Tao Xiao-Chun, Hu De-Chang, Yin Li-Xin, Wang Chen, Lu Jin-Gen
Department of Anorectal, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
World J Clin Cases. 2021 Oct 6;9(28):8537-8544. doi: 10.12998/wjcc.v9.i28.8537.
Necrotizing fasciitis is a fulminant necrotizing soft tissue disease with a high fatality rate. It always starts with impact on the deep fascia rapidly and might result in secondary necrosis of the subcutaneous tissue, fascia, and muscle. Thus, timely and multiple surgical operations are needed for the treatment. Meanwhile, the damage of skin and soft tissue caused by multiple surgical operations may require dermatoplasty and other treatments as a consequence.
Here, we report a case of 50-year-old male patient who was admitted to our hospital with symptoms of necrotizing fasciitis caused by cryptoglandular infection in the perianal and perineal region. The symptoms of necrotizing fasciitis, also known as the cardinal features, include hyperpyrexia, excruciatingly painful lesions, demonstration gas in the tissue, an obnoxious foul odor and uroschesis. The results of postoperative pathology met the diagnosis. Based on the premise of complete debridement, multiple incisions combined with thread-dragging therapy (a traditional Chinese medicine therapy) and intensive supportive therapies including comprising antibiotics, nutrition and fluids were given. The outcome of the treatment was satisfactory. The patient recovered quickly and achieved ideal anal function and morphology.
Timely and effective debridement and multiple incisions combined with thread-dragging therapy are an integrated treatment for necrotizing fasciitis.
坏死性筋膜炎是一种具有高死亡率的暴发性坏死性软组织疾病。它总是迅速起始于对深筋膜的影响,并可能导致皮下组织、筋膜和肌肉的继发性坏死。因此,治疗需要及时进行多次外科手术。同时,多次外科手术造成的皮肤和软组织损伤可能需要进行皮肤移植等治疗。
在此,我们报告一例50岁男性患者,因肛周和会阴区隐窝腺感染导致坏死性筋膜炎症状而入住我院。坏死性筋膜炎的症状,也称为主要特征,包括高热、病变剧痛、组织内出现气体、恶臭和排尿困难。术后病理结果符合诊断。在彻底清创的前提下,给予多次切开联合拖线疗法(一种中医疗法)以及包括抗生素、营养和补液在内的强化支持治疗。治疗效果满意。患者恢复迅速,实现了理想的肛门功能和形态。
及时有效的清创和多次切开联合拖线疗法是坏死性筋膜炎的综合治疗方法。