Clinical Study of Damage Control Surgery in the Management of Odontogenic Cervical Necrotizing Fasciitis with Septic Shock.

OBJECTIVE

To evaluate the clinical efficacy of damage control surgery (DCS) in the treatment of odontogenic cervical Necrotizing Fasciitis (CNF) complicated with septic shock.

METHODS

From January 2019 to January 2022, 8 cases with odontogenic cervical Necrotizing Fasciitis (CNF) complicated with septic shock were selected. According to the concept of damage control surgery (DCS), they were treated with incision and decompression, debridement and sealing vacuum suction (VSD) at the early stage, anti-shock, anti-infection, life support. At the later stage, the patients were treated by skin autograft combined with early rehabilitation.

RESULTS

In 8 cases, shock was corrected in a short time, lac decreased rapidly, infection index including white blood cell (WBC), C-reactive protein (CRP), thrombocytocrit (PCT) decreased rapidly, organ function including blood urea nitrogen (BUN), total bilirubin (Tbil), Aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin (Alb), creatine kinase (CK) was improved effectively, P < .05. The wounds of all the patients were effectively closed and cured. The average days of hospitalization were 21-42 days (27.00±3.20 days). No recurrence was found in the follow-up of 6 months.

CONCLUSION

Odontogenic cervical Necrotizing fasciitis with septic shock progresses rapidly. Damage control surgery can effectively control infection, correct shock and avoid further deterioration of organ function. This scheme has unique advantages, which can make the wound repaired in time and improve the success rate of treatment. It is worth popularizing in clinic.