Institute for Plastic Surgery, Southern Illinois University School of Medicine.
Southern Illinois University School of Medicine, Springfield, IL.
Medicine (Baltimore). 2021 Mar 12;100(10):e24981. doi: 10.1097/MD.0000000000024981.
Necrotizing fasciitis (NF) is a rapidly progressing bacterial soft tissue infection with a high mortality rate. It is characterized by significant soft tissue destruction with associated sepsis. The mainstay of treatment is coverage with appropriate broad-spectrum antibiotic therapy and emergent surgical debridement.
A previously healthy 66-year-old female presented with a deep laceration to her right, posterior calf with subsequent contamination with lake water. After the wound was irrigated and closed, the patient developed NF.
Laceration of the right lower extremity complicated by NF secondary to Aeromonas sobria.
The patient underwent emergent surgical debridements with intravenous broad-spectrum antibiotics and negative pressure wound therapy. The lower extremity was reconstructed with split-thickness skin grafts.
The patient's initial penetrating trauma was closed in the emergency room, and the patient was discharged home with antibiotics. She returned the next day with unstable vitals and was admitted to the intensive care unit. Her condition continued to deteriorate, and she underwent serial surgical debridements. Her condition improved and was discharged home after 13 days in the hospital.
Close monitoring for NF is important for tissue infections sustained in aquatic environments. Timely identification and surgical management of NF increases overall survival.
坏死性筋膜炎（NF）是一种迅速进展的细菌性软组织感染，死亡率很高。其特征是严重的软组织破坏，并伴有败血症。治疗的主要方法是使用适当的广谱抗生素治疗和紧急手术清创。
一位 66 岁的既往健康女性，右侧小腿后侧有一处深度裂伤，随后被湖水污染。伤口冲洗并缝合后，患者发生了 NF。
右侧下肢裂伤，继发于嗜水气单胞菌的 NF。
患者接受了紧急手术清创，静脉使用广谱抗生素和负压伤口治疗。下肢采用断层皮片移植进行重建。
患者最初的穿透性创伤在急诊室被闭合，并用抗生素出院回家。第二天，患者生命体征不稳定，被收入重症监护病房。她的病情持续恶化，接受了多次手术清创。经过 13 天的住院治疗，她的病情好转并出院。
对于在水生环境中发生的组织感染，密切监测 NF 非常重要。及时识别和手术治疗 NF 可提高总体生存率。
