，表现为肌肉、筋膜及周围软组织坏死。
一名64岁男性因高处坠落致胫骨骨折，在另一家机构接受了微创钢板接骨术的胫骨手术。术后，患者在胫骨手术部位发生了极为罕见的坏死性筋膜炎。当患者转至我院时，迅速发展为中毒性休克和凝血病。
尽管患者在急诊室接受了抗生素治疗并迅速被转至手术室进行手术，但其病情迅速恶化，不幸死于感染性休克和多器官功能衰竭。
我们的研究旨在强调，即使损伤为单纯闭合性骨折，老年糖尿病患者围手术期仍有发生坏死性筋膜炎的风险。医生必须对免疫抑制患者的早期炎症体征和疼痛保持警惕。
