Chang Shu-Hao, Jiang Ching-Chuan, Liu Tom J, Kuo Yu-Feng, Yeh Ping-Chun
Department of Orthopedics, Fu Jen Catholic University Hospital, Fu Jen Catholic University, No. 69, Guizi Rd., Taishan Dist., New Taipei City 24352, Taiwan.
School of Medicine, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City 24205, Taiwan.
Diagnostics (Basel). 2023 Mar 16;13(6):1125. doi: 10.3390/diagnostics13061125.
Necrotizing fasciitis is a relatively rare and serious fatal soft-tissue infection that is characterized by a rapidly spreading bacterial infection located in the subcutaneous tissues. We report a 59-year-old man who was diagnosed with acute necrotizing fasciitis, following a primary total knee replacement. He received primary total knee replacement that was uneventful and smooth intraoperatively. An immediate high fever was reported in the next few days, with several complications, confirming a diagnosis of necrotizing fasciitis. The most effective treatment for this disease is a rapid primary diagnosis and surgical debridement. Gold standard treatment includes intravenous therapy, such as antibiotics, surgical debridement, and intensive care. As a result of possible GI complications that triggered necrotizing fasciitis, the patient underwent flap reconstruction. This report's aim is to review the comprehensive treatment, management, and experience of necrotizing fasciitis, highlighting the roles with a multidisciplinary care team for improving the condition of this patient.
坏死性筋膜炎是一种相对罕见且严重的致命性软组织感染,其特征为皮下组织中细菌感染迅速扩散。我们报告一例59岁男性,在初次全膝关节置换术后被诊断为急性坏死性筋膜炎。他接受的初次全膝关节置换术在术中顺利且平稳。术后几天内随即出现高热,并伴有多种并发症,确诊为坏死性筋膜炎。针对这种疾病最有效的治疗方法是快速的初步诊断和手术清创。金标准治疗包括静脉治疗,如使用抗生素、手术清创和重症监护。由于可能引发坏死性筋膜炎的胃肠道并发症,患者接受了皮瓣重建手术。本报告的目的是回顾坏死性筋膜炎的综合治疗、管理及经验,强调多学科护理团队在改善该患者病情方面所发挥的作用。