《8 例颈坏死性筋膜炎及游离组织移植治疗病例报告》
Eight Tales of Cervical Necrotizing Fasciitis and Free Tissue Transfer.
机构信息
Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
出版信息
Ann Otol Rhinol Laryngol. 2023 Feb;132(2):226-232. doi: 10.1177/00034894221088179. Epub 2022 Apr 2.
OBJECTIVES
Aggressive surgical debridement is required in cervical necrotizing fasciitis, and in severe defects, subsequent free tissue transfer might be necessary. However, there is concern that the inflammatory environment of the infection site may threaten free flap viability, particularly with concerns for thrombosis of feeding vessels and compromised tissue integration. Cases in the head and neck area are rare, so there are limited data regarding outcomes of free tissue transfer in these patients.
METHODS
A retrospective chart review assessed patients with cervical necrotizing fasciitis treated at an academic tertiary hospital between 2015 and 2021. Twenty-five patients were identified, and eight required free tissue transfer after adequate surgical debridement. Treatment, hospital course, and demographic data were collected on these eight patients.
RESULTS
All flaps had full survival at follow up (median follow up 3 months, range 1-39 months) without concerns for vascular compromise.
CONCLUSION
These data suggest that in patients with large soft tissue defects due to cervical necrotizing fasciitis, free tissue transfer may be a safe treatment modality.
目的
在颈坏死性筋膜炎中需要进行积极的外科清创术，对于严重的缺损，随后可能需要进行游离组织转移。然而，人们担心感染部位的炎症环境可能会威胁游离皮瓣的存活能力，特别是在担心供养血管血栓形成和组织整合受损的情况下。头颈部的病例很少，因此关于这些患者进行游离组织转移的结果数据有限。
方法
回顾性分析了 2015 年至 2021 年在一家学术性三级医院接受治疗的颈坏死性筋膜炎患者。共确定了 25 例患者，其中 8 例在充分的外科清创术后需要游离组织转移。对这 8 例患者的治疗、住院过程和人口统计学数据进行了收集。
结果
所有皮瓣在随访时均完全存活（中位数随访时间为 3 个月，范围为 1-39 个月），没有血管受累的担忧。
结论
这些数据表明，对于由于颈坏死性筋膜炎导致的大面积软组织缺损患者，游离组织转移可能是一种安全的治疗方式。
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