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双侧股后神经皮穿支皮瓣成功治疗福尼尔坏疽:一例报告

Bilateral femoral posterior neurocutaneous perforater flap successfully treating Fournier gangrene: A case report.

作者信息

Wang Tao, Zhao Gang, Rui Yong-Jun, Mi Jing-Yi

机构信息

Department of Hand Surgery, Wuxi NO.9 People's Hospital Affiliated to Soochow University, Wuxi, China.

出版信息

Medicine (Baltimore). 2017 Nov;96(46):e8720. doi: 10.1097/MD.0000000000008720.

Abstract

RATIONALE

Necrotizing fasciitis (NF), characterized by widespread fascial necrosis, is a rare disease in clinic. Fournier gangrene (FG) is a special type of NF involved of perineum and scrotum. To our knowledge, no article has reported on bilateral femoral posterior neurocutaneous perforater flap treating for FG.

PATIENT CONCERNS

A 61-year-old Chinese male complained of perineal skin necrosis for 19 days. The patient received treatment in other hospital due to chronic bronchitis on April 15th and body temperature ranged from 38 to 39 °C. Then he received antiinfection therapy. Perianal cutaneous occurred mild necrosis on May 08th. And the necrosis generally deteriorated. He came to our hospital for treating necrosis in area of perineum and scrotum on May 28th.

DIAGNOSES

He was diagnosed with FG and chronic bronchitis.

INTERVENTIONS

The patient underwent debridement on June 2nd and received bilateral femoral posterior neurocutaneous perforater flap on June 29th. Besides, the patient was treated with whole-body nutrition support and antibiotic treatment.

OUTCOMES

One week after the 2nd operation, the flap showed normal color. The result shows good outcome and no recurrence of the clinical symptoms occur till now.

LESSONS

FG is rare. Bilateral femoral posterior neurocutaneous perforater flap is an effective procedure to treat FG. The outcome of combined therapy is satisfactory.

摘要

理论依据

坏死性筋膜炎(NF)以广泛的筋膜坏死为特征,是临床上一种罕见的疾病。福尼尔坏疽(FG)是NF的一种特殊类型,累及会阴和阴囊。据我们所知,尚无文章报道采用双侧股后神经皮穿支皮瓣治疗FG。

患者情况

一名61岁的中国男性,主诉会阴皮肤坏死19天。该患者于4月15日因慢性支气管炎在其他医院接受治疗,体温在38至39°C之间,随后接受抗感染治疗。5月8日肛周皮肤出现轻度坏死,且坏死情况普遍恶化。5月28日他来我院治疗会阴和阴囊部位的坏死。

诊断

他被诊断为FG和慢性支气管炎。

干预措施

患者于6月2日行清创术,并于6月29日接受双侧股后神经皮穿支皮瓣手术。此外,患者接受了全身营养支持和抗生素治疗。

结果

第二次手术后一周,皮瓣颜色正常。结果显示效果良好,至今临床症状未复发。

经验教训

FG较为罕见。双侧股后神经皮穿支皮瓣是治疗FG的有效方法。综合治疗的效果令人满意。

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